Continuous deep sedation in patients nearing death

doi:10.1136/bmj.39511.514051.80

BMJ 2008;336:781-782 (12 April), doi:10.1136/bmj.39511.514051.80 (published 14 March 2008)

Editorials

Continuous deep sedation in patients nearing death

Imprecise taxonomy makes interpreting trends difficult

The first 150 words of the full text of this article appear below.

Deep sedation is occasionally the only effective treatment forrefractory symptoms and suffering in terminally ill patients.In their accompanying study, Rietjens and colleagues reporta significant rise in continuous deep sedation in the Netherlandsfrom 5.6% in 2001 to 7.1% in 2005, while cases of euthanasiadeclined over the same period.¹

Continuous deep sedation is an accepted treatment in the Netherlandsfor patients whose life expectancy is two weeks or less. TheDutch study reports that 1200 fewer people died as a resultof euthanasia but 1800 more died as a result of terminal sedationin 2005 than in 2001. Although the increase follows the publicationin 2002 of guidelines for general practitioners on the use ofcontinuous deep sedation, and attention in the Dutch media,the cause of this trend is unclear. There is concern that continuousdeep sedation may enable doctors to evade the procedural requirementsfor . . . [Full text of this article]

Scott A Murray, St Columba’s professor of primary palliative care¹, Kirsty Boyd, consultant in palliative medicine², Ira Byock, director of palliative medicine and professor of anesthesiology and community and family medicine³

¹ Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX, ² Palliative Care Service, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, ³ Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756-0001, USA

Scott.Murray@ed.ac.uk

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Please, don’t forget ethical responsibilities: Philip J Harrison
BMJ 2008 336: 1085. [Extract] [Full Text] [PDF]

Continuous deep sedation for patients nearing death in the Netherlands: descriptive study: Judith Rietjens, Johannes van Delden, Bregje Onwuteaka-Philipsen, Hilde Buiting, Paul van der Maas, and Agnes van der Heide
BMJ 2008 336: 810-813. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Harrison, P. J (2008). Please, don't forget ethical responsibilities. BMJ 336: 1085-1085 [Full text]
Treloar, A. J (2008). Dutch research reflects problems with the Liverpool care pathway. BMJ 336: 905-905 [Full text]

Rapid Responses:

Read all Rapid Responses

A term impossible to define?: Don C Aston
bmj.com, 11 Apr 2008 [Full text]
Please, dont forget ethical responsibities: Philip J. Harrison
bmj.com, 22 Apr 2008 [Full text]
Continuous Deep Sedation in the UK- Dutch research reflects problems with the Liverpool Care Pathway: Adrian J Treloar
bmj.com, 14 Apr 2008 [Full text]
Helpful Article: Graeme M Mackenzie
bmj.com, 14 Apr 2008 [Full text]
Continuous Deep Sedation and LCP concerns: Fiona M Downs, et al.
bmj.com, 16 Apr 2008 [Full text]
Re: Continuous Deep Sedation and LCP concerns: Mary Knowles
bmj.com, 17 Apr 2008 [Full text]
Re: Continuous Deep Sedation in the UK- Dutch research reflects problems with the Liverpool Care Pathway: John E Ellershaw
bmj.com, 4 May 2008 [Full text]
LCP concerns;- clarifications and an apology: Adrian Treloar
bmj.com, 6 May 2008 [Full text]
Palliative care and sedation: the Liverpool Care Pathway: Gillian M Craig
bmj.com, 19 May 2008 [Full text]
LCP - amend , don't abandon: Ian N Back
bmj.com, 21 May 2008 [Full text]