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The use of palliative sedation: A comparison of attitudes of French-speaking physicians from Quebec and Switzerland

Published online by Cambridge University Press:  14 May 2014

Serge Dumont ,
Danielle Blondeau ,
Véronique Turcotte ,
Gian Domenico Borasio ,
Thierry Currat ,
Rose-Anna Foley  and
Michel Beauverd
Serge Dumont*
Affiliation:
School of Social Service, Laval University, Quebec City, Canada
Danielle Blondeau
Affiliation:
Faculty of Nursing, Laval University, Quebec City, Canada
Véronique Turcotte
Affiliation:
Laval University Cancer Research Centre, Quebec City, Canada
Gian Domenico Borasio
Affiliation:
Palliative Care Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Thierry Currat
Affiliation:
Palliative Care Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Rose-Anna Foley
Affiliation:
Palliative Care Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Michel Beauverd
Affiliation:
Palliative Care Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
*
Address correspondence and reprint requests to: Serge Dumont, School of Social Work, Pavillon Charles de Koninck, 1030, Avenue des Sciences Humaines, Laval University, Quebec, Quebec, Canada G1V 0A6. E-mail: [email protected]
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Abstract

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.

Method:

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.

Significance of results:

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.

Keywords

SedationLawsRegulationsEnd of lifeDecision making
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 839 - 847
Copyright
Copyright © Cambridge University Press 2014 

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