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Physicians' perceptions of palliative sedation for existential suffering: a systematic review
Paulo Rodrigues1, Johan Menten2, Chris Gastmans2
1ETHICS 7446 - Centre d'éthique médicale, Université Catholique de Lille, Lille, France paulusrod@gmail.com.
BMJ Supportive & Palliative Care
|September 5, 2019
Summary
Physicians lack consensus on palliative sedation for existential suffering (PS-ES). This systematic review explores influencing factors, conditions for use, and alternatives, highlighting the need for further research into ethical considerations.
Area of Science:
- Medical Ethics
- Palliative Care
- Clinical Practice
Background:
- Palliative sedation for existential suffering (PS-ES) is a contentious clinical practice.
- Physician perceptions and clinical practice guidelines on PS-ES lack consensus.
Purpose of the Study:
- To investigate physicians' perceptions of PS-ES.
- To identify factors influencing PS-ES decisions.
- To explore conditions for PS-ES implementation and alternatives.
Main Methods:
- Systematic review of qualitative, quantitative, and mixed-methods studies.
- Searched seven electronic databases (PubMed, CINAHL, Embase, etc.) through March 2019.
- Thematic synthesis and quality appraisal of 17 included publications.
Main Results:
- Physicians hold divided views on the appropriateness of PS-ES.
- Identified case-related and individual-related factors influencing perceptions.
- No consensus exists on criteria for initiating PS-ES; alternatives were noted.
Conclusions:
- Physician consensus on PS-ES remains elusive.
- Further research is needed to understand influencing factors and underlying ethical principles.
- Clarifying perceptions is crucial for developing consistent clinical approaches.
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