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Continuous sedation until death: moral justifications of physicians and nurses: a content analysis of opinion pieces

Sam Rys (UGent) , Freddy Mortier (UGent) , Luc Deliens (UGent) , Reginald Deschepper (UGent) , Margaret Pabst Battin and Johan Bilsen (UGent)
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Abstract
Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. A content analysis of opinion pieces in medical and nursing literature was conducted to examine how clinicians define and describe CSD, and how they justify this practice morally. Most publications were written by physicians and published in palliative or general medicine journals. Terminal Sedation and Palliative Sedation are the most frequently used terms to describe CSD. Seventeen definitions with varying content were identified. CSD was found to be morally justified in 73 % of the publications using justifications such as Last Resort, Doctrine of Double Effect, Sanctity of Life, Autonomy, and Proportionality. The debate over CSD in the opinion sections of medical and nursing journals lacks uniform terms and definitions, and is profoundly marked by 'charged language', aiming at realizing agreement in attitude towards CSD. Not all of the moral justifications found are equally straightforward. To enable a more effective debate, the terms, definitions and justifications for CSD need to be further clarified.
Keywords
Palliative care, CONTINUOUS DEEP SEDATION, Terminal care, Opinions, Content analysis, Palliative Sedation, Deep Sedation, Terminal Sedation, CONTINUOUS PALLIATIVE SEDATION, PATIENTS NEARING DEATH, TERMINAL SEDATION, ASSISTED SUICIDE, SLOW EUTHANASIA, NETHERLANDS, CARE, EXPERIENCES

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MLA
Rys, Sam, Freddy Mortier, Luc Deliens, et al. “Continuous Sedation Until Death: Moral Justifications of Physicians and Nurses: a Content Analysis of Opinion Pieces.” MEDICINE HEALTH CARE AND PHILOSOPHY 16.3 (2013): 533–542. Print.
APA
Rys, S., Mortier, F., Deliens, L., Deschepper, R., Pabst Battin, M., & Bilsen, J. (2013). Continuous sedation until death: moral justifications of physicians and nurses: a content analysis of opinion pieces. MEDICINE HEALTH CARE AND PHILOSOPHY, 16(3), 533–542.
Chicago author-date
Rys, Sam, Freddy Mortier, Luc Deliens, Reginald Deschepper, Margaret Pabst Battin, and Johan Bilsen. 2013. “Continuous Sedation Until Death: Moral Justifications of Physicians and Nurses: a Content Analysis of Opinion Pieces.” Medicine Health Care and Philosophy 16 (3): 533–542.
Chicago author-date (all authors)
Rys, Sam, Freddy Mortier, Luc Deliens, Reginald Deschepper, Margaret Pabst Battin, and Johan Bilsen. 2013. “Continuous Sedation Until Death: Moral Justifications of Physicians and Nurses: a Content Analysis of Opinion Pieces.” Medicine Health Care and Philosophy 16 (3): 533–542.
Vancouver
1.
Rys S, Mortier F, Deliens L, Deschepper R, Pabst Battin M, Bilsen J. Continuous sedation until death: moral justifications of physicians and nurses: a content analysis of opinion pieces. MEDICINE HEALTH CARE AND PHILOSOPHY. 2013;16(3):533–42.
IEEE
[1]
S. Rys, F. Mortier, L. Deliens, R. Deschepper, M. Pabst Battin, and J. Bilsen, “Continuous sedation until death: moral justifications of physicians and nurses: a content analysis of opinion pieces,” MEDICINE HEALTH CARE AND PHILOSOPHY, vol. 16, no. 3, pp. 533–542, 2013.
@article{5672986,
  abstract     = {{Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. A content analysis of opinion pieces in medical and nursing literature was conducted to examine how clinicians define and describe CSD, and how they justify this practice morally. Most publications were written by physicians and published in palliative or general medicine journals. Terminal Sedation and Palliative Sedation are the most frequently used terms to describe CSD. Seventeen definitions with varying content were identified. CSD was found to be morally justified in 73 % of the publications using justifications such as Last Resort, Doctrine of Double Effect, Sanctity of Life, Autonomy, and Proportionality. The debate over CSD in the opinion sections of medical and nursing journals lacks uniform terms and definitions, and is profoundly marked by 'charged language', aiming at realizing agreement in attitude towards CSD. Not all of the moral justifications found are equally straightforward. To enable a more effective debate, the terms, definitions and justifications for CSD need to be further clarified.}},
  author       = {{Rys, Sam and Mortier, Freddy and Deliens, Luc and Deschepper, Reginald and Pabst Battin, Margaret and Bilsen, Johan}},
  issn         = {{1386-7423}},
  journal      = {{MEDICINE HEALTH CARE AND PHILOSOPHY}},
  keywords     = {{Palliative care,CONTINUOUS DEEP SEDATION,Terminal care,Opinions,Content analysis,Palliative Sedation,Deep Sedation,Terminal Sedation,CONTINUOUS PALLIATIVE SEDATION,PATIENTS NEARING DEATH,TERMINAL SEDATION,ASSISTED SUICIDE,SLOW EUTHANASIA,NETHERLANDS,CARE,EXPERIENCES}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{533--542}},
  title        = {{Continuous sedation until death: moral justifications of physicians and nurses: a content analysis of opinion pieces}},
  url          = {{http://dx.doi.org/10.1007/s11019-012-9444-2}},
  volume       = {{16}},
  year         = {{2013}},
}

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