title: Sedation of patients in intensive care medicine and nursing: ethical issues.
abstract: This article focuses on the ethical aspects of medically-induced sedation and pain relief in intensive care medicine. The study results reported are part of a larger investigation of patients' experiences of being sedated and receiving pain relief, and also families' experiences of having a close relative under controlled sedation in an intensive care unit. The study is based on qualitative in-depth interviews with nine nurses and six doctors working in intensive care and surgical units in a major Norwegian hospital. The textual data are interpreted according to Kvale's method for analyzing qualitative data. There are ethical problems regarding how to achieve an acceptable balance between a patient's subjective well-being and the medical need for reduced sedation. The authors discuss whether some medical reasons for reduced sedation are ethically justifiable, given the actual medical knowledge available. The study also addresses the ethical consequences of reducing medically-induced sedation and the demands it puts on interdisciplinary co-operation and communication, as well as the importance of improving the quality of medical and nursing care.
authors.affiliation: Section for Medical Ethics, Faculty of Medicine, PO Box 1130 Blindern, University of Oslo, Oslo, Norway. p.nortvedt@medisin.uio.no
authors.forename: Per
authors.initials: P
authors.lastname: Nortvedt
authors.forename: Gunnvald
authors.initials: G
authors.lastname: Kvarstein
authors.forename: Ingvild
authors.initials: I
authors.lastname: Jønland
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D016292:Procedural Sedation / Q000379:methods; D003422:Critical Care / Q000941:ethics* / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007362:Intensive Care Units / Q000941:ethics* / Q000592:standards; D008297:Male; D008505:Medical Staff, Hospital / Q000941:ethics* / Q000592:standards; D008875:Middle Aged; D033262:Narration; D009664:Norway; D009741:Nursing Staff, Hospital / Q000941:ethics* / Q000592:standards; D010148:Intractable Pain / Q000188:drug therapy / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives