End-of-Life Sedation and Gendered Grief Pathways: A Longitudinal Qualitative Study of Spouses Bereaved by Cancer.

This study investigates how bereaved partners make sense of their spouse’s end of life when it involves continuous deep sedation until death (CDSUD) or intermittent sedation, and how these experiences shape the first year of grieving. Although CDSUD is legally defined in France, little is known about its psychological and relational consequences for close relatives. Using a longitudinal Interpretative Phenomenological Analysis (IPA), six partners who had lost a spouse to cancer were interviewed at three points—three, six, and twelve months after the death. Interviews explored experiences of illness, sedation, dying, and bereavement. Ten cross-cutting themes indicate that grief is a dynamic, evolving process characterized by emotional upheaval, shifting relational landscapes, and ongoing meaning-making. Sedation, particularly CDSUD, emerged as a liminal relational moment that signaled the end of mutual exchange and the beginning of symbolic separation. Early defensive strategies gradually gave way to symbolic resources that supported narrative integration. Continuing bonds, family relationships, and the quality of professional support strongly influenced the trajectory of bereavement, helping partners move from rupture toward an internalized, transformed relationship with the deceased. The findings highlight the relational and symbolic dimensions of end-of-life sedation and emphasize the need for psychologically attuned palliative care and bereavement.