Sedation Before Ventilator Withdrawal

Abstract

...We report on a recent case that is challenging, both because of its unique circumstances and because it concerns an issue not much discussed in the literature -- sedation before ventilator withdrawal. We explore the question of whether it is morally justifiable to sedate an alert patient before his life-supporting ventilator is disconnected. Alert, ventilator-dependent patients will likely experience symptoms of suffocation and air hunger if their artificial ventilation is stopped....And yet sedation, especially heavy sedation, virtually ensures that the patient will die, even though death is already highly probable. The issue of sedation combined with ventilator removal is directly related to the difficult question of the difference between allowing a patient to die and actively producing the death of a patient....