The Moral Difference or Equivalence between Continuous Sedation until Death and Physician-Assisted Death: Word Games or War Games?

Continuous Sedation until Death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. Some argue that CSD is morally equivalent to Physician Assisted Death (PAD), that it is a form of 'slow euthanasia'. A qualitative thematic content analysis of opinion pieces was conducted to describe and classify arguments that support or reject a moral difference between CSD and PAD. The recurring discussions on the relationship between CSD and PAD in the opinion sections of medical and nursing journals highlight the lack of agreement among clinicians on this topic. Arguments pro and contra a moral difference refer to the same ambiguous concepts. This demonstrates that the debate is first and foremost a semantic rather than a factual dispute focusing on the normative framework of CSD. Given the prevalent ambiguity, the debate on CSD appears to be a classical symbolic struggle for moral authority.