Deep Sedation Becoming More Common for Dying Patients in Holland

Study doesn't make clear if practice is being carried out in lieu of euthanasia

By Steven Reinberg
HealthDay Reporter

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FRIDAY, March 21 (HealthDay News) -- Continuous deep sedation is becoming more common than euthanasia in the Netherlands when treating terminally ill patients who are nearing death, Dutch researchers report.

Euthanasia is legal in the Netherlands, but it's not clear from the study whether continuous deep sedation is being used as a substitute for euthanasia, or whether it's proving to be a better way to care for the terminally ill who would otherwise suffer an uncomfortable death.

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Deep sedation is often used when other methods of controlling pain or discomfort fail. The technique can be used intermittently or continuously until death occurs. The level of sedation can vary from a lowered state of consciousness to unconsciousness. Patients are often kept in deep sedation for several days before they die, the researchers noted.

"The increased use of continuous deep sedation for patients nearing death in the Netherlands suggests that this practice is increasingly considered as part of regular medical practice," said lead researcher Judith Rietjens, a postdoctoral researcher in the Department of Public Health at Erasmus University Medical Center in Rotterdam.

The increase in the use of continuous deep sedation may be explained by increased knowledge and media attention about the technique, Rietjens said. "Also, the use of continuous deep sedation may in some situations be a relevant alternative to the use of euthanasia for patients," she added.

An earlier study done in 2001 in six European countries found that deep sedation was used in 8.5 percent of all deaths in patients with cancer and other diseases. The technique was used both in and out of the hospital, researchers found.

For the new study, Rietjens's team collected data on 6,860 deaths that occurred between August and November 2005 in the Netherlands. The researchers found that the use of continuous deep sedation rose from 5.6 percent of all deaths in 2001 to 7.1 percent of deaths in 2005 -- an increase of 1,800 cases, the researchers noted.

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