Continuous Palliative Sedation for Existential Distress? A Survey of Canadian Palliative Care Physicians' Views

J Palliat Care. 2017 Jan;32(1):26-33. doi: 10.1177/0825859717711301.

Abstract

Background: Palliative sedation can be used for refractory symptoms during end-of-life care. However, continuous palliative sedation (CPS) for existential distress remains controversial due to difficulty determining when this distress is refractory.

Objectives: The aim was to determine the opinions and practices of Canadian palliative care physicians regarding CPS for existential distress.

Methods: A survey focusing on experience and views regarding CPS for existential distress was sent to 322 members of the Canadian Society of Palliative Care Physicians.

Results: Eighty-one surveys returned (accessible target, 314), resulting in a response rate of 26%. One third (31%) of the respondents reported providing CPS for existential distress. On a 5-point Likert-type scale, 40% of participants disagreed, while 43% agreed that CPS could be used for existential distress alone.

Conclusion: Differing opinions exist regarding this complex and potentially controversial issue, necessitating the education of health-care professionals and increased awareness within the general public.

Keywords: continuous palliative sedation; end-of-life care; existential distress; palliative care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Canada
  • Deep Sedation / ethics*
  • Deep Sedation / psychology
  • Existentialism / psychology*
  • Female
  • Hospice Care / ethics*
  • Hospice Care / psychology
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Middle Aged
  • Palliative Care / ethics*
  • Physicians / psychology*
  • Stress, Psychological / drug therapy
  • Surveys and Questionnaires
  • Terminal Care / ethics*
  • Terminal Care / psychology

Substances

  • Hypnotics and Sedatives