title: Framework for continuous palliative sedation therapy in Canada.
abstract: BACKGROUND
  Canada does not have a standardized ethical and practice framework for continuous palliative sedation therapy (CPST). Although a number of institutional and regional guidelines exist, Canadian practice varies. Given the lack of international and national consensus on CPST, the Canadian Society for Palliative Care Physicians (CSPCP) formed a special task force to develop a consensus-based framework for CPST.
  
  
  OBJECTIVE
  Through a preliminary review of sedation practices nationally and internationally, it was determined that although considerable consensus was emerging on this topic, there remained both areas of contention and a lack of credible scientific evidence to support a definitive clinical practice guideline. This led to the creation of a framework to help guide policy, practice, and research.
  
  
  METHODS
  This framework was developed through the following steps: 1) literature review; 2) identification of issues; 3) preparation of a draft framework; 4) expert consultation and revision; 5) presentation at conferences and further revision; and 6) further revision and national consensus building.
  
  
  RESULTS
  A thorough literature review, including gray literature, of sedation therapy at the end of life was conducted from which an initial framework was drafted. This document was reviewed by 30 multidisciplinary experts in Canada and internationally, revised several times, and then submitted to CSPCP members for review. Consensus was high on most parts of the framework.
  
  
  CONCLUSIONS
  The framework for CPST will provide a basis for the development of safe, effective, and ethical use of CPST for patients in palliative care and at the end of life.
authors: Palliative Care, Western Memorial Regional Hospital, Corner Brook, Newfoundland and Labrador, Canada. merv.d@nf.sympatico.ca
authors: Mervyn M
authors: MM
authors: Dean
authors: Victor
authors: V
authors: Cellarius
authors: Blair
authors: B
authors: Henry
authors: Doreen
authors: D
authors: Oneschuk
authors: S Lawrence
authors: SL
authors: Librach Canadian Society Of Palliative Care Physicians Taskforce
mesh_terms: D002170:Canada; D032921:Consensus; D054810:Deep Sedation / Q000379:methods / Q000592:standards*; D006291:Health Policy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000592:standards; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care / Q000941:ethics / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic
chemical_list: D006993:Hypnotics and Sedatives