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Open Access 01-12-2024 | Research

Continuous palliative sedation until death: a qualitative study of palliative care clinicians’ experiences

Authors: Alexandra Guité-Verret, Jessica Boivin, Andrew M. R. Hanna, James Downar, Shirley H. Bush, Isabelle Marcoux, Diane Guay, Diane Tapp, Julie Lapenskie, Bruno Gagnon

Published in: BMC Palliative Care | Issue 1/2024

Abstract

Background

The practice of continuous palliative sedation until death is the subject of much medical and ethical debate, which is reflected in the inconsistency that persists in the literature regarding the definition and indications of palliative sedation.

Aim

This study aims to gain a better understanding of palliative care clinicians’ experiences with continuous palliative sedation.

Design

We conducted a qualitative study based on focus group discussions.

Setting/participants

We conducted six focus groups with a total of 28 palliative care clinicians (i.e., 15 nurses, 12 physicians, and 1 end-of-life doula) from diverse care settings across Canada, where assisted dying has recently been legalized.

Results

An interpretative phenomenological analysis was used to consolidate the data into six key themes: responding to suffering; grappling with uncertainty; adapting care to ensure ongoing quality; grounding clinical practice in ethics; combining medical expertise, relational tact, and reflexivity; and offering an alternative to assisted death.

Conclusions

Interaction with the patient’s family, uncertainty about the patient’s prognosis, the concurrent practice of assisted dying, and the treatment of existential suffering influence the quality of sedation and indicate a lack of clear palliative care guidelines. Nevertheless, clinicians exhibit a reflective and adaptive capacity that can facilitate good practice.

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Title: Continuous palliative sedation until death: a qualitative study of palliative care clinicians’ experiences
Authors: Alexandra Guité-Verret
Jessica Boivin
Andrew M. R. Hanna
James Downar
Shirley H. Bush
Isabelle Marcoux
Diane Guay
Diane Tapp
Julie Lapenskie
Bruno Gagnon
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Palliative Care / Issue 1/2024
Electronic ISSN: 1472-684X
DOI: https://doi.org/10.1186/s12904-024-01426-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Continuous palliative sedation until death: a qualitative study of palliative care clinicians’ experiences

Abstract

Background

Aim

Design

Setting/participants

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Design

Setting/participants

Results

Conclusions

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