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            <title xml:lang="en">Palliative sedation at home and medical decision making, a qualitative study</title>
            <title xml:lang="fr">Les cadres de la décision de sédation en fin de vie au domicile : le point de vue des médecins de soins palliatifs</title>
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            <idno type="halRefHtml">&lt;i&gt;Anthropologie et Santé&lt;/i&gt;, 2016, Incertitude médicale, prise de décision et accompagnement en fin de vie, 12, &lt;a target="_blank" href="https://dx.doi.org/10.4000/anthropologiesante.2072"&gt;&amp;#x27E8;10.4000/anthropologiesante.2072&amp;#x27E9;&lt;/a&gt;</idno>
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            <idno type="stamp" n="COMUE-NORMANDIE">Normandie Université</idno>
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            <idno type="stamp" n="UNIROUEN">Université de Rouen Normandie</idno>
            <idno type="stamp" n="UNILEHAVRE">Université Le Havre Normandie</idno>
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                <title xml:lang="en">Palliative sedation at home and medical decision making, a qualitative study</title>
                <title xml:lang="fr">Les cadres de la décision de sédation en fin de vie au domicile : le point de vue des médecins de soins palliatifs</title>
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                <term xml:lang="en">decision-making</term>
                <term xml:lang="en">home care</term>
                <term xml:lang="en">end of life</term>
                <term xml:lang="en">palliative care</term>
                <term xml:lang="en">sedation</term>
                <term xml:lang="fr">fin de vie</term>
                <term xml:lang="fr">domicile</term>
                <term xml:lang="fr">sédation</term>
                <term xml:lang="fr">décision</term>
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              <p>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.</p>
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              <p>Dans le débat public sur la fin de vie en France, le terme de « sédation » se fait de plus en plus entendre. Quels sont les enjeux concrets de cette nouvelle modalité des pratiques médicales qui consiste à endormir les patients proches de leur mort ? En France, de tels actes sont très mal connus, en particulier au domicile car ils sont très difficiles à observer voire inaccessibles. Nous avons mené une enquête qualitative par entretiens auprès de 27 médecins français formés aux soins palliatifs sur des situations de prise de décision récentes d'une sédation au domicile. Notre approche a consisté, à partir des récits de ces praticiens, à décrypter les enjeux éthiques auxquels ils se trouvent confrontés, à analyser les « cadres » du jugement médical mobilisé dans ces cas, à rendre compte de la perspective du médecin vis-à-vis du patient et de son entourage, et ainsi à mieux comprendre comment ces décisions sont prises. Cette enquête montre que la sédation est une pratique liminaire qui, pour ces praticiens, interroge certains principes des soins palliatifs.</p>
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