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Updated: Jun 5, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
[Refractory sufferings at the end of life: Which considerations, which propositions?]
Clémence Joly1, Elisabeth Ghazi Elie, Eric Maillet
1CHU Charles-Nicolle, unité régionale de soins palliatifs, 76031 Rouen, France. clemence.joly@chu-rouen.fr
Abstract:
Refractory suffering of terminally ill people may be physical (pain, dyspnea, vomiting...) or existential (spiritual sufferings, anxiousness...). End-of-life decisions are often around ethics. Decision making near the end of life consists in witholding and withdrawing life-support treatment and prescribing both of treatments with risk of double effect and sedation for distress. In France, such decisions are defined by the deontology code and by the law of April 22nd, 2005 concerning the end of life and patients' rights. Recommendations from medical societies specify the means of implementation: obtaining other medical opinions, the patient's informed consent and full transparency of the decision (noted in the patient's medical chart).
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