The position statement and its commentators: consensus, compromise or confusion?

The Ethics Task Force of the EAPC has done a significant job in forwarding the discussion of the relationship between palliative care and euthanasia, as the wealth of international commentary on the document surely illustrates. The position paper is commendably succinct and, in some respects, unambiguous in the views defended. Notably, the document abjures discussion of anything other than voluntary active euthanasia and, in its general tenor, rejects euthanasia as in any way part of palliative care. However, it must be clear from the range of reaction to the position taken that this document leaves many issues unresolved and thus leaves open the possibility of a continuing debate of the issues among those involved in pallia tive care. This is by no means necessarily a bad thing / on the contrary, a refusal to have a continuing debate would surely reflect badly on the Association / and it is notable that the Association has not adopted the paper as an official statement. However, there may be some disadvantages in a document that provokes such a range of commentary. To what extent does this represent diversity of moral belief in those invited to contribute and to what extent do ambiguities in the position paper need to be resolved? Is there an inevitable pluralism here, or can we identify an area of shared value in palliative care? We shall consider this key question under the slightly provocative subtitle: consensus, compromise or confusion? Our commentary falls into several parts. F irst, we consider the problems of definition in this contentious field, in particular whether the position paper offers satisfactory definitions of two key terms, `euthanasia’ and t̀erminal sedation’. Next we look at contrasting views of how palliative care and euthanasia are related to each other (if at all). Thirdly, we discuss the types of ethical arguments used in the debate, and finally, we offer our own brief and tentative conclusions. There is a truly remarkable volume of commentary in this issue and we cannot possibly do justice to it all. (The editors are to be congratulated on obtaining 55 articles from 32 different countries!) Instead we refer to a small selection of the commentaries from time to time to illustrate the diversity, but in each case many other authors could have been referred to or quoted to illustrate the same point.