Development of a clinical guideline for palliative sedation therapy using the Delphi method.

Background: Although palliative sedation therapy is often used in palliative care settings, no clinical guideline is available.

Objective: To construct a clinical guideline for palliative sedation therapy.

Design: The consensus methods using the Delphi technique on the basis of a systematic literature review was used.

Setting/subjects: A national multidisciplinary committee (five palliative care physicians, four nurses, two oncologists, two psychiatrists, two anesthesiologists, two bioethicists, a medical social worker, and a lawyer).

Measurements: Validity scoring based on the Delphi method and feasibility.

Results: After three sequential sessions of discussion by the Delphi method, an external review by specialists, end-users, and bereaved family members, and a field test, a clinical guideline for palliative sedation therapy was constructed. This guideline includes definitions of palliative sedation therapy, description of the ethical basis of palliative sedation therapy, recommendations about clinical practices in continuous-deep sedation, and diagrams illustrating the clinical application of continuous-deep sedation.

Conclusion: We constructed a clinical guideline for palliative sedation therapy using the Delphi technique. The clinical efficacy of this guideline should be tested in the future.