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Am J Hosp Palliat Care. 2015 Jun;32(4):407-16. doi: 10.1177/1049909114527152. Epub 2014 Mar 26.

Bridging the gap between continuous sedation until death and physician-assisted death: a focus group study in nursing homes in Flanders, Belgium.

Author information

1
Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium samrys@vub.ac.be.
2
Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
3
End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium Bioethics Institute Ghent, Ghent University, Ghent, Belgium.
4
End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.

Abstract

The distinction between continuous sedation until death (CSD) and physician-assisted death (PAD) has become a topic of medical ethical debate. We conducted 6 focus groups to examine how nursing home clinicians perceive this distinction. For some, the difference is clear whereas others consider CSD a form of euthanasia. Another group situates CSD between pain relief and ending life. Arguments for these perspectives refer to the following themes: intention, dosage of sedative drugs, unconsciousness, and the pace of the dying process. Generally, CSD is considered emotionally easier to deal with since it entails a gradual dying process. Nursing home clinicians have diverging perceptions of the relation between CSD and PAD; some consider CSD to be more than a purely palliative measure, that is, also as a means to hasten death.

KEYWORDS:

continuous sedation until death; euthanasia; nursing homes; palliative care; palliative sedation; physician-assisted death

PMID:
24671029
DOI:
10.1177/1049909114527152
[Indexed for MEDLINE]

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