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            "title": "Questions éthiques associées à la pratique de la sédation en phase terminale",
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                    "firstName": "Jean-Claude",
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                    "firstName": "Suzanne",
                    "lastName": "Rameix"
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            "abstractNote": "Résumé\nLa pratique de la sédation en phase terminale pose de nombreuses questions éthiques : il s’agit de la terminologie employée, des indications, de la définition des symptômes réfractaires, des frontières entre sédation et euthanasie. Les interrogations éthiques sont plus importantes dans certaines situations comme lorsque la souffrance est essentiellement psychique ou lors des arrêts ou abstentions thérapeutiques. La distinction avec l’euthanasie directe semble imprécise pour un grand nombre de médecins. Les auteurs analysent ce point en se référant aux données factuelles et analyses relatives à la situation aux Pays-Bas, aux controverses liées aux décisions d’abstention ou d’arrêt de l’hydratation et aux prescriptions dont la finalité est extrinsèque aux buts thérapeutiques. Les auteurs discutent les critères habituellement retenus pour faire la distinction entre sédation et euthanasie : l’intention du prescripteur, le respect de l’autonomie du patient, le principe de proportionnalité et la règle du double effet. Le respect attentif de procédures est utile pour la validité éthique de la décision : il s’agit de la délibération collégiale, du respect de l’avis du patient, de la visibilité de la décision ; il faut cependant souligner les limites des solutions exclusivement procédurales.\nSummary\nThe practice of terminal sedation brings up a number of ethical questions about terminology, indications, definition of the refractory symptoms and dividing line between sedation and euthanasia. The questions are more important in situations like psycho-existential suffering or withdrawal/withholding of treatment. For number of physicians, palliative sedation has an unclear border with euthanasia. The authors analyze this aspect by referring to the factual data and ethical analyses relative to the situation in the Netherlands, to the controversies about withdrawal/withholding hydration and to decisions of sedation which are extrinsic of the therapeutic goal. The authors discuss the criteria usually retained to make a distinction between sedation and euthanasia: physician's intention, respect for patient's autonomy, principle of proportionality and rule of the double effect. Careful procedures can be a mark of ethical decision-making: there is question of collectively deliberation, respect to the patient's opinion, decision's visibility; after all, emphasis is made on the limits of exclusively procedural solutions.",
            "publicationTitle": "Médecine Palliative : Soins de Support - Accompagnement - Éthique",
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            "date": "juin 2010",
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                    "firstName": "Julie",
                    "lastName": "Mazoyer"
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