Medicalisation, suffering and control at the end of life: The interplay of deep continuous palliative sedation and assisted dying

Hanssen Koksvik, G., Richards, N. , Gerson, S. M., Materstvedt, L. J. and Clark, D. (2020) Medicalisation, suffering and control at the end of life: The interplay of deep continuous palliative sedation and assisted dying. Health, (doi: 10.1177/1363459320976746) (Early Online Publication)

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Abstract

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’.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Clark, Professor David and Gerson, Dr Sheri Mila and Materstvedt, Professor Lars and Richards, Dr Naomi and Koksvik, Dr Gitte
Authors: Hanssen Koksvik, G., Richards, N., Gerson, S. M., Materstvedt, L. J., and Clark, D.
College/School:College of Social Sciences > School of Interdisciplinary Studies
Journal Name:Health
Publisher:SAGE
ISSN:1363-4593
ISSN (Online):1461-7196
Published Online:11 December 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Health 2020
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
170345Interventions at the end of life: social, historical and comparative analysis to promote global improvement.David ClarkWellcome Trust (WELLCOTR)103319/Z/13/ZIS - Interdisciplinary Studies