title: Continuous deep sedation for patients nearing death in the Netherlands: descriptive study.
abstract: OBJECTIVE
  To study the practice of continuous deep sedation in 2005 in the Netherlands and compare it with findings from 2001.
  
  
  METHODS
  Questionnaire study about random samples of deaths reported to a central death registry in 2005 and 2001.
  
  
  METHODS
  Nationwide physician study in the Netherlands.
  
  
  METHODS
  Reporting physicians received a questionnaire about the medical decisions that preceded the patient's death; 78% (n=6860) responded in 2005 and 74% (n=5617) in 2001.
  
  
  METHODS
  Characteristics of continuous deep sedation (attending physician, types of patients, drugs used, duration, estimated effect on shortening life, palliative consultation). Requests for euthanasia.
  
  
  RESULTS
  The use of continuous deep sedation increased from 5.6% (95% confidence interval 5.0% to 6.2%) of deaths in 2001 to 7.1% (6.5% to 7.6%) in 2005, mostly in patients treated by general practitioners and in those with cancer (in 2005, 47% of sedated patients had cancer v 33% in 2001). In 83% of cases sedation was induced by benzodiazepines, and in 94% patients were sedated for periods of less than one week until death. Nine per cent of those who received continuous deep sedation had previously requested euthanasia but their requests were not granted. Nine per cent of the physicians had consulted a palliative expert.
  
  
  CONCLUSIONS
  The increased use of continuous deep sedation for patients nearing death in the Netherlands and the limited use of palliative consultation suggests that this practice is increasingly considered as part of regular medical practice.
authors.affiliation: Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, Netherlands. j.rietjens@erasmusmc.nl
authors.forename: Judith
authors.initials: J
authors.lastname: Rietjens
authors.forename: Johannes
authors.initials: J
authors.lastname: van Delden
authors.forename: Bregje
authors.initials: B
authors.lastname: Onwuteaka-Philipsen
authors.forename: Hilde
authors.initials: H
authors.lastname: Buiting
authors.forename: Paul
authors.initials: P
authors.lastname: van der Maas
authors.forename: Agnes
authors.initials: A
authors.lastname: van der Heide
mesh_terms: D000328:Adult; D000368:Aged; D054810:Deep Sedation / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008875:Middle Aged; D009426:Netherlands; D011364:Professional Practice / Q000706:statistics & numerical data; D012042:Registries; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods*; D019452:Terminally Ill
chemical_list: D006993:Hypnotics and Sedatives