Indication d'une sédation en phase terminale ou en fin de vie chez l'enfant : propositions à partir d'une synthèse de la littérature

There is no recent publication based on either literature review or experts' group opinions concerning sedation during end of life or terminal phase in paediatrics. The aim of this review is to describe some indications of sedation during terminal phase or end of life in childhood, based on literature and expert's opinion confrontation. Paediatric palliative care specificities and some complex or singular situations are described and discussed in various paediatrics fields such as neonatology, neuropaediatry, with brief focus on some specific situations in paediatric or neonatal intensive care. Indications of sedation which are proposed do not pretend to exhaustiveness. The decision-making must be done with responsibility and with the most possible objectivity. The singular emotional context of paediatrics must be considered and taken into account. Indication of sedation must always stand in legacy and be supported by a specific ethical preoccupation. The ethical questioning is omnipresent during all the reflexive time needed to identify an indication of sedation in paediatrics. This work proves the necessity of research and the necessity to validate clinical practice in this field.