Palliative care physicians' decision-making about palliative sedation for existential suffering: A Belgian nationwide qualitative study.

Autor:	Rodrigues P; ETHICS EA 7446, Catholic University of Lille, Lille, France., Ostyn J; Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium., Mroz S; End-of-Life Care Research Group, Free University of Brussels (VUB), Brussels, Belgium., Ronse A; Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium., Menten J; Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Leuven, Belgium., Gastmans C; Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium.
Jazyk:	angličtina
Zdroj:	Palliative & supportive care [Palliat Support Care] 2024 Feb; Vol. 22 (1), pp. 119-127.
DOI:	10.1017/S1478951522001559
Abstrakt:	Objectives: This study aims to provide an in-depth understanding of the content and process of decision-making about palliative sedation for existential suffering (PS-ES) as perceived by Belgian palliative care physicians. Methods: This Belgian nationwide qualitative study follows a grounded theory approach . We conducted semistructured interviews with 25 palliative care physicians working in 19 Belgian hospital-based palliative care units and 4 stand-alone hospices. We analyzed the data using the Qualitative Analysis Guide of Leuven , and we followed the Consolidated Criteria for Reporting Qualitative Research Guidelines (COREQ). Results: Analysis of the data identified several criteria that physicians apply in their decision-making about PS-ES, namely, the importance of the patient's demand, PS-ES as a last resort option after all alternatives have been applied, the condition of unbearable suffering combined with other kinds of suffering, and the condition of being in a terminal stage. Regarding the process of decision-making itself, physicians refer to the need for multidisciplinary perspectives supported by an interpretative dialogue with the patient and all other stakeholders. The decision-making process involves a specific temporality and physicians' inner conviction about the need of PS-ES. Significance of Results: Belgian palliative care physicians are not sure about the criteria regarding decision-making in PS-ES. To deal with complex existential suffering in end-of-life situations, they stress the importance of participation by all stakeholders (patient, relatives, palliative care team, other physicians, nurses, social workers, physiotherapists, occupational therapists, chaplains, etc.) in the decision-making process to prevent inadequate decisions being made.
Databáze:	MEDLINE
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