Original Article
Continuous Deep Sedation: Physicians' Experiences in Six European Countries

https://doi.org/10.1016/j.jpainsymman.2005.07.004Get rights and content
Under an Elsevier user license
open archive

Abstract

Continuous deep sedation (CDS) is sometimes used to treat refractory symptoms in terminally ill patients. The aim of this paper was to estimate the frequency and characteristics of CDS in six European countries: Belgium, Denmark, Italy, The Netherlands, Sweden, and Switzerland. Deaths reported to death registries were sampled and the reporting doctors received a mailed questionnaire about the medical decision making that preceded the death of the patient. The total number of deaths studied was 20,480. The response rate ranged between 44% (Italy) and 75% (The Netherlands). Of all deaths, CDS was applied in 2.5% in Denmark and up to 8.5% in Italy. Of all patients receiving CDS, 35% (Italy) and up to 64% (Denmark and The Netherlands) did not receive artificial nutrition or hydration. Patients who received CDS were more often male, younger than 80 years old, more likely to have had cancer, and died more often in a hospital compared to nonsudden deaths without CDS. The high variability of frequency and characteristics of CDS in the studied European countries points out the importance of medical education and scientific debate on this issue.

Key Words

Sedation
palliative care
medical end-of-life decisions

Cited by (0)

This study was supported by a grant from the fifth Framework program of the European Commission (Contract QLRT-1999-30859). The Swiss part of the project was funded by the Swiss Federal Office for Education and Research (Contract BBW 99.0889).