Sociological and ethical reflections on the use of palliative sedation and medicalized end of life among professionals in the field of oncology

This interdisciplinary research project concerns the medicalized end of life and the practice of sedation in the various departments making up a cancer center. Sedation is the subject of law n°2016-87 Claeys-Leonetti. Among other things, this law promotes that under certain conditions and "at the patient's request, in order to avoid all suffering and not to undergo unreasonable obstinacy a deep and continuous sedation causing an alteration of consciousness maintained until death" may be proposed. Deep and continuous sedation until death raises ethical questions, as it leads to tensions between different wishes, responsibilities and legitimacies. It also raises sociological questions about the ways in which this practice is organized within institutions and services, particularly with regard to changes in routine or the distribution of body maintenance and personal care tasks. In general terms, the Claeys-Leonetti law highlights the issues surrounding medical decision-making, the place of the various players in it (healthcare professionals, patients, carers) and decision-support aids (recommendations, regulations, collegiality, "advance directives", etc.). Despite these challenges, the practice of sedation is still poorly understood in France, particularly in oncology. Our research is therefore based on an exploratory questionnaire survey of all caregivers at the Toulouse Oncopole (doctors, interns, nurses, care assistants, biologists, user representatives, etc.), to understand their knowledge of the Claeys-Leonetti law. Subsequently, she implements in-depth qualitative research, through focus groups with the various departments, individual interviews with professionals and non-participant observations.