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Pulmonologists' experiences with palliative sedation for terminally ill patients
Article indépendant
Background: The Norwegian Medical Association has devised guidelines for palliative sedation, most recently revised in 2014. The aim of the study was to examine pulmonologists' familiarity with these guidelines and their use of palliative sedation in pulmonary patients with a terminal illness.
Material and method: An electronic questionnaire was sent to all members of the Norwegian Association for Pulmonary Medicine (529 doctors) in October 2022. The responses were analysed using descriptive statistics, and the free-text comments were analysed using systematic text condensation.
Results: A total of 50 doctors responded to the questionnaire (9.5 % response rate). Twenty-two were familiar with the guidelines, but only a minority felt they were clear and served as an effective support tool. Thirty-seven reported that palliative sedation was practised at their workplace, but the frequency varied considerably. Twenty-five participants had been involved in administering palliative sedation at least once, and 19 had encountered ethical challenges in connection with this. Sedation was normally performed on lung cancer patients with intractable dyspnoea and pain, but also on other patients. The decision-making generally took place in an interdisciplinary team, and the free-text comments highlighted how this collaboration helped doctors feel supported and reassured. It was pointed out that there is a fine line between palliative sedation and euthanasia, and there is a desire for the grey areas to be further clarified in the guidelines.
Interpretation: The definition of palliative sedation is still interpreted in different ways and is often considered unclear. It may be helpful to include diagnosis-specific recommendations when revising the current guidelines.
http://dx.doi.org/10.4045/tidsskr.23.0778
Voir la revue «Tidsskrift for den Norske laegeforening, 144»
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