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Language Development01:22

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Children master language quickly and with relative ease, supported by both biological predisposition and reinforcement. B. F. Skinner (1957) proposed that language is learned through reinforcement, while Noam Chomsky (1965) argued that language acquisition mechanisms are biologically determined.
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Related Experiment Video

Updated: Feb 10, 2026

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[Palliative sedation : Development and consensus of a German language documentation template].

C Klein1, C Wittmann2, K N Wendt2

  • 1Palliativmedizinische Abteilung in der Anästhesiologischen Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland. carsten.klein@uk-erlangen.de.

Der Anaesthesist
|May 17, 2018
PubMed
Summary

This study developed a German documentation template for palliative sedation (PS) to ensure ethical and medically sound end-of-life care. The template, based on the EAPC framework, addresses key aspects like indications and symptom management, facilitating consistent application.

Keywords:
DocumentationHospice careHypnotics and sedativesPalliative medicinePractice guideline

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Area of Science:

  • Palliative Care
  • Anesthesiology
  • Medical Documentation

Background:

  • Palliative sedation (PS) is a therapeutic option for intractable suffering at the end of life.
  • Anesthesiologists are increasingly involved in end-of-life sedation decisions across various care settings.
  • While international guidelines exist, Germany lacks official PS guidelines, highlighting the need for standardized protocols.

Purpose of the Study:

  • To develop a German language template for the preparation, application, documentation, and evaluation of palliative sedation.
  • To align the template with current international frameworks, particularly the European Association for Palliative Care (EAPC) framework on PS.
  • To create an empirically based, multiprofessional consensus document for PS practices in Germany.

Main Methods:

  • A draft template was created using the EAPC framework and existing institutional templates.
  • An online Delphi survey involving 136 palliative care professionals assessed the draft's relevance, wording, and feasibility.
  • An expert panel refined the template based on Delphi survey results, achieving consensus above 75% for all items.

Main Results:

  • The Delphi process and expert panel led to significant template revisions, clarifying indications and the documentation of vital parameters.
  • A consensus was reached on documenting sedation levels and symptom burden, with a flexible approach to vital signs monitoring.
  • All 16 documentation template items achieved high consensus (78-100%) for relevance, clarity, and feasibility.

Conclusions:

  • An empirically based, multiprofessional consensus documentation template for palliative sedation is now available in German.
  • The template emphasizes core elements like indications and decision-making, while acknowledging challenges in vital signs documentation, especially in outpatient and hospice settings.
  • This resource supports the medically and ethically sound use of PS and aids future research, with the template accessible online.