The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study
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 freq...
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| Format: | Article |
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Elsevier
2012
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| Online Access: | https://eprints.nottingham.ac.uk/2743/ |
| _version_ | 1848790864355131392 |
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| author | Anquinet, Livia Rietjens, Judith A.C. Seale, Clive Seymour, Jane Deliens, Luc van der Heide, Agnes |
| author_facet | Anquinet, Livia Rietjens, Judith A.C. Seale, Clive Seymour, Jane Deliens, Luc van der Heide, Agnes |
| author_sort | Anquinet, Livia |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T18:19:23Z |
| format | Article |
| id | nottingham-2743 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T18:19:23Z |
| publishDate | 2012 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-27432020-05-04T20:21:29Z https://eprints.nottingham.ac.uk/2743/ 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 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. Elsevier 2012-07 Article PeerReviewed Anquinet, Livia, Rietjens, Judith A.C., Seale, Clive, Seymour, Jane, Deliens, Luc and van der Heide, Agnes (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). pp. 33-43. ISSN 0885-3924 http://www.sciencedirect.com/science/article/pii/S0885392412000632 doi:10.1016/j.jpainsymman.2011.07.007 doi:10.1016/j.jpainsymman.2011.07.007 |
| spellingShingle | Anquinet, Livia Rietjens, Judith A.C. Seale, Clive Seymour, Jane Deliens, Luc van der Heide, Agnes The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study |
| title | The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study |
| title_full | The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study |
| title_fullStr | The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study |
| title_full_unstemmed | The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study |
| title_short | The practice of continuous deep sedation until death in Flanders (Belgium), The Netherlands, and the U.K.: a comparative study |
| title_sort | practice of continuous deep sedation until death in flanders (belgium), the netherlands, and the u.k.: a comparative study |
| url | https://eprints.nottingham.ac.uk/2743/ https://eprints.nottingham.ac.uk/2743/ https://eprints.nottingham.ac.uk/2743/ |