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Medicalisation, suffering and control at the end of life: The interplay of deep continuous palliative sedation and assisted dying
Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine ( IF 1.9 ) Pub Date : 2020-12-11 , DOI: 10.1177/1363459320976746
Gitte Hanssen Koksvik 1, 2 , Naomi Richards 2 , Sheri Mila Gerson 2 , Lars Johan Materstvedt 1 , David Clark 2
Affiliation  

Medicalisation is a pervasive feature of contemporary end of life and dying in Western Europe and North America. In this article, we focus on the relationship between two specific aspects of the medicalisation of dying: deep continuous palliative sedation until death and assisted dying. We draw upon a qualitative interview study with 29 health professionals from three jurisdictions where assisted dying is lawful: Flanders, Belgium; Oregon, USA; and Quebec, Canada. Our findings demonstrate that the relationship between palliative sedation and assisted dying is often perceived as fluid and complex. This is inconsistent with current laws as well as with ethical and clinical guidelines according to which the two are categorically distinct. The article contributes to the literature examining health professionals’ opinions and experiences. Moreover, our findings inform a discussion about emergent themes: suffering, timing, autonomy and control – which appear central in the wider discourse in which both palliative sedation and assisted dying are situated, and which in turn relate to the wider ideas about what constitutes a ‘good death’.



中文翻译:

临终时的医疗、痛苦和控制:深度持续姑息性镇静和辅助死亡的相互作用

医疗化是西欧和北美当代生命终结和死亡的普遍特征。在本文中,我们关注死亡医学化的两个具体方面之间的关系:直到死亡的深度持续姑息性镇静和辅助死亡。我们对来自三个合法辅助死亡司法管辖区的 29 名卫生专业人员进行了定性访谈研究:比利时佛兰德斯;美国俄勒冈州;和加拿大魁北克。我们的研究结果表明,姑息性镇静和辅助死亡之间的关系通常被认为是不稳定和复杂的。这不符合现行法律以及两者完全不同的伦理和临床指南。这篇文章有助于研究卫生专业人员的观点和经验的文献。而且,

更新日期:2021-01-14
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