• Br J Gen Pract · Oct 2013

    Opinions of the Dutch public on palliative sedation: a mixed-methods approach.

    • Hilde T H van der Kallen, Natasja J H Raijmakers, Judith A C Rietjens, Alex A van der Male, Herman J Bueving, Johannes J M van Delden, and Agnes van der Heide.
    • Departments of General Practice and Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
    • Br J Gen Pract. 2013 Oct 1;63(615):e676-82.

    BackgroundPalliative sedation is defined as deliberately lowering a patient's consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia.AimTo inform healthcare professionals about attitudes of the general public regarding palliative sedation. design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews.MethodOne thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing palliative sedation (response rate 78%); 16 participants were interviewed.ResultsIn total, 22% of the responders indicated knowing the term 'palliative sedation'. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient's life (79%, P = 0.54).ConclusionMost of the general public accept the use of palliative sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what palliative sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options.

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