{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T03:57:59Z","timestamp":1781236679924,"version":"3.54.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Theor Med Bioeth"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Many ethicists who have opposed euthanasia have nonetheless approved of various practices which have been believed to hasten, or risk hastening, the death of terminally ill and suffering patients. For instance, they have approved of a practice which I shall call \u2018end-of-life sedation,\u2019 or \u2018EOL sedation.\u2019 This practice involves administering drugs with sedating effects to relieve suffering at the end of life. Some have\u00a0believed that EOL sedation risks\u00a0hastening death by suppressing respiration\u00a0in certain cases. The main difference, according to these opponents of euthanasia, is that whereas euthanasia by definition involves an intention to kill, EOL sedation does not. At most, it is argued, EOL sedation foreseeably but unintentionally hastens, or risks hastening death as a byproduct of relieving the patient\u2019s suffering while they are still alive. As such, it has been argued that EOL sedation is supported by the rule of double effect (RDE). In his paper, \u201cThe last low whispers of our dead,\u201d Daniel P. Sulmasy raises objections to a specific form of EOL sedation called \u2018palliative sedation,\u2019 focusing especially on two variants of that practice which have been defended by Timothy Quill and colleagues. Palliative sedation involves intentionally sedating a patient as a means of relieving their suffering rather than foreseeably sedating them as a byproduct of targeting specific symptoms. Sulmasy argues that palliative sedation, so defined, is neither supported by RDE nor permissible. Here it is argued that Sulmasy\u2019s criticisms of this practice, and of the specific variants of it which he singles out for special criticism, are unsuccessful.<\/jats:p>","DOI":"10.1007\/s11017-026-09762-5","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:24:02Z","timestamp":1780460642000},"page":"281-298","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The last low whispers revisited: a reply to Sulmasy on palliative sedation"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5583-094X","authenticated-orcid":false,"given":"Harrison","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"issue":"3","key":"9762_CR1","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s11017-018-9459-7","volume":"39","author":"Daniel P. 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Palliative sedation, foregoing life-sustaining treatment, and aid-in-dying: What is the difference? Theoretical Medicine and Bioethics 36 (3): 197\u2013213. https:\/\/doi.org\/10.1007\/s11017-015-9329-5.","journal-title":"Theoretical Medicine and Bioethics"},{"issue":"19","key":"9762_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.19.1521","volume":"279","author":"Edmund D. Pellegrino","year":"1998","unstructured":"Pellegrino, Edmund D.. 1998. Emerging ethical issues in palliative care. JAMA 279 (19) : 1521. https:\/\/doi.org\/10.1001\/jama.279.19.1521.","journal-title":"JAMA"},{"key":"9762_CR5","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctvpj7707","volume-title":"Intention, character, and double effect","author":"Lawrence Masek","year":"2018","unstructured":"Masek, Lawrence. 2018. Intention, character, and double effect. 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