Ghent University, Department of Philosophy and Moral Sciences, Blandijnberg 2, 9000 Ghent, Belgium.
Bioethics. 2012 Jul;26(6):329-36. doi: 10.1111/j.1467-8519.2010.01861.x. Epub 2011 Jan 17.
Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the 'natural death' hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a 'natural' death by medical practitioners, patients' relatives and patients. We attempt to show that the label 'natural' cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as 'natural' death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases.
不同国家（例如英国、比利时和荷兰）的调查显示，在生命末期持续深度镇静（CDS）的发生率近年来显著增加。可以提出几种假设来解释这种做法的日益普及。在本文中，我们专注于我们所谓的“自然死亡”假设，即 CDS 广泛应用的原因是因为接受 CDS 后，医疗从业者、患者亲属和患者都认为这种死亡是一种“自然”的死亡。我们试图表明，将 CDS 后死亡贴上“自然”的标签是有问题的。我们认为，将 CDS 后死亡标记为“自然死亡”与一系列促进这种做法的复杂机制有关。然而，我们的批评并不排除 CDS 在许多情况下可能在临床和伦理上是合理的观点。
