Sedation in palliative medicine: The need for terminological and conceptual adjustment

Introduction. In France "sedation in palliative medicine" is the subject of medical, legal and socio-political discussions, linked to the delicate ethical question posed by the limits between life and death. A careful reading of the "official French texts" concerning this issue immediately reveals intra-textual, inter-textual and inter-discursive terminological and conceptual inconsistencies. To our knowledge no semantic analysis has been published. Aim of the study. To establish an "inventory", identifying the term sedation, its derivatives and related expressions through the French official texts and studying their meaning; to understand which expressions are privileged and in which speeches; to know if the change concerning the medical, legal and socio-political reference framework has an impact on the conceptualization of such terms and associated expressions. Material and methods. Nine "French official texts" about the sedation in palliative medicine have been selected and organized into typologies: medical speech, legal speech and sociopolitical speech. The analysis unfolds in three steps: identification of the semes via the explicit definitions of "sedation", followed by a conceptual approach and finally a quantitative study and a qualitative study. Results. Explicit definitions were identified in five texts. A total of 75 associated expressions were counted. Important terminological and conceptual variations can be observed on an inter textual level, making any inter-discursive analysis difficult or even impossible. Discuss/on. The first objective has been achieved; the other two require deepening. The assessment has shown three new aspects. Three generic terms/expressions and their respective definitions were discussed. A generic expression and its definition princeps have been suggested. Conclusion. Knowing that "speaking is a form of action on others and not just a representation of the world", the terminological and conceptual consistency has to be required. (C) 2016 Elsevier Masson SAS. All rights reserved.