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Regulations on palliative sedation: an international survey across eight European countries
BACKGROUND: Palliative sedation is a commonly accepted medical practice. This study aims to clarify how palliative sedation is regulated in various countries and whether this may impact its practice. METHODS: An online survey requesting regulations on palliative sedation was conducted in Belgium, Ge...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897985/ https://www.ncbi.nlm.nih.gov/pubmed/36303453 http://dx.doi.org/10.1093/eurpub/ckac153 |
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author | Garralda, Eduardo Busa, Csilla Pozsgai, Éva Osztromok-Lukacs, Veronika Csikós, Agnes Radbruch, Lukas Hasselaar, Jeroen Menten, Johan Payne, Sheila Adile, Claudio Hurducas, Flavia Centeno, Carlos |
author_facet | Garralda, Eduardo Busa, Csilla Pozsgai, Éva Osztromok-Lukacs, Veronika Csikós, Agnes Radbruch, Lukas Hasselaar, Jeroen Menten, Johan Payne, Sheila Adile, Claudio Hurducas, Flavia Centeno, Carlos |
author_sort | Garralda, Eduardo |
collection | PubMed |
description | BACKGROUND: Palliative sedation is a commonly accepted medical practice. This study aims to clarify how palliative sedation is regulated in various countries and whether this may impact its practice. METHODS: An online survey requesting regulations on palliative sedation was conducted in Belgium, Germany, Hungary, Italy, The Netherlands, Spain, Romania and the UK. Purposive sampling strategy was used to identify clinicians from different medical fields and legal experts for each country. Regulations were analyzed using the principles of the European Association for Palliative Care Framework on palliative sedation. Country reports describing how palliative sedation is regulated were elaborated. RESULTS: One hundred and thirty-nine out of 223 (62%) participants identified 31 laws and other regulations affecting palliative sedation. In Spain, 12 regional laws recognize palliative sedation as a right of the patient at the end of life when there are refractory symptoms. In Italy, the law of informed consent and advance directives specifically recognizes the doctor can use deep sedation when there are refractory symptoms. There are also general medical laws that, while not explicitly referring to palliative sedation, regulate sedation-related principles: the obligation of doctors to honour advance directives, informed consent, the decision-making process and the obligation to document the whole process. In Germany, the Netherlands and the UK, palliative sedation is also regulated through professional guidelines that are binding as good practice with legal significance. CONCLUSIONS: Palliative sedation is considered in the general law of medical practice, in laws regarding the patient’s autonomy, and through professional guidelines. |
format | Online Article Text |
id | pubmed-9897985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-98979852023-02-06 Regulations on palliative sedation: an international survey across eight European countries Garralda, Eduardo Busa, Csilla Pozsgai, Éva Osztromok-Lukacs, Veronika Csikós, Agnes Radbruch, Lukas Hasselaar, Jeroen Menten, Johan Payne, Sheila Adile, Claudio Hurducas, Flavia Centeno, Carlos Eur J Public Health Health Services Research BACKGROUND: Palliative sedation is a commonly accepted medical practice. This study aims to clarify how palliative sedation is regulated in various countries and whether this may impact its practice. METHODS: An online survey requesting regulations on palliative sedation was conducted in Belgium, Germany, Hungary, Italy, The Netherlands, Spain, Romania and the UK. Purposive sampling strategy was used to identify clinicians from different medical fields and legal experts for each country. Regulations were analyzed using the principles of the European Association for Palliative Care Framework on palliative sedation. Country reports describing how palliative sedation is regulated were elaborated. RESULTS: One hundred and thirty-nine out of 223 (62%) participants identified 31 laws and other regulations affecting palliative sedation. In Spain, 12 regional laws recognize palliative sedation as a right of the patient at the end of life when there are refractory symptoms. In Italy, the law of informed consent and advance directives specifically recognizes the doctor can use deep sedation when there are refractory symptoms. There are also general medical laws that, while not explicitly referring to palliative sedation, regulate sedation-related principles: the obligation of doctors to honour advance directives, informed consent, the decision-making process and the obligation to document the whole process. In Germany, the Netherlands and the UK, palliative sedation is also regulated through professional guidelines that are binding as good practice with legal significance. CONCLUSIONS: Palliative sedation is considered in the general law of medical practice, in laws regarding the patient’s autonomy, and through professional guidelines. Oxford University Press 2022-10-27 /pmc/articles/PMC9897985/ /pubmed/36303453 http://dx.doi.org/10.1093/eurpub/ckac153 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Health Services Research Garralda, Eduardo Busa, Csilla Pozsgai, Éva Osztromok-Lukacs, Veronika Csikós, Agnes Radbruch, Lukas Hasselaar, Jeroen Menten, Johan Payne, Sheila Adile, Claudio Hurducas, Flavia Centeno, Carlos Regulations on palliative sedation: an international survey across eight European countries |
title | Regulations on palliative sedation: an international survey across eight European countries |
title_full | Regulations on palliative sedation: an international survey across eight European countries |
title_fullStr | Regulations on palliative sedation: an international survey across eight European countries |
title_full_unstemmed | Regulations on palliative sedation: an international survey across eight European countries |
title_short | Regulations on palliative sedation: an international survey across eight European countries |
title_sort | regulations on palliative sedation: an international survey across eight european countries |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897985/ https://www.ncbi.nlm.nih.gov/pubmed/36303453 http://dx.doi.org/10.1093/eurpub/ckac153 |
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