Continuous deep sedation, physician-assisted suicide, and euthanasia in Huntington's disorder

Area of Science:

• Medical Ethics
• Palliative Care
• Neurology

Background:

• Huntington's disorder presents complex end-of-life care challenges.
• Physician-assisted suicide (PAS) and euthanasia are debated for competent patients with progressive neurodegenerative diseases.
• Continuous deep sedation (CDS) is an alternative palliative care option.

Purpose of the Study:

• To assess Swedish physicians' and the public's attitudes towards CDS.
• To evaluate acceptance of CDS as an alternative for Huntington's patients requesting PAS/euthanasia.
• To compare these attitudes with existing recommendations.

Main Methods:

• A questionnaire-based survey was distributed to 1200 physicians and 1201 members of the public in Stockholm.
• Respondents evaluated a vignette of a Huntington's patient requesting PAS and euthanasia.
• Attitudes towards CDS as an alternative were assessed, alongside general views on PAS and euthanasia.

Main Results:

• Response rates were 56% for physicians and 52% for the public.
• A majority of the general public and a significant proportion of physicians expressed more liberal views on CDS.
• These liberal views exceed current Swedish and international recommendations for CDS.

Conclusions:

• There is a notable divergence between public/physician attitudes and current CDS recommendations.
• A broader societal discussion regarding CDS guidelines is warranted.
• Special consideration for CDS is needed for patients with progressive neurodegenerative disorders like Huntington's.