Journal of Medical Ethics 40 (4):235-240 (2014)

Abstract
Background Studies describing physicians’ experiences with sedation at the end of life are indispensible for informed palliative care practice, but they are scarce. We describe the accounts of physicians from the USA and the Netherlands, two countries with different regulations on end-of-life decisions regarding their use of sedation.Methods Qualitative face-to-face interviews were held in 2007–2008 with 36 physicians , including primary care physicians and specialists. We applied purposive sampling and conducted constant comparative analyses.Results In both countries, the use of sedation was described in diverse terms, especially in the USA, and was often experienced as emotionally challenging. Respondents stated different and sometimes multiple intentions for their use of sedation. Besides alleviating severe suffering, most Dutch respondents justified its use by stating that it does not hasten death, while most American respondents indicated that it might hasten death but that this was justifiable as long as that was not their primary intention. While many Dutch respondents indicated that they initiated open discussions about sedation proactively to inform patients about their options and to allow planning, the accounts of American respondents showed fewer and less-open discussions, mostly late in the dying process and with the patient's relatives.Conclusions The justification for sedation and the openness with which it is discussed were found to differ in the accounts of respondents from the USA and the Netherlands. Further clarification of practices and research into the effect and effectiveness of the use of sedation is recommended to enhance informed reflection and policy making
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/medethics-2012-100561
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 64,132
Through your library

References found in this work BETA

Terminal Sedation and the "Imminence Condition".V. Cellarius - 2008 - Journal of Medical Ethics 34 (2):69-72.

Add more references

Citations of this work BETA

Moral Concerns with Sedation at the End of Life.Charles Douglas - 2014 - Journal of Medical Ethics 40 (4):241-241.

Add more citations

Similar books and articles

Moral Concerns with Sedation at the End of Life.Charles Douglas - 2014 - Journal of Medical Ethics 40 (4):241-241.

Analytics

Added to PP index
2012-09-16

Total views
23 ( #476,443 of 2,454,754 )

Recent downloads (6 months)
1 ( #449,241 of 2,454,754 )

How can I increase my downloads?

Downloads

My notes