A qualitative study on continuous deep sedation until death as an alternative to assisted suicide in Switzerland.

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State: Public
Version: author
License: CC BY 4.0
Serval ID
serval:BIB_376F7FB0F58F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A qualitative study on continuous deep sedation until death as an alternative to assisted suicide in Switzerland.
Journal
BMC palliative care
Author(s)
Tomczyk M., Dieudonné-Rahm N., Jox R.J.
ISSN
1472-684X (Electronic)
ISSN-L
1472-684X
Publication state
Published
Issued date
14/05/2021
Peer-reviewed
Oui
Volume
20
Number
1
Pages
67
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
According to the European Association for Palliative Care, decisions regarding palliative sedation should not be made in response to requests for assisted dying, such as euthanasia or assisted suicide. However, several studies show that continuous deep sedation until death (CDSUD) - a particular form of sedation - has been considered as an alternative to these practices in some countries. In Switzerland, where assisted suicide is decriminalized and CDSUD is not legally regulated, no studies have comprehensively investigated their relation. Our study aimed to identify and describe the experience among palliative care physicians of CDSUD as a potential alternative to assisted suicide in the French-speaking part of Switzerland.
We performed an exploratory multicentre qualitative study based on interviews with palliative care physicians in the French-speaking part of Switzerland and conducted linguistic and thematic analysis of all interview transcripts. The study is described in accordance with COREQ guidelines.
We included 10 interviews conducted in four palliative care units. Our linguistic analysis shows four main types of sedation, which we called 'rapid CDSUD', 'gradual CDSUD', 'temporary sedation' and 'intermittent sedation'. CDSUD (rapid or gradual) was not considered an alternative to assisted suicide, even if a single situation has been reported. In contrast, 'temporary' or 'intermittent sedation', although not medically indicated, was sometimes introduced in response to a request for assisted suicide. This was the fact when there were barriers to an assisted suicide at home (e.g., when transfer home was impossible or the patient wished not to burden the family).
These preliminary results can guide clinical, ethical, linguistic and legal reflection in this field and be used to explore this question more deeply at the national and international levels in a comparative, interdisciplinary and multiprofessional approach. They can also be useful to update Swiss clinical guidelines on palliative sedation in order to include specific frameworks on various sedation protocols and sedation as an alternative to assisted suicide. Potential negative impacts of considering palliative sedation as an alternative to assisted suicide should be nuanced by open and honest societal debate.
Keywords
Assisted suicide, Continuous deep sedation until death, French-speaking part of Switzerland, Palliative care, Palliative sedation, Physicians, Qualitative study, Temporary sedation
Pubmed
Web of science
Open Access
Yes
Create date
25/05/2021 14:56
Last modification date
05/06/2021 6:33
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