Continuous Deep Sedation Until Death in Belgium: A Nationwide Survey

Chambaere, Kenneth; Bilsen, Johan; Cohen, Joachim; Rietjens, Judith Anna Cathari; Onwuteaka‐Philipsen, Bregje D.; Mortier, Freddy; Deliens, Luc

doi:10.1001/archinternmed.2009.542

Cited by 77 publications

(54 citation statements)

References 9 publications

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“…The estimated frequency of the use of palliative sedation varies considerably in scientific literature, partly due to differences in definition and research setting. Comparable nationwide studies showed frequencies in Europe of 2.5% up to 16% of all deaths 3–5. Continuous deep sedation was given up to the moment of death in 8.2% of all deaths in The Netherlands in 2005 6…”

Section: Introductionmentioning

confidence: 99%

Continuous palliative sedation until death: practice after introduction of the Dutch national guideline

Swart

Heide

Brinkkemper

et al. 2012

BMJ Support Palliat Care

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Section: Introductionmentioning

confidence: 99%

Continuous palliative sedation until death: practice after introduction of the Dutch national guideline

Swart

Heide

Brinkkemper

et al. 2012

BMJ Support Palliat Care

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“…Palliative sedation is found to be involved in about 14.5% of all cases (Chambaere, Bilsen, Cohen, Rietjens, et al, 2010).…”

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confidence: 99%

Attitudes of Belgian Students of Medicine, Philosophy, and Law Toward Euthanasia and the Conditions for Its Acceptance

et al. 2015

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Euthanasia is legal in Belgium if due care criteria are met, which is judged by committees including physicians, ethicists, and jurists. We examined whether students in these disciplines differ in how they judge euthanasia as an acceptable act. A cross-sectional, anonymous e-mail survey revealed that they have similar attitudes and accept its legalization. Therefore, joint decision-making of physicians, ethicists, and lawyers regarding euthanasia seems to have a common attitudinal base in Belgium. However, they differ to some extent regarding the conditions they put forward for euthanasia being acceptable. Philosophy of life (religion) was an independent predictor of these attitudes.

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“…This may lead to sedation not being discussed, or discussed only very late in the disease trajectory when the patient is suffering severely and obtaining her consent has become problematic or even impossible, thereby deflecting decision making to a third party 8. As mentioned above, available research indicates that, in Belgium in 2007, a request was made by the patient in only 10% of all continuous deep sedation (CDS) v cases, and in another 20% while there was no request, the patient had consented to CDS 6…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the reasons why CS should be initiated, existing guidelines leave some room for interpretation. One example of a difference in national practices is that in The Netherlands in 2001, in accordance with a Dutch guideline,4 the initiation of CS was requested or consented to by the patient in 59% of cases,5 while in Belgium in 2007, a request for or a consent to continuous sedation was obtained in only 30% of cases 6. This indicates that there might be many factors influencing whether, why and when medical practitioners decide on CS.…”

Section: Introductionmentioning

confidence: 99%

Factors that facilitate or constrain the use of continuous sedation at the end of life by physicians and nurses in Belgium: results from a focus group study

et al. 2012

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Continuous sedation at the end of life (CS) is the practice whereby a physician uses sedatives to reduce or take away a patient's consciousness until death. Although the incidence of CS is rising, as of yet little research has been conducted on how the administration of CS is experienced by medical practitioners. Existing research shows that many differences exist between medical practitioners regarding how and how often they perform CS. We conducted a focus group study to find out which factors may facilitate or constrain the use of continuous sedation by physicians and nurses. The participants often had clear ideas on what could affect the likelihood that sedation would be used. The physicians and nurses in the focus groups testified that the use of continuous sedation was facilitated in cases where a patient has a very limited life expectancy, suffers intensely, makes an explicit request and has family members who can cope with the stress that accompanies sedation. However, this 'paradigm case' was considered to occur only rarely. Furthermore, deviations from the paradigm case were said to be sometimes due to physicians initiating the discussion on CS too late or not initiating it at all for fear of inducing the patient. Deviations from the paradigm case may also occur when sedation proves to be too difficult for family members who are said to sometimes pressure the medical practitioners to increase dosages and speed up the sedation.

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Continuous Deep Sedation Until Death in Belgium: A Nationwide Survey

Abstract: Author Contributions: Dr Drekonja had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Johnson.

Cited by 77 publications

References 9 publications

Continuous palliative sedation until death: practice after introduction of the Dutch national guideline

Continuous palliative sedation until death: practice after introduction of the Dutch national guideline

Attitudes of Belgian Students of Medicine, Philosophy, and Law Toward Euthanasia and the Conditions for Its Acceptance

Factors that facilitate or constrain the use of continuous sedation at the end of life by physicians and nurses in Belgium: results from a focus group study

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