Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium

Raus, K, Brown, J ORCID: https://orcid.org/0000-0002-9489-1654, Seale, C, Rietjens, JA, Janssens, R, Bruinsma, S, Mortier, F, Payne, S and Sterckx, S, 2014. Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium. BMC Medical Ethics, 15: 14. ISSN 1472-6939

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Abstract

Background: Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress.

Methods: This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology.

Results: The participants’ responses can be captured as different dimensions of ‘closeness’, i.e. the degree to which one feels connected or ‘close’ to a certain decision or event. We distinguished four types of ‘closeness’, namely emotional, physical, decisional, and causal. Using these four dimensions of ‘closeness’ it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility.

Conclusion: Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia.

Item Type:	Journal article
Publication Title:	BMC Medical Ethics
Creators:	Raus, K., Brown, J., Seale, C., Rietjens, J.A., Janssens, R., Bruinsma, S., Mortier, F., Payne, S. and Sterckx, S.
Publisher:	Springer
Date:	2014
Volume:	15
ISSN:	1472-6939
Identifiers:	Number Type 10.1186/1472-6939-15-14 DOI 1824376 Other
Rights:	This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
Divisions:	Schools > School of Social Sciences
Record created by:	Jonathan Gallacher
Date Added:	26 Oct 2023 07:50
Last Modified:	26 Oct 2023 07:50
URI:	https://irep.ntu.ac.uk/id/eprint/50126

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