title: Opinions of the Dutch public on palliative sedation: a mixed-methods approach.
abstract: BACKGROUND
  Palliative 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.
  
  
  OBJECTIVE
  To 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.
  
  
  METHODS
  One 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.
  
  
  RESULTS
  In 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).
  
  
  CONCLUSIONS
  Most 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.
authors.affiliation: Departments of General Practice and Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
authors.forename: Hilde T H
authors.initials: HT
authors.lastname: van der Kallen
authors.forename: Natasja J H
authors.initials: NJ
authors.lastname: Raijmakers
authors.forename: Judith A C
authors.initials: JA
authors.lastname: Rietjens
authors.forename: Alex A
authors.initials: AA
authors.lastname: van der Male
authors.forename: Herman J
authors.initials: HJ
authors.lastname: Bueving
authors.forename: Johannes J M
authors.initials: JJ
authors.lastname: van Delden
authors.forename: Agnes
authors.initials: A
authors.lastname: van der Heide
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010166:Palliative Care / Q000523:psychology*; D011368:Professional-Family Relations; D011639:Public Opinion; D013727:Terminal Care / Q000523:psychology*
chemical_list: D006993:Hypnotics and Sedatives