Between Euthanasia and Dysthanasia: The Ethical Issue of Sedation in the Terminal Phase of Illness

Background: Deep sedation, euthanasia and therapeutic relentlessness lead us today to rethink the paradigm of life and the contingency of human existence. Between therapeutic relentlessness, the unreasonable care which uses heavy therapeutic means which are often disproportionate to the expected benefit, namely keeping alive a patient whose condition is considered medically hopeless; and euthanasia which would precipitate the process of death would be sedation in the terminal phase of the illness. Should doctors and families of comatose patients decide the “life” and “death” of their patients? For anti-euthanasia associations, doctors, relatives of terminally ill patients and the State itself, if they accept the principle of euthanasia, they are “murderers”, while for pro-euthanasists, the dignity of the human being would recommend that the days of patients in situations considered critical be shortened, to avoid unnecessary suffering and humiliation. Methods: A systematic review of the literature was carried out to identify relevant articles relating to euthanasia, dysthanasia and sedation in the terminal phase of illness. The search was conducted in French or English in three databases: PubMed, Google Scholar and Science Direct. Objectives: The objectives of this article are: 1) define the terminologies and concepts of palliative sedation, deep sedation, deep and continuous sedation until death, euthanasia and dysthanasia; 2) present aspects of the meaning of life and the human person in African cultures; and 3) propose an ethical reflection on the value of life. Results: After precisely defining the concepts of euthanasia, dysthanasia and sedation, this research presented the African anthropological and ethical approach to the mysteries of life and death. Conclusion: With this in mind, the golden rule of medicine always remains as such “Primum non nocere”.