With this paper, we aim at supporting the comprehension of the terminological confusion, the resulting empirical and ethical problems and at developing strategies for creating clearer definitions that avoid the problems reported as much as possible. In addition, there is a lack of rigorous conceptual analysis of existing definitions by which deficits could be identified and could pave the way for the improvement of definitions. While both the ‘data problem’ and the ‘problem of ethical pre-emption’ are alleged to have their roots in terminology, to the best of our knowledge, there has never been an analysis of how exactly definitions of ‘palliative sedation’ and similar terms cause these problems. It has been suggested that exclusion of controversial cases of sedation by means of definitions produces a lack of transparency and open discussion and, consequently, a lack of a search for improvement. They criticise that moral discourse is decided beforehand (‘pre-empted’) when practices are defined as “therapy” or “ethically acceptable”, as it is the case in the well-known European Association for Palliative Care (EAPC) definition. In addition to this ‘data problem’, there is a second problem reported to be connected with definitions, which we call the ‘problem of ethical pre-emption’: Authors have argued that sedation is an ethically controversial procedure in palliative care. The vagueness of definitions and their variety are considered as contributing causes for this,. It has been observed that there is an unexplained variation concerning the frequency of sedation in palliative care practice. One problem which has been raised repeatedly in this context is that of inconsistent empirical data. The problem with defining sedation practices and the existence of heterogeneous definitions has been criticised repeatedly in the light of associated problems relevant for good practice and research. Good practice, research and fruitful discussion often depend on good and comprehensible terms. Sedation in palliative care is frequently and, simultaneously, controversially discussed, for example, regarding the indication, safety or justification compared to other end-of-life measures. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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