Does Sedation Affect Patients' Spiritual Experiences at the End-of-Life?
Anne Dalle Ave, PhD, Kennedy Institute of Ethics, Georgetown University
Sedation is commonly used at the end-of-life in order to provide comfort to suffering patients. As a consequence, consciousness may be impacted, either as a primary intention, such as in palliative sedation, or as a secondary effect of medications used to relieve specific symptoms.
As sedation decreases consciousness, it may affect one’s potential to convert, grow spiritually or connect with the Divine. We propose an analysis of the pros and cons of sedation with respect to patients’ spiritual experience at the end of life. Consciousness enables us, through meditation and prayer for instance, to connect with the Sacred. Sedation, by impacting consciousness, may deprive us of the possibility to pray and meditate, as ways to access the Sacred. However, despite the development of medicine and cognitive sciences, it remains uncertain what consciousness is, and how it works.
Consciousness, defined as the capacity for self-awareness and awareness of the environment, may be much broader than one tends to think, and may not depend solely on one’s biological state (e.g. sedation) or the function of a particular body part (i.e. the brain). Thus, we may consider the possibility that patients without detectable consciousness may still remain conscious of the Divine. Examples such as near-death experiences, mystical experiences of Saints during sleep, or patients who report awareness during general anesthesia may support such hypotheses.
Second, from a spiritual perspective, suffering cannot be said uniformly to be bad. On the one hand, intense suffering, such as pain or despair, may induce mystical experiences, such as out-of-body experiences. On the other hand, intense suffering may be a barrier to the peace of mind necessary to listen to the voice of God. Depending on the patient’s situation, sedation may thus either prevent or promote patients’ access to God.
Third, the dying process may be a propitious moment for spiritual realization or conversion. When the boundaries between life and death become blurred, the veil of illusion dissipates, letting us see the Divine in us and all around us. Sedation may interfere with the process of spiritual realization, but suffering may also colonize a patient’s consciousness such that spiritual growth become all but impossible.
Fourth, patients with deep faith may want to experience the dying process with awareness. Both eastern and western traditions emphasize the importance of being conscious during the transition. However, not all patients have faith, and sedation may be embraced by some as a last resort to avoid confrontation with our inevitable finitude.
As healers, healthcare professionals offer compassionate care to body and soul. While palliative sedation may be an answer to bodily suffering, it may not be the adequate answer to the pain of the soul. By seeing that opening a space for the Sacred is part of their work, healthcare professionals might become more cautious in their use of sedating drugs at the end of life. Sedation may not be a coherent solution at the end-of-life. However, as every patient has different spiritual path and different threshold of suffering, sedation may be the last possibility to offer relief to some of us.
As sedation decreases consciousness, it may affect one’s potential to convert, grow spiritually or connect with the Divine. We propose an analysis of the pros and cons of sedation with respect to patients’ spiritual experience at the end of life. Consciousness enables us, through meditation and prayer for instance, to connect with the Sacred. Sedation, by impacting consciousness, may deprive us of the possibility to pray and meditate, as ways to access the Sacred. However, despite the development of medicine and cognitive sciences, it remains uncertain what consciousness is, and how it works.
Consciousness, defined as the capacity for self-awareness and awareness of the environment, may be much broader than one tends to think, and may not depend solely on one’s biological state (e.g. sedation) or the function of a particular body part (i.e. the brain). Thus, we may consider the possibility that patients without detectable consciousness may still remain conscious of the Divine. Examples such as near-death experiences, mystical experiences of Saints during sleep, or patients who report awareness during general anesthesia may support such hypotheses.
Second, from a spiritual perspective, suffering cannot be said uniformly to be bad. On the one hand, intense suffering, such as pain or despair, may induce mystical experiences, such as out-of-body experiences. On the other hand, intense suffering may be a barrier to the peace of mind necessary to listen to the voice of God. Depending on the patient’s situation, sedation may thus either prevent or promote patients’ access to God.
Third, the dying process may be a propitious moment for spiritual realization or conversion. When the boundaries between life and death become blurred, the veil of illusion dissipates, letting us see the Divine in us and all around us. Sedation may interfere with the process of spiritual realization, but suffering may also colonize a patient’s consciousness such that spiritual growth become all but impossible.
Fourth, patients with deep faith may want to experience the dying process with awareness. Both eastern and western traditions emphasize the importance of being conscious during the transition. However, not all patients have faith, and sedation may be embraced by some as a last resort to avoid confrontation with our inevitable finitude.
As healers, healthcare professionals offer compassionate care to body and soul. While palliative sedation may be an answer to bodily suffering, it may not be the adequate answer to the pain of the soul. By seeing that opening a space for the Sacred is part of their work, healthcare professionals might become more cautious in their use of sedating drugs at the end of life. Sedation may not be a coherent solution at the end-of-life. However, as every patient has different spiritual path and different threshold of suffering, sedation may be the last possibility to offer relief to some of us.