When Moral Arguments Become Intractable

Abstract

Cassell and Rich's argument that “existential suffering” should merit terminal sedation (TS) in end-of-life (EOL) scenarios just like refractory, physical, and psychiatric morbidity strikes me as an appealing, patient-centered approach. The idea that I can exert considerable control over my dying when the Grim Reaper pays me his inevitable visit is at least somewhat comforting. Similarly, their argument that existential vs physical EOL suffering is a distinction without a real difference has much to commend it. Nevertheless and despite all its rhetoric, the American Medical Association (AMA) is the country's most prominent advocacy group for physicians, not health care consumers; and what might be in the …