Abstract：
BACKGROUND: The situation in France is unique, having a legal framework for continuous and deep sedation (CDS). However, its use in intensive care units (ICU), combined with the withdrawal of life-sustaining therapies, still raises ethical issues, particularly its potential to hasten death. The legalization of assistance in dying, i.e., assisted suicide or euthanasia at the patient\'s request, is currently under discussion in France. The objectives of this national survey were first, to assess whether ICU professionals perceive CDS administered to ICU patients as a practice that hastens death, in addition to relieving unbearable suffering, and second, to assess ICU professionals\' perceptions of assistance in dying.
METHODS: A national survey with online questionnaires for ICU physicians and nursesaddressed through the French Society of Anesthesiology and Critical Care Medicine.
RESULTS: A total of 956 ICU professionals responded to the survey (38% physicians and 62% nurses). Of these, 22% of physicians and 12% of nurses (p < 0.001) felt that the purpose of CDS was to hasten death. For 20% of physicians, CDS combined with terminal extubation was considered an assistance in dying. For 52% of ICU professionals, the current framework did not sufficiently cover the range of situations that occur in the ICU. A favorable opinion on the potential legalization of assistance in dying was observed in 83% of nurses and 71% of physicians (p < 0.001), with no preference between assisted suicide and euthanasia.
CONCLUSIONS: Our findings highlight the tension between CDS and assisted suicide/euthanasia in the specific context of intensive care and suggest that ICU professionals would be supportive of a legislative evolution.
METHODS: A national survey with online questionnaires for ICU physicians and nursesaddressed through the French Society of Anesthesiology and Critical Care Medicine.
RESULTS: A total of 956 ICU professionals responded to the survey (38% physicians and 62% nurses). Of these, 22% of physicians and 12% of nurses (p < 0.001) felt that the purpose of CDS was to hasten death. For 20% of physicians, CDS combined with terminal extubation was considered an assistance in dying. For 52% of ICU professionals, the current framework did not sufficiently cover the range of situations that occur in the ICU. A favorable opinion on the potential legalization of assistance in dying was observed in 83% of nurses and 71% of physicians (p < 0.001), with no preference between assisted suicide and euthanasia.
CONCLUSIONS: Our findings highlight the tension between CDS and assisted suicide/euthanasia in the specific context of intensive care and suggest that ICU professionals would be supportive of a legislative evolution.
摘要：
背景：法国的情况是独一无二的，具有持续深度镇静(CDS)的法律框架。然而,它在重症监护病房(ICU)中的使用，结合生命维持疗法的退出，仍然引发道德问题，尤其是它加速死亡的潜力。协助死亡的合法化，即，应患者要求协助自杀或安乐死，目前正在法国进行讨论。这次全国调查的目标首先是,评估ICU专业人员是否认为给予ICU患者CDS是一种加速死亡的做法，除了减轻难以忍受的痛苦，第二,评估ICU专业人员对死亡援助的看法。
方法：一项全国性调查，通过法国麻醉学和重症监护医学学会对ICU医师和护士进行在线问卷调查。
结果：共有956名ICU专业人员回答了调查（38％的医生和62％的护士）。其中,22％的医生和12％的护士（p<0.001）认为CDS的目的是加速死亡。对于20%的医生来说，CDS与末端拔管相结合被认为是死亡的辅助手段。对于52％的ICU专业人员，目前的框架没有充分涵盖ICU中发生的各种情况.在83％的护士和71％的医生中观察到关于死亡援助的潜在合法化的有利意见（p<0.001），在协助自杀和安乐死之间没有偏好。
结论：我们的研究结果强调了在重症监护的特定背景下CDS与辅助自杀/安乐死之间的紧张关系，并表明ICU专业人员将支持立法发展。
方法：一项全国性调查，通过法国麻醉学和重症监护医学学会对ICU医师和护士进行在线问卷调查。
结果：共有956名ICU专业人员回答了调查（38％的医生和62％的护士）。其中,22％的医生和12％的护士（p<0.001）认为CDS的目的是加速死亡。对于20%的医生来说，CDS与末端拔管相结合被认为是死亡的辅助手段。对于52％的ICU专业人员，目前的框架没有充分涵盖ICU中发生的各种情况.在83％的护士和71％的医生中观察到关于死亡援助的潜在合法化的有利意见（p<0.001），在协助自杀和安乐死之间没有偏好。
结论：我们的研究结果强调了在重症监护的特定背景下CDS与辅助自杀/安乐死之间的紧张关系，并表明ICU专业人员将支持立法发展。
