Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T22:06:30.187Z Has data issue: false hasContentIssue false
  • English
  • Français

Attitudes of Quebec doctors toward sedation at the end of life: An exploratory study

Published online by Cambridge University Press:  30 September 2009

Danielle Blondeau ,
Serge Dumont ,
Louis Roy  and
Isabelle Martineau
Danielle Blondeau*
Affiliation:
Faculty of Nursing, Pavillon Ferdinand-Vandry, Université Laval, Québec City, Québec, Canada
Serge Dumont
Affiliation:
School of Social Work, Université Laval, Québec City, Québec, Canada
Louis Roy
Affiliation:
Centre hospitalier universitaire de Québec, Pavillon Hôtel-Dieu de Québec, Quebéc City, Quebéc, Canada
Isabelle Martineau
Affiliation:
Maison Michel-Sarrazin, Québec City, Québec, Canada
*
Address correspondence and reprint requests to: Danielle Blondeau, Faculty of Nursing, Pavillon Ferdinand-Vandry, Université Laval, Quebec City, QC G1V 0A6, Canada. E-mail: Danielle.Blondeau@fsi.ulaval.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The induction of sedation at the end of life is a much debated practice and not very documented. The goal of this study was to explore the practice from both a clinical and ethical point of view.

Methods:

Data were collected through semistructured interviews with 19 Quebec physicians working in palliative care.

Results:

Doctors' first priority was their patients, not patients' families. Clinically, the therapeutic aim of sedation was strictly to relieve suffering on the part of the patient. Ethically, getting the patient's consent was imperative. The family's consent was only required in cases of incapacity. Generally, sedation and euthanasia were seen as two distinct practices.

Significance of the research:

There are still very few guidelines regarding end-of-life sedation in Québec, and its normative framework is more implicit than explicit. It should be noted that most of the respondents regarded sedation and euthanasia as two distinct practices.

Keywords

End of lifeSedationEthical issuesExistential sufferingEuthanasia
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 3 , September 2009 , pp. 331 - 337
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bergeron, P. (1992). La Commission Rochon sous le prisme des alliances (La Commission Rochon sous le prisme des alliances: The Rochon Commission viewed from possible alliances). Doctoral thesis. Quebec City: Université Laval.Google Scholar
Billings, J.A. & Block, S.D. (1996). Slow euthanasia. Journal of Palliative Care, 12, 21–30.CrossRefGoogle ScholarPubMed
Blondeau, D., Godin, G., Gagné, C., et al. (2004). Do ethical principles explain moral norm? A test for consent to organ donation. Journal of Applied Biobehavioral Research, 9, 230–243.CrossRefGoogle Scholar
Blondeau, D., Lavoie, M., Valois, R., et al. (2000). The attitude of Canadian nurses towards advance directives. Nursing Ethics, 7, 418–430.CrossRefGoogle ScholarPubMed
Blondeau, D., Roy, L., Dumont, S., et al. (2005). Physicians' and pharmacists' attitudes toward the use of sedation at the end of life: Influence of prognosis and type of suffering. Journal of Palliative Care, 21, 238–245.CrossRefGoogle ScholarPubMed
Blondeau, D., Valois, P., Keyserlingk, E.W., et al. (1998). Comparison of patients' and health-care professionals' attitudes toward advance directives. Journal of Medical Ethics, 24, 328–335.CrossRefGoogle Scholar
Burt, R.A. (2005). The end of autonomy. The Hastings Center Report. Spec. No.: S9–13.CrossRefGoogle ScholarPubMed
Calender, F. (2000). From ‘the pedagogue of recreation’ to the teacher's assistant. Scandinavian Journal of Educational Research, 44, 207–224.CrossRefGoogle Scholar
Carrière, M. (1998). La structuration locale du champ des troubles mentaux dans le contexte de la réorganisation des services de santé (Local structuring of mental health service within the context of the general reorganisation of health services). Doctoral thesis. Quebec City: Université Laval.Google Scholar
Demers, L. (1996). Hôpital communautaire, hôpital universitaire: la régulation de l'engorgement de l'urgence dans un centre hospitalier universitaire (Control of emergency services in University hospital Centers). Doctoral thesis. Quebec City: Université Laval.Google Scholar
Deslauriers, J.P. (1991). Recherche qualitative, guide pratique (Recherche qualitative, guide pratique: A practical guide for qualitative research). Montréal: McGraw-Hill.Google Scholar
Giddens, A. (1987). La constitution de la société: Éléments de la théorie de la structuration La constitution de la société: The Constitution of Society Translated from English by Audet, M.. Paris: Presses universitaires de France.Google Scholar
Morita, T. (2004). Palliative sedation to relieve psycho-existential suffering of terminally ill cancer patients. Journal of Pain and Symptom Management, 28, 445–450.CrossRefGoogle ScholarPubMed
Murata, H. & Morita, T. (2006). Conceptualization of psycho-existential suffering by the Japaneese Task Force: The first step of a nationwide project. Palliative and Supportive Care, 4, 279–285.CrossRefGoogle ScholarPubMed
Murray, H.T. & Jennings, B. (2005). The quest to reform end of life care: Rethinking assumptions and setting new directions. The Hastings Center Report. Spec. No.: S52–7.CrossRefGoogle ScholarPubMed
New, C. (1994). Structure, agency and social transformation. Journal for the Theory of Social Behaviour, 24, 187–205.CrossRefGoogle Scholar
Orentlicher, D. (1997). The Supreme Court and physician-assisted suicide: Rejecting assisted suicide but embracing euthanasia. New England Journal of Medicine, 337, 1236–1239.CrossRefGoogle ScholarPubMed
Phillips, T. & Smith, P. (2000). Police violence occasioning citizen complaint: An empirical analysis of time-space dynamics. The British Journal of Criminology, 40, 480–496.CrossRefGoogle Scholar
Poupart, J., Deslauriers, J.P., Groulx, L.H., et al. (1997). La recherche qualitative enjeux épistémologiques et méthodologiques (Qualitative research: epistemological and methodological issues). Montréal: Gaétan Morin.Google Scholar
Purkis, M.E. (1994). Entering the field: Intrusions of the social and its exclusion from studies of nursing practice. International Journal of Nursing Studies, 31, 315–336.CrossRefGoogle ScholarPubMed
Quill, T.E. & Byock, I.R. (2000). Responding to intractable terminal suffering: The role of terminal sedation and voluntary refusal of foods and fluids. Annals of Internal Medicine, 132, 408–414.CrossRefGoogle ScholarPubMed
Quill, T.E., Dresser, R. & Brock, D.W. (1997). The rule of double effect: A critique of its role in end-of-life decision making. New England Journal of Medicine, 337, 1768–1771.CrossRefGoogle ScholarPubMed
Rousseau, P. (2002). Existential Suffering and Palliative Sedation in Terminal Illness, Progress in Palliative Care, 10, 222–224.CrossRefGoogle Scholar
Saint-Pierre, M. (2000). Un projet d'intégration des activités mère-enfant, sa mise en œuvre et l'action des acteurs collectifs (Initiating integration of maternal-infant care services and the input of different parties involved) Doctoral thesis. Quebec City: Université Laval.Google Scholar
Strang, P., Strang, S., Hultborn, R., et al. (2004). Existential pain: An entity, a provocation, or a challenge. Journal of Pain and Symptom Management, 27, 241–250.CrossRefGoogle ScholarPubMed
Turgeon, J., Dumont, S., St-Pierre, M., et al. (2006). La problématique de la continuité des soins en oncologie (Continuity of cancer care in Quebec: beyond the symptoms). Canadian Family Physician.Google Scholar