La sédation en médecine palliative : l'inévitable focalisation sur euthanasie ?

Sedation in palliative medicine is nowadays a well-assimilated practice by specialized teams, but remains a source of many questions involving sometimes difficulties even for experienced caregivers. This work questions about border between sedation and euthanasia. Indeed, ethical issues of sedation in palliative medicine are almost always designed in the perspective of reflection and debate on euthanasia controversy, particularly situations of sedation wrongly called “terminal”, which means maintained until the patient's death. Current recommendations appear as a “shaping” of the double effect rule, due to an excessive focus on the risk of confusion between sedation and euthanasia. However, double effect rule and principle of intentionality reveal certain limits, causing questioning about the notions of consent and autonomy, and ask heteronomy as true foundation of care relationship.