Elimination of Pain Versus Elimination of Suffering: Why CDS Is Ethically Preferable to PAS

Abstract

Raus and colleagues (2011) contend that continuous deep sedation (CDS) cannot substitute for physician-assisted suicide (PAS) because CDS is merely good for eliminating pain, whereas PAS takes the further step of ending suffering (e.g., the suffering resulting from the loss of autonomy or dignity). So when the elimination of suffering (instead of pain) is at stake, Raus and colleagues maintain that CDS is completely powerless and, hence, that the possibility of PAS should not be dismissed out of hand. I argue, however, that once one's consciousness is completely and irrevocably "shut down," as in the case of CDS, one loses not only the capacity for feeling pain but also the capacity for suffering as well. Such being the case, I argue that CDS is ethically preferable to PAS because it can put an end to life's suffering just like PAS while not killing the terminally ill patient.The plan of the paper is as follows. In the first section, I clarify the distinction between the concept of pain and the concept of suffering, for this is essential for a critical assessment of Raus and colleagues' argument. In the second section, I lay out Raus and colleagues' argument in detail. In the third section, I explain why Raus and colleagues are wrong to think that CDS is merely good for the elimination of pain but not suffering (or why CDS is also good for the elimination of suffering). In the conclusion, I elaborate on why, other things being equal, CDS is an ethically preferable alternative to PAS. PAIN VERSUS SUFFERINGTo start with, the idea of pain is to be distinguished from the idea of suffering. Although a person in pain might be suffering, she or he need not be. Arguably, a laboring woman might experience pain during the delivery process, yet does not suffer; she might instead be filled up with joys of giving birth to a newborn. Conversely, a suffering person need not be in pain. Romeo suffers from unrequited love but he need not experience any pain when he suffers. So the idea of suffering and the idea of pain are distinct. RAUS AND COLLEAGUES' ARGUMENTArmed with the distinction between pain and suffering, we can proceed to clarify why Raus and colleagues contend that CDS is not ethically preferable to PAS. According to