title: Bridging the gap between continuous sedation until death and physician-assisted death: a focus group study in nursing homes in Flanders, Belgium.
abstract: The distinction between continuous sedation until death (CSD) and physician-assisted death (PAD) has become a topic of medical ethical debate. We conducted 6 focus groups to examine how nursing home clinicians perceive this distinction. For some, the difference is clear whereas others consider CSD a form of euthanasia. Another group situates CSD between pain relief and ending life. Arguments for these perspectives refer to the following themes: intention, dosage of sedative drugs, unconsciousness, and the pace of the dying process. Generally, CSD is considered emotionally easier to deal with since it entails a gradual dying process. Nursing home clinicians have diverging perceptions of the relation between CSD and PAD; some consider CSD to be more than a purely palliative measure, that is, also as a means to hasten death.
authors.affiliation: Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium samrys@vub.ac.be.
authors.forename: Sam
authors.initials: S
authors.lastname: Rys
authors.affiliation: Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Reginald
authors.initials: R
authors.lastname: Deschepper
authors.affiliation: End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium Bioethics Institute Ghent, Ghent University, Ghent, Belgium.
authors.forename: Freddy
authors.initials: F
authors.lastname: Mortier
authors.affiliation: End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.affiliation: Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Bilsen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001530:Belgium; D003643:Death; D054810:Deep Sedation / Q000941:ethics / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006707:Homes for the Aged; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009014:Morals; D009735:Nursing Homes; D036301:Qualitative Research; D012067:Religion; D012111:Residence Characteristics; D017236:Suicide, Assisted / Q000941:ethics / Q000523:psychology*; D013727:Terminal Care / Q000941:ethics / Q000523:psychology
keywords: continuous sedation until death; euthanasia; nursing homes; palliative care; palliative sedation; physician-assisted death