Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries

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dc.cclicenceCC-BY-NC-NDen
dc.contributor.authorSeymour, Janeen
dc.contributor.authorRietjens, Judithen
dc.contributor.authorBruinsma, Sophieen
dc.contributor.authorDeliens, Lucen
dc.contributor.authorSterckx, Sigriden
dc.contributor.authorMortier, Freddyen
dc.contributor.authorBrown, Jayneen
dc.contributor.authorMathers, Nigelen
dc.contributor.authorvan der Heide, Agnesen
dc.date.acceptance2014-07-24en
dc.date.accessioned2018-03-08T08:45:16Z
dc.date.available2018-03-08T08:45:16Z
dc.date.issued2014-07-25
dc.descriptionOpen access articleen
dc.description.abstractBACKGROUND: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. METHODS: Qualitative case studies using interviews. SETTING: Hospitals, the domestic home and hospices or palliative care units. PARTICIPANTS: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients. RESULTS: UK respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation. In contrast, Belgian respondents predominantly described the use of deep sedation, emphasizing the importance of responding to the patient's request. Dutch respondents emphasized making an official medical decision informed by the patient's wish and establishing that a refractory symptom was present. Respondents employed rationales that showed different stances towards four key issues: the preservation of consciousness, concerns about the potential hastening of death, whether they perceived continuous sedation until death as an 'alternative' to euthanasia and whether they sought to follow guidelines or frameworks for practice. CONCLUSION: This qualitative analysis suggests that there is systematic variation in end-of-life care sedation practice and its conceptualization in the United Kingdom, Belgium and the Netherlands.en
dc.funderN/Aen
dc.identifier.citationSeymour, J., Rietjens, J., Bruinsma, S., Deliens, L., Sterckx, S., Mortier, F., Mathers, N., van der Heide, A., Brown, J. (2014) Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries. Palliative Medicine, 29(1), pp.48-59.en
dc.identifier.doihttps://doi.org/10.1177/0269216314543319
dc.identifier.urihttp://hdl.handle.net/2086/15383
dc.language.isoenen
dc.peerreviewedYesen
dc.projectidN/Aen
dc.publisherSageen
dc.researchinstituteInstitute of Health, Health Policy and Social Careen
dc.subjectcontinuous sedationen
dc.subjectcancer patientsen
dc.subjectqualitative interviewen
dc.subjectnurse practiceen
dc.subjectEuropean countriesen
dc.titleUsing continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countriesen
dc.typeArticleen

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