Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians

Background: In Switzerland, continuous deep sedation until death (CDSUD) is not legally regulated and the current clinical practice guidelines on palliative sedation from 2005 do not refer to it. In contrast, in France, a neighbouring country, CDSUD is regulated by a specific law and professional gu...

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Main Authors: Martyna Tomczyk, Roberto Andorno, Ralf J. Jox
Format: Article
Language:English
Published: SAGE Publishing 2023-12-01
Series:Palliative Care and Social Practice
Online Access:https://doi.org/10.1177/26323524231219509
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author Martyna Tomczyk
Roberto Andorno
Ralf J. Jox
author_facet Martyna Tomczyk
Roberto Andorno
Ralf J. Jox
author_sort Martyna Tomczyk
collection DOAJ
description Background: In Switzerland, continuous deep sedation until death (CDSUD) is not legally regulated and the current clinical practice guidelines on palliative sedation from 2005 do not refer to it. In contrast, in France, a neighbouring country, CDSUD is regulated by a specific law and professional guidelines. International studies show that in culturally polymorphic countries, there are variations in the end-of-life practices between linguistic regions and that a linguistic region shares many cultural characteristics with the neighbouring country. Objectives: This study aimed to explore the attitudes of palliative care physicians from the French-speaking part of Switzerland on the question of whether CDSUD should be legally regulated in the country, and to identify their arguments. Our study also aimed to assess whether a hypothetical Swiss law on CDSUD should be similar to the current legal regulation of this practice in France. Design: We conducted a multicentre exploratory qualitative study based on face-to-face interviews with palliative care physicians in the French-speaking part of Switzerland. Methods: We analysed the interview transcripts using thematic analysis, combining deductive and inductive coding. Results: Most of the participants were opposed to having specific legal regulation of CDSUD in Switzerland. Their arguments were diverse: some focused on medical and epistemological aspects of CDSUD, whereas others emphasized the legal inconvenience of having such regulation. None had the opinion that, if CDSUD were legally regulated in Switzerland, the regulation should be similar to that in France. Conclusion: This study allows to better understand why palliative care physicians in French-speaking Switzerland may be reluctant to have legal regulation of CDSUD. Further studies covering the whole country would be needed to gain a more complete picture of Swiss palliative care physicians on this question.
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spelling doaj.art-feed8dc2a8a445fd9347dcd0597b46b32024-01-31T13:03:20ZengSAGE PublishingPalliative Care and Social Practice2632-35242023-12-011710.1177/26323524231219509Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physiciansMartyna TomczykRoberto AndornoRalf J. JoxBackground: In Switzerland, continuous deep sedation until death (CDSUD) is not legally regulated and the current clinical practice guidelines on palliative sedation from 2005 do not refer to it. In contrast, in France, a neighbouring country, CDSUD is regulated by a specific law and professional guidelines. International studies show that in culturally polymorphic countries, there are variations in the end-of-life practices between linguistic regions and that a linguistic region shares many cultural characteristics with the neighbouring country. Objectives: This study aimed to explore the attitudes of palliative care physicians from the French-speaking part of Switzerland on the question of whether CDSUD should be legally regulated in the country, and to identify their arguments. Our study also aimed to assess whether a hypothetical Swiss law on CDSUD should be similar to the current legal regulation of this practice in France. Design: We conducted a multicentre exploratory qualitative study based on face-to-face interviews with palliative care physicians in the French-speaking part of Switzerland. Methods: We analysed the interview transcripts using thematic analysis, combining deductive and inductive coding. Results: Most of the participants were opposed to having specific legal regulation of CDSUD in Switzerland. Their arguments were diverse: some focused on medical and epistemological aspects of CDSUD, whereas others emphasized the legal inconvenience of having such regulation. None had the opinion that, if CDSUD were legally regulated in Switzerland, the regulation should be similar to that in France. Conclusion: This study allows to better understand why palliative care physicians in French-speaking Switzerland may be reluctant to have legal regulation of CDSUD. Further studies covering the whole country would be needed to gain a more complete picture of Swiss palliative care physicians on this question.https://doi.org/10.1177/26323524231219509
spellingShingle Martyna Tomczyk
Roberto Andorno
Ralf J. Jox
Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians
Palliative Care and Social Practice
title Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians
title_full Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians
title_fullStr Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians
title_full_unstemmed Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians
title_short Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians
title_sort should continuous deep sedation until death be legally regulated in switzerland an exploratory study with palliative care physicians
url https://doi.org/10.1177/26323524231219509
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AT ralfjjox shouldcontinuousdeepsedationuntildeathbelegallyregulatedinswitzerlandanexploratorystudywithpalliativecarephysicians