the perspectives of clinical staff and bereaved informal care-givers on the use of continuous sedation until death for cancer patients the study protocol of the unbiased study临床人员的观点和失去亲人的非正式照顾者使用连续镇静直到死亡的癌症患者的研究方案的研究.pdfVIP

Seymour et al. BMC Palliative Care 2011, 10:5 /1472-684X/10/5 STUDY PROTOCOL Open Access The perspectives of clinical staff and bereaved informal care-givers on the use of continuous sedation until death for cancer patients: The study protocol of the UNBIASED study 1* 2,3 1 3 2,4 2 Jane Seymour , Judith Rietjens , Jayne Brown , Agnes van der Heide , Sigrid Sterckx , Luc Deliens , the UNBIASED study team Abstract Background: A significant minority of dying people experience refractory symptoms or extreme distress unresponsive to conventional therapies. In such circumstances, sedation may be used to decrease or remove consciousness until death occurs. This practice is described in a variety of ways, including: ‘palliative sedation’, ‘terminal sedation’, ‘continuous deep sedation until death’, ‘proportionate sedation’ or ‘palliative sedation to unconsciousness’. Surveys show large unexplained variation in incidence of sedation at the end of life across countries and care settings and there are ethical concerns about the use, intentions, risks and significance of the practice in palliative care. There are also questions about how to explain international variation in the use of the practice. This protocol relates to the UNBIASED study (UK Netherlands Belgium International Sedation Study), which comprises three linked studies with separate funding sources in the UK, Belgium and the Netherlands. The aims of the study are to explore decision-making surrounding the application of continuous sedation until death in contemporary clinical practice, and to understand the experiences of clinical staff and decedents’ informal care- givers of the use of continuous sedation until death and their pe