The use of palliative sedation: A comparison of attitudes of French-speaking physicians from Quebec and Switzerland.
OBJECTIVE
Previous literature has suggested that laws and regulations may impact the use of palliative sedation. Our present study compares the attitudes of French-speaking physicians practicing in the Quebec and Swiss environments, where different laws are in place regarding physician-assisted suicide.


METHODS
Data were drawn from two prior studies, one by Blondeau and colleagues and another by Beauverd and coworkers, employing the same two-by-two experimental design with length of prognosis and type of suffering as independent variables. Both the effect of these variables and the effect of their interaction on Swiss and Quebec physicians' attitudes toward sedation were compared. The written comments of respondents were submitted to a qualitative content analysis and summarized in a comparative perspective.


RESULTS
The analysis of variance showed that only the type of suffering had an effect on physicians' attitudes toward sedation. The results of the Wilcoxon test indicated that the attitudes of physicians from Quebec and Switzerland tended to be different for two vignettes: long-term prognosis with existential suffering (p = 0.0577) and short-term prognosis with physical suffering (p = 0.0914). In both cases, the Swiss physicians were less prone to palliative sedation.


CONCLUSIONS
The attitudes of physicians from Quebec and Switzerland toward palliative sedation, particularly regarding prognosis and type of suffering, seem similar. However, the results suggest that physicians from Quebec could be slightly more open to palliative sedation, even though most were not in favor of this practice as an answer to end-of-life existential suffering.
School of Social Service,Laval University,Quebec City,Canada.
Serge
S
Dumont
Faculty of Nursing,Laval University,Quebec City,Canada.
Danielle
D
Blondeau
Laval University Cancer Research Centre,Quebec City,Canada.
Véronique
V
Turcotte
Palliative Care Service, Department of Medicine,Centre Hospitalier Universitaire Vaudois,Lausanne,Switzerland.
Gian Domenico
GD
Borasio
Palliative Care Service, Department of Medicine,Centre Hospitalier Universitaire Vaudois,Lausanne,Switzerland.
Thierry
T
Currat
Palliative Care Service, Department of Medicine,Centre Hospitalier Universitaire Vaudois,Lausanne,Switzerland.
Rose-Anna
RA
Foley
Palliative Care Service, Department of Medicine,Centre Hospitalier Universitaire Vaudois,Lausanne,Switzerland.
Michel
M
Beauverd
D001291:Attitude of Health Personnel; D054810:Deep Sedation / Q000706:statistics & numerical data*; D005065:Euthanasia / Q000523:psychology*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D010820:Physicians / Q000523:psychology*; D011379:Prognosis; D036301:Qualitative Research; D011792:Quebec; D011795:Surveys and Questionnaires; D013557:Switzerland
Decision making; End of life; Laws; Regulations; Sedation