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.authorAnquinet, Livia
dc.contributor.authorRietjens, J.
dc.contributor.authorHeide, A.
dc.contributor.authorBruinsma, Sophie
dc.contributor.authorJanssens, Rien
dc.contributor.authorDeliens, Luc
dc.contributor.authorAddington-Hall, Julia
dc.contributor.authorSmithson, W. Henry
dc.contributor.authorSeymour, Jane
dc.contributor.funderEconomic and Social Research Councilen
dc.contributor.funderFonds Wetenschappelijk Onderzoeken
dc.contributor.funderStichting Tegen Kankeren
dc.contributor.funderUniversiteit Genten
dc.contributor.funderNederlandse Organisatie voor Wetenschappelijk Onderzoeken
dc.contributor.funderZonMwen
dc.date.accessioned2018-10-05T11:01:59Z
dc.date.available2018-10-05T11:01:59Z
dc.date.issued2013-12-05
dc.date.updated2018-10-05T10:51:16Z
dc.description.abstractObjective: 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.sponsorshipEconomic and Social Research Council (Grant No: RES-062-23-2078)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationAnquinet, 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.3450en
dc.identifier.doi10.1002/pon.3450
dc.identifier.endpage546en
dc.identifier.issn1057-9249
dc.identifier.issn1099-1611
dc.identifier.issued5en
dc.identifier.journaltitlePsycho-Oncologyen
dc.identifier.startpage539en
dc.identifier.urihttps://hdl.handle.net/10468/6981
dc.identifier.volume23en
dc.language.isoenen
dc.publisherJohn Wiley & Sons Ltd.en
dc.relation.urihttps://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.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectContinuous sedationen
dc.subjectPsychological sufferingen
dc.subjectExistential sufferingen
dc.subjectEnd of lifeen
dc.titlePhysicians' 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 lifeen
dc.typeArticle (peer-reviewed)en
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