Livia Anquinet
The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study
Anquinet, Livia; Rietjens, Judith A.C.; Seale, Clive; Seymour, Jane; Deliens, Luc; van der Heide, Agnes
Authors
Judith A.C. Rietjens
Clive Seale
Jane Seymour
Luc Deliens
Agnes van der Heide
Abstract
Context:Existing empirical evidence shows that continuous deep sedation until death is given in about 15% of all deaths in Flanders, Belgium (BE), 8% in The Netherlands (NL), and 17% in the U.K.
Objectives:This study compares characteristics of continuous deep sedation to explain these varying frequencies.
Methods:In Flanders, BE (2007) and NL (2005), death certificate studies were conducted. Questionnaires about continuous deep sedation and other decisions were sent to the certifying physicians of each death from a stratified sample (Flanders, BE: n = 6927; NL: n = 6860). In the U.K. in 2007–2008, questionnaires were sent to 8857 randomly sampled physicians asking them about the last death attended.
Results:The total number of deaths studied was 11,704 of which 1517 involved continuous deep sedation. In Dutch hospitals, continuous deep sedation was significantly less often provided (11%) compared with hospitals in Flanders, BE (20%) and the U.K. (17%). In U.K. home settings, continuous deep sedation was more common (19%) than in Flanders, BE (10%) or NL (8%). In NL in both settings, continuous deep sedation more often involved benzodiazepines and lasted less than 24 hours. Physicians in Flanders combined continuous deep sedation with a decision to provide physician-assisted death more often. Overall, men, younger patients, and patients with malignancies were more likely to receive continuous deep sedation, although this was not always significant within each country.
Conclusion:Differences in the prevalence of continuous deep sedation appear to reflect complex legal, cultural, and organizational factors more than differences in patients’ characteristics or clinical profiles. Further in-depth studies should explore whether these differences also reflect differences between countries in the quality of end-of-life care.
Citation
Anquinet, L., Rietjens, J. A., Seale, C., Seymour, J., Deliens, L., & van der Heide, A. (2012). The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study. Journal of Pain and Symptom Management, 44(1), https://doi.org/10.1016/j.jpainsymman.2011.07.007
Journal Article Type | Article |
---|---|
Publication Date | Jul 1, 2012 |
Deposit Date | Apr 1, 2014 |
Publicly Available Date | Apr 1, 2014 |
Journal | Journal of Pain and Symptom Management |
Print ISSN | 0885-3924 |
Electronic ISSN | 1873-6513 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 44 |
Issue | 1 |
DOI | https://doi.org/10.1016/j.jpainsymman.2011.07.007 |
Public URL | https://nottingham-repository.worktribe.com/output/1006992 |
Publisher URL | http://www.sciencedirect.com/science/article/pii/S0885392412000632 |
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