and symptom management, sometimes pain and other symptoms are unmanageable. In such cases, the hospice care team may use total sedation to relief suffering from uncontrolled symptoms. Total sedation may be referred to as palliative or terminal sedation. This involves using of sedatives to bring about a level of comfort in a terminally ill patient that is facing unrelieved pain or suffering. Most health care professional does not consider total sedation as euthanasia. The use of total sedation to relief suffering is an ethically acceptable intervention, especially in the face of imminent death (Fine, 2001, p. 81). I proposed to include euthanasia as a permitted option when caring for terminally ill patients with intractable suffering.
Euthanasia is a deliberate act undertaken by one person with the intention of ending life of another person to relieve that persons suffering and where the act is the cause of death (Gupta, Bhatnagar, & Mishra, 2006, p. 1). In other words, itis the act of ending the life of a patient due to severe suffering by the patient (Fine, 2001), which may end the suffering faster than total sedation. Euthanasia can be voluntary or involuntary, both raises ethical controversies. In voluntary euthanasia, physicians get informed consent from the patient. Physician assisted suicide is a huge ethical issue in the United States (Friend, 2011). The legality of the actions is another issue of concern that contributes to increased ethical dilemmas. It is currently legal in some states. For example, Oregon, USA has legalized only physician-assisted suicide in 1997 (Gupta et al., 2006, p. 1). However, euthanasia is mostly illegal in the United States.
Principles such as autonomy (self-determined) invoked as justifications for this potentially controversial end of life (EOL) care practice (Keown, 2004, p. 621). Autonomy comes from the Greek words “authos” (self) and “nomos” (rule or law) and originally referred to the right of