Christian perspectives on palliative sedation: a literature study.

Background: Christianity has always been concerned about the fate of the sick and the dying. Charity is one of the seven Christian virtues and is seen as an act of love for one's neighbour. At the same time, Christianity is a strong defender of the dignity of human life, especially the most vulnerable. In the context of advanced disease and end of life, all major Christian traditions (Anglican, Catholic, Eastern Orthodox and Protestant) advocate appropriate care to protect the dignity of those suffering from illness or facing the prospect of death. This translates into a strong opposition to any treatment that actively seeks to end a person's life, such as euthanasia or physician-assisted suicide. Less clear is where these Christian traditions stand on palliative sedation; a treatment that aims to alleviate the suffering caused by refractory symptoms by lowering the level of consciousness. However, it is important to know and understand a religious tradition's position on a particular treatment. Religious beliefs influence the decision-making process of both patients and healthcare professionals.

Method: A comprehensive and systematic literature study was undertaken to determine the position of the four major Christian traditions (Anglican, Catholic, Eastern Orthodox and Protestant).

Results: Although sources are scarce, there are explicit positions on palliative sedation in each of the four Christian traditions has regarding palliative sedation. These positions can be found in official Church documents, in academic debate or in the broader bioethical debate within each community.

Conclusions: Overall, there is a positive but cautious attitude towards palliative sedation in the four major Christian traditions. All recognise that palliative sedation can help alleviate patient suffering. They remain cautious in their support, however, as they consider the line between palliative sedation and life-ending treatments (e.g. euthanasia) to be too blurred. Moreover, the Christian traditions are aware that lowering the level of consciousness is not without its problems. Palliative sedation should therefore not be used without good reason.