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Dutch Doctors Make Increasing Use of Deep Sedation

Change takes place in groups where euthanasia common; cases of euthanasia also have declined

FRIDAY, March 21 (HealthDay News) -- An increasing number of patients nearing death in the Netherlands are being put under continuous deep sedation, according to a report released March 20 in BMJ Online First.

Judith Rietjens, of Erasmus MC in Rotterdam, the Netherlands, and colleagues conducted a questionnaire-based study of medical decisions taken by 6,860 physicians in 2005. Of these, 5,617 had completed a similar questionnaire in 2001.

Whereas 5.6 percent of the reported deaths in 2001 were preceded by continuous deep sedation, this was used in 7.1 percent of cases in 2005, the researchers found. Of these, 47 percent were cancer patients in 2005, versus 33 percent in 2001. Benzodiazepines, the recommended drug for continuous deep sedation, was used in 83 percent of cases in 2005, and 94 percent of patients were under sedation for less than seven days, the report indicates. Only 9 percent of doctors consulted a palliative expert, and 9 percent of patients had previously been denied their request for euthanasia.

"Continuous deep sedation has possibly increasingly been used as a relevant alternative to euthanasia," the authors write. "This increase took place mostly in the subgroups in which euthanasia is most common: patients attended by general practitioners and those with cancer."

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