Pediatrician Ambiguity in Understanding Palliative Sedation at the End of Life

Context:Palliative sedation is a means of relieving intractable symptoms at the end of life, however, guidelines about its use lack consistency. In addition, ethical concerns persist around the practice. There are reports of palliative sedation in the pediatric literature, which highlight various institutional perspectives.Objectives:This survey of 4786 pediatric providers sought to describe their knowledge of and current practices around pediatric palliative sedation.Methods:Our survey was administered to pediatricians who care for children at the end of life. The survey assessed agreement with a definition of palliative sedation, as well as thoughts about its alignment with aggressive symptom management. Bivariate analyses using χ2 and analysis of variance were calculated to determine the relationship between responses to closed-ended questions. Open-ended responses were thematically coded by the investigators and reviewed for agreement.Results:Nearly half (48.6%) of the respondents indicated that the s...