Confusion entre anxiolyse et sédation dans certaines situations en phase terminale ?

A semi-structured survey conducted among caregivers of a regional hospital in France reveals a confusion between anxiolysis and sedation in some situations of terminal illness. Analysis of the results reveals that this confusion is due to the difficulty in clearly identifying anxiety, the absence of a reassessment of treatment and finally from a trivialization of vigilance disorders at the end of life. Added the difficulty of the notion of refractory symptom and of modulation of sedation's depth. Furthermore the molecule used for sedation has also an indication as anxiolytic and has, for some caregivers, a symbolic connotation of “serene end of life”, as its name suggests, “hypno-well”, good sleep. All this contributes to the confusion. These findings lead to proposals for trainings, tools, places of listening and exchanges. The reflection about the use of a single molecule for two different indications, anxiolysis and sedation, seems to be useful.