Dataset Information

Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium.

ABSTRACT:

Background

Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress.

Methods

This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology.

Results

The participants' responses can be captured as different dimensions of 'closeness', i.e. the degree to which one feels connected or 'close' to a certain decision or event. We distinguished four types of 'closeness', namely emotional, physical, decisional, and causal. Using these four dimensions of 'closeness' it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility.

Conclusion

Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia.

SUBMITTER: Raus K

PROVIDER: S-EPMC3942295 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Publications

Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium.

Raus Kasper K Brown Jayne J Seale Clive C Rietjens Judith A C JA Janssens Rien R Bruinsma Sophie S Mortier Freddy F Payne Sheila S Sterckx Sigrid S

BMC medical ethics 20140220

<h4>Background</h4>Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress.<h4>Methods</h4>This study is an international qualitative interview study involving interviews with physicians, nurses, and rela ...[more]

PMID: 24555871

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Project description:A research link between conditional reasoning and mathematics has been reported only for late adolescents and adults, despite claims about the pivotal importance of conditional reasoning, i.e., reasoning with if-then statements, in mathematics. Secondary students' problems with deductive reasoning in mathematics have been documented for a long time. However, evidence from developmental psychology shows that even elementary students possess some early conditional reasoning skills in familiar contexts. It is still an open question to what extent conditional reasoning with mathematical concepts differs from conditional reasoning in familiar everyday contexts. Based on Mental Model Theory (MMT) of conditional reasoning, we assume that (mathematical) content knowledge will influence the generation of models, when conditionals concern mathematical concepts. In a cross-sectional study, 102 students in Cyprus from grades 2, 4, and 6 solved four conditional reasoning tasks on each type of content (everyday and mathematical). All four logical forms, modus ponens (MP), modus tollens (MT), denial of the antecedent (DA), and affirmation of the consequent (AC), were included in each task. Consistent with previous findings, even second graders were able to make correct inferences on some logical forms. Controlling for Working Memory (WM), there were significant effects of grade and logical form, with stronger growth on MP and AC than on MT and DA. The main effect of context was not significant, but context interacted significantly with logical form and grade level. The pattern of results was not consistent with the predictions of MMT. Based on analyses of students' chosen responses, we propose an alternative mechanism explaining the specific pattern of results. The study indicates that deductive reasoning skills arise from a combination of knowledge of domain-general principles and domain-specific knowledge. It extends results concerning the gradual development of primary students' conditional reasoning with everyday concepts to reasoning with mathematical concepts adding to our understanding of the link between mathematics and conditional reasoning in primary school. The results inspire the development of educational interventions, while further implications and limitations of the study are discussed.

Dataset Information

Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium.

Background

Methods

Results

Conclusion

Publications

Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium.

Similar Datasets

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