Kennis en opvattingen van het Nederlandse publiek over palliatieve sedatie*

Onderzoek
13-02-2014
Hilde T.H. van der Kallen, Natasja J.H. Raijmakers, Judith A.C. Rietjens, Alex A. van der Male, Herman J. Bueving, Johannes J.M. van Delden en Agnes van der Heide

Opinions of the Dutch public on palliative sedation: a mixed method approach

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

A cross-sectional survey among members of the Dutch general public followed by qualitative interviews.

Method

1960 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. 81% 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.

Conflict of interest: none declared. Financial support: This study was supported via ZonMw. The sponsors approved the study design, but were not involved in the collection, analysis and interpretation of data.