Intentions at the End of Life: Continuous Deep Sedation and France's Claeys-Leonetti law.

The article focuses on the ethical and intentional implications of France's 2016 Claeys-Leonetti Law, which uniquely grants terminally ill patients the right to continuous deep sedation until death (CDS), recognizing it as a sui generis medical practice distinct from both palliative sedation and euthanasia. By legally framing CDS as a "third way" to alleviate suffering without actively causing death, the law clarifies and constrains the intentions of physicians and patients involved, aiming to reduce ambiguity and ethical confusion surrounding end-of-life care. The paper argues that this legal and procedural context shapes clinical intentions by establishing clear rules and practices, thereby enhancing transparency and ethical analysis, while also acknowledging ongoing challenges related to prognosis accuracy, withdrawal of artificial nutrition and hydration, permanent loss of consciousness ("social death"), and the use of analgesics. The French experience highlights the importance of distinguishing CDS from euthanasia and invites broader reflection on how legislation can influence the intentionality and ethical evaluation of medical actions at the end of life.