Existential, or non-somatic suffering, is often associated with the management of refractory pain at the end-stage of life. Because of misleading sympathologies, this condition is often either mis-diagnosed or even ignored. When diagnosed as a part of a futile medical condition, this Paper argues that deep, palliative, or terminal sedation be offered to the distressed, dying patient as an efficacious and ethical response to preserving a semblance of human dignity in the dying process. Not only is this option of care humane and compassionate, it is consistent with the ideal of best patient care. The notion of care should not only address and include somatic issues of intractable pain management, but — as well — non-somatic or existential suffering occurring in the absence of physical symptoms. Interestingly, sound holistic medicine traces its very province to the foundational value, or chrism of cura personalis which in turn directs respect be given to all individuals and to their souls. The importance of preserving human dignity should, thus, be recognized correctly as a human right. In sum, the doctrine of medical futility is a proper template for evaluating degrees of end-of-life care. Acceptance of this principle allows — in turn — for a greater openness to utilize palliative sedation.
George P. Smith II, Existential Suffering and Cura Personalis: Dilemmas at the End-of-Life, CUA Columbus School of Law Legal Studies Research Paper No. 2015-3 (2015).