Opinions of the Dutch public on palliative sedation: a mixed-methods approach.
van der Kallen HT, Raijmakers NJ, Rietjens JA, van der Male AA, Bueving HJ, van Delden JJ, van der Heide A.
Br J Gen Pract. 2013 Oct;63(615):676-82.
Source
Departments of General Practice and Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands.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. Aim 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. Method 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).
Conclusion
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.
Design and setting
A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method 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).
Conclusion
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.
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