We read with great interest the article of Rietjens et al
1about continuous deep sedation in Netherlands. The authors compared the rate of deep sedation at the end of life in 2005, 2010, and 2015, and they found a considerable increase of this practice throughout the years, especially for older and cancer patients. Palliative sedation (PS) often represents a fundamental tool in long-term care medicine for physicians attending to terminally ill patients, when no other treatments can relieve their suffering. End-of-life periodically steps into the limelight because of all its ethical, religious, and legal implications. The right to decide on one's own life often comes into conflict with states' laws.
- Rietjens J.A.C.
- Heijltjes M.T.
- van Delden JJM
- et al.
The rising frequency of continuous deep sedation in the Netherlands, a repeated cross-sectional survey in 2005, 2010, and 2015.
J Am Med Dir Assoc. 2019; 20: 1367-1372
- Servillo G.
- Striano P.
End-of-life: Still an Italian dilemma.
Intensive Care Med. 2008; 34: 1333-1335
3In this respect, Netherlands is one of the most advanced nations in terms of cutting-edge legislation about end-of-life, but not all countries have shown such sensitivity toward these issues over the years. We would like to highlight some outstanding questions regarding PS and the gap between its purposes and its application in clinical practice.
- Servillo G.
- Vargas M.
End of life in intensive care unit.
Transl Med UniSa. 2011; 1: 237-242
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- The rising frequency of continuous deep sedation in the Netherlands, a repeated cross-sectional survey in 2005, 2010, and 2015.J Am Med Dir Assoc. 2019; 20: 1367-1372
- End-of-life: Still an Italian dilemma.Intensive Care Med. 2008; 34: 1333-1335
- End of life in intensive care unit.Transl Med UniSa. 2011; 1: 237-242
- Palliative sedation in end-of-life care.Curr Opin Oncol. 2013; 25: 360-367
- Continuous palliative sedation for patients with advanced cancer at a tertiary care cancer center.BMC Palliat Care. 2018; 17: 13
- Palliative sedation therapy does not hasten death: Results from a prospective multicenter study.Ann Oncol. 2009; 20: 1163-1169
- The physiologic effects of pain on the endocrine system.Pain Ther. 2013; 2: 75-86
- Palliative sedation: The position statement of the Italian National Committee for Bioethics.Minerva Anestesiol. 2017; 83: 524-528
- Informed consent for tracheostomy procedures in Intensive Care Unit: An Italian national survey.Minerva Anestesiol. 2013; 79: 741-749
- Changing the Italian rules on the legal representative: The Cirinnà Act.Minerva Anestesiol. 2017; 83: 903-905
Published online: May 10, 2020
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