title: Justifying continuous sedation until death: a focus group study in nursing homes in Flanders, Belgium.
abstract: Continuous Sedation until Death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, has become a common practice in nursing homes in Flanders (Belgium). Quantitative research has suggested that CSD is not always properly applied. This qualitative study aims to explore and describe the circumstances under which nursing home clinicians consider CSD to be justified. Six focus groups were conducted including 10 physicians, 24 nurses, and 14 care assistants working in either Catholic or non-Catholic nursing homes of varying size. Refractory suffering, limited life expectancy and respecting patient autonomy are considered essential elements in deciding for CSD. However, multiple factors complicate the care of nursing home residents at the end of life, and often hinder clinicians from putting these elements into practice. Nursing home clinicians may benefit from more information and instruction about managing CSD in the complex care situations which typically occur in nursing homes.
authors.affiliation: Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium. samrys@vub.ac.be
authors.forename: Sam
authors.initials: S
authors.lastname: Rys
authors.forename: Reginald
authors.initials: R
authors.lastname: Deschepper
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.forename: Freddy
authors.initials: F
authors.lastname: Mortier
authors.forename: Johan
authors.initials: J
authors.lastname: Bilsen
mesh_terms: D000328:Adult; D001530:Belgium; D003643:Death; D005065:Euthanasia; D005260:Female; D017144:Focus Groups; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D013727:Terminal Care
chemical_list: D006993:Hypnotics and Sedatives