Physicians' experiences and perspectives regarding the use of continuous sedation until death for cancer patients in the context of psychological and existential suffering at the end of life

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dc.contributor.author Anquinet, Livia
dc.contributor.author Rietjens, J.
dc.contributor.author Heide, A.
dc.contributor.author Bruinsma, Sophie
dc.contributor.author Janssens, Rien
dc.contributor.author Deliens, Luc
dc.contributor.author Addington-Hall, Julia
dc.contributor.author Smithson, W. Henry
dc.contributor.author Seymour, Jane
dc.date.accessioned 2018-10-05T11:01:59Z
dc.date.available 2018-10-05T11:01:59Z
dc.date.issued 2013-12-05
dc.identifier.citation Anquinet, L., Rietjens, J., Heide, A., Bruinsma, S., Janssens, R., Deliens, L., Addington-Hall, J., Smithson, W. H. and Seymour, J. (2014) 'Physicians' experiences and perspectives regarding the use of continuous sedation until death for cancer patients in the context of psychological and existential suffering at the end of life', Psycho-Oncology, 23(5), pp.539-546. doi:10.1002/pon.3450 en
dc.identifier.volume 23 en
dc.identifier.issued 5 en
dc.identifier.startpage 539 en
dc.identifier.endpage 546 en
dc.identifier.issn 1057-9249
dc.identifier.issn 1099-1611
dc.identifier.uri http://hdl.handle.net/10468/6981
dc.identifier.doi 10.1002/pon.3450
dc.description.abstract Objective: The use of continuous sedation until death for terminally ill cancer patients with unbearable and untreatable psychological and existential suffering remains controversial, and little in-depth insight exists into the circumstances in which physicians resort to it. Methods Our study was conducted in Belgium, the Netherlands, and the UK in hospitals, PCUs/hospices, and at home. We held interviews with 35 physicians most involved in the care of cancer patients who had psychological and existential suffering and had been continuously sedated until death. Results In the studied countries, three groups of patients were distinguished regarding the origin of their psychological and existential suffering. The first group had preexisting psychological problems before they became ill, the second developed psychological and existential suffering during their disease trajectory, and the third presented psychological symptoms that were characteristic of their disease. Before they resorted to the use of sedation, physicians reported that they had considered an array of pharmacological and psychological interventions that were ineffective or inappropriate to relieve this suffering. Necessary conditions for using sedation in this context were for most physicians the presence of refractory symptoms, a short life expectancy, and an explicit patient request for sedation. Conclusions Physicians in our study used continuous sedation until death in the context of psychological and existential suffering after considering several pharmacological and psychological interventions. Further research and debate are needed on how and by whom this suffering at the end of life should be best treated, taking into account patients' individual preferences. en
dc.description.sponsorship Economic and Social Research Council (Grant No: RES-062-23-2078) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons Ltd. en
dc.relation.uri https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.3450
dc.rights © 2013, the Authors. Psycho-Oncology published by John Wiley & Sons, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject Continuous sedation en
dc.subject Psychological suffering en
dc.subject Existential suffering en
dc.subject End of life en
dc.title Physicians' experiences and perspectives regarding the use of continuous sedation until death for cancer patients in the context of psychological and existential suffering at the end of life en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother William Henry Smithson, General Practice, University College Cork, Cork, Ireland. +353-21-490-3000 Email: henry.smithson@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2018-10-05T10:51:16Z
dc.description.version Published Version en
dc.internal.rssid 456735012
dc.contributor.funder Economic and Social Research Council en
dc.contributor.funder Fonds Wetenschappelijk Onderzoek en
dc.contributor.funder Stichting Tegen Kanker en
dc.contributor.funder Universiteit Gent en
dc.contributor.funder Nederlandse Organisatie voor Wetenschappelijk Onderzoek en
dc.contributor.funder ZonMw en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Psycho-Oncology en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress henry.smithson@ucc.ie en


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© 2013, the Authors. Psycho-Oncology published by John Wiley & Sons, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Except where otherwise noted, this item's license is described as © 2013, the Authors. Psycho-Oncology published by John Wiley & Sons, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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