Sédater ou ne pas sédater ?

Transitory or continuous deep sedation at the end of life remains a controversial topic among politicians, economists and the general public. It is strange that we in palliative care use the term “sedation”, which is usually associated with anesthetics. In a professional context, we noticed that using this term was sometimes difficult; we can imagine the impact it might have on non-medical people. This article depicts the daily life stories experienced at the palliative care unit of the Nice (France) university hospital, each of them with its own uniqueness. In some cases, transitory sedation during care procedures was necessary to provide sufficient comfort to the patient. In other cases, deep sedation at the end of life was the only possible solution to ease refractory pain, when treatments had failed. Sometimes sedation was not required. What is your view? What would you have done in these situations? What is your take on sedation? Is the term “sedation” always used or are other terms employed to refer to the same experience? Many questions can be raised about this term, which is recurrently used in the media and can be quite frightening, as people tend to associate it with approaching death. Our work as caregivers requires constant ethical reflection upon the choices we make for our patients to really adapt to their situation and their expectations, as well as their actual suffering. Caution and humility are at the heart of our practice at a stage where it is important to focus on the quality rather than the quantity of the patient's life.