title: Clarifying an Expanded Use of Continuous Sedation Until Death: A Reply to the Commentary by McCammon and Piemonte.
abstract: Susan D. McCammon and Nicole M. Piemonte offer a thoughtful and thorough commentary on our manuscript entitled "Expanding the use of Continuous Sedation Until Death." In this reply we attempt to clarify and further defend our position. We show how continuous sedation until death is not a "first resort" but rather a legitimate option among many that should available to terminally ill patients whose life expectancy is less than six months. We also attempt to show that we do not equivocate the meaning of palliative care as the commentators suggested. We argue that the traditional notion of palliative care should move beyond relief of "experienced suffering" to relief of potential suffering for those whose life expectancy is less than six months. Lastly, we challenge the commentator's position that the realm of ordinary medicine" should be the guide to care, by showing how the notion of ordinary medicine has been successfully challenged in both bioethical scholarship and the courts in a way that shows ordinary medicine to be an evolving concept rather than a static, universal guide.
authors.affiliation: Cuyahoga Community College, Western Campus, Department of Philosophy, 11000 Pleasant Valley Rd., Parma, OH 44103-5150 USA. Samuel.lipuma@tri-c.edu.
authors.forename: Samuel H
authors.initials: SH
authors.lastname: LiPuma
authors.affiliation: Cleveland State University, Department of Philosophy, 2121 Euclid Ave., RT 1932, Cleveland, Ohio 44115-2214 USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: DeMarco
mesh_terms: D003657:Decision Making / Q000941:ethics*; D054810:Deep Sedation / Q000941:ethics*; D006801:Humans; D008297:Male; D059408:Pain Management / Q000941:ethics*; D010166:Palliative Care / Q000941:ethics*; D018802:Patient-Centered Care / Q000941:ethics*; D026684:Personal Autonomy; D013727:Terminal Care / Q000941:ethics*; D019452:Terminally Ill; D016312:Treatment Refusal