Advances in Medical Ethics
Open Access

Abstract

Background: This article aims to explore the idea of proportionality within the context of the application of continuous deep sedation in end-of-life care, and to evaluate its importance in discerning intention. Methods: Two case studies are used to explore the concept of proportionality and the ‘Doctrine of the Double Effect’. The first highlights the importance of a holistic appreciation of a patient’s clinical, social, emotional, psychological, spiritual and cultural contexts. The second case study evaluates the appropriateness of a proportional response to continuous deep sedation. Results: The case studies show that the responses made by a patient’s multidisciplinary care teams ought to ‘fit’ the situation. This highlights the need for proportionate, appropriate measures that are in keeping with the wishes and goals of the patient, and suggests a need to consider individuals’ narratives and a holistic appreciation of their situations. Conclusions: Application of the Theory or Principle of Proportionality is imperative to expound the intentions of the physician, and the multidisciplinary care team as a whole. The idea of proportionality encapsulates the idea of appropriate use and, in keeping with the patient’s wishes, echoes the central ethos of a palliative care approach.

Author Info

Published: 01-Nov-2015 , DOI: 10.35248/2385-5495.2015.2.6

Copyright: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.