Les cadres de la décision de sédation en fin de vie au domicile : le point de vue des médecins de soins palliatifs

In the public debate about the end of life in France, the term “palliative sedation” is used more and more often. What are the concrete stakes in this new method of the medical practice which consists in putting patients close to death to sleep? In France, such acts are little known, particularly when carried out at home because they are very difficult, even inaccessible to observe. We led a qualitative investigation by interviewing 27 French doctors trained in palliative care on cases when sedation at home had recently been decided. Our approach consisted, starting from what these practitioners had declared, in deciphering the ethical stakes they are confronted with, analyzing the “frames” of the medical judgment used in these cases, reporting the doctor toward patient perspective and thus better understanding how decisions are made. This investigation shows that sedation is an introductory practice which, for these practitioners, questions certain principles of palliative care