Bridging the Gap Between Continuous Sedation Until Death and Physician-Assisted Death: A Focus Group Study in Nursing Homes in Flanders, Belgium

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...

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Bibliographic Details
Published in:American journal of hospice & palliative medicine 2015-06, Vol.32 (4), p.407-416
Main Authors: Rys, Sam, Deschepper, Reginald, Mortier, Freddy, Deliens, Luc, Bilsen, Johan
Format: Article
Language:English
Subjects:
Adult
Attitude of Health Personnel
Attitude to Death
Belgium
Death
Deep Sedation - ethics
Deep Sedation - psychology
Female
Focus Groups
Homes for the Aged
Humans
Longitudinal Studies
Male
Middle Aged
Morals
Nursing
Nursing Homes
Qualitative Research
Religion
Residence Characteristics
Suicide, Assisted - ethics
Suicide, Assisted - psychology
Terminal Care - ethics
Terminal Care - psychology
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Summary: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.
ISSN:1049-9091
1938-2715
DOI:10.1177/1049909114527152