AMSTERDAM — Raising concern about possible unregulated euthanasia cases, researchers have claimed that Dutch doctors administer “terminal sedation” in four to 10 percent of patient deaths.
Researchers from the Erasmus Medical Centre and the Free University medical Centre in Amsterdam said some of these deaths verge on euthanasia and should possibly come into consideration for assessment as such.
Euthanasia has been legal in the Netherlands since April 2002, allowing assisted suicides if the patient officially requests to die, is suffering from extreme pain or a terminal illness and a second medical opinion has been sought. The Netherlands was the first nation to legalise euthanasia.
In administering terminal sedation, patients who are dying are given sedation that that keeps them in a coma until death. They also go without fluid and food, newspaper De Volkskrant reported on Tuesday.
In contrast to euthanasia, terminal sedation is not aimed at ending a patient’s life but the administering of drugs is often part of palliative care to combat pain, fear and distress.
But terminal sedation can result in the death of patients and its application has increased in recent years. It is sometimes an alternative to euthanasia, the newspaper reported.
According to the Rotterdam researchers, 43.8 percent of patient deaths in the Netherlands are the result of a “medical decision”. This includes the active ending of a patient’s life or deciding to no longer treat a patient. Ten percent of these decisions can be traced back to terminal sedation.
The researchers — who published their work in the academic periodical Annals of Internal Medicine on Tuesday — based their findings on the third large study into medical decisions around the ending of life. The study was published last year and asked 410 Dutch doctors whether they used terminal sedation and why.
The answers indicated that 52 percent had applied on occasion terminal sedation and in a large majority of these cases, the sedation was administered partly to hasten a patient’s death.
Terminal sedation does not need to be reported to authorities, but euthanasia does. A special commission then assesses the euthanasia case to determine if regulations were breached.
The Dutch public prosecution chief Joan de Wijkerslooth concluded in June that a grey area had developed between euthanasia and terminal sedation and urged for the implementation of better regulations.