This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on ISI (2)  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in this journal  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Rietjens et al¹ compared the practices of palliative sedation and euthanasia in the Netherlands. Two conclusions deserve further attention. In 36% of the patients, palliative sedation was performed with morphine only. The estimated life shortening due to sedatives (including morphine) was 1 to 4 weeks in 21% and more than 1 month in 6%.

Palliative sedation is considered to be an effective treatment for dispelling refractory symptoms in patients near death. Benzodiazepines such as midazolam are proper sedatives for palliative care for patients with refractory symptoms such as delirium and terminal agitation. Palliation of pain or dyspnea first requires opioids. Although many palliative patients receive opioids prior to the initiation of palliative sedation, opioids are empirically not effective at producing sustained sedation.

Delirium is one of the distressing symptoms at the end of life, requiring palliative sedation. Terminal delirium has multiple causes, and recent studies suggest that accumulations of toxic . . . [Full Text of this Article]

AUTHOR INFORMATION
Erwin J. O. Kompanje, PhD; Lia van Zuylen, MD, PhD; C. C. D. (Karin) van der Rijt, MD, PhD

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTER

Morphine Is Not a Sedative and Does Not Shorten Life—Reply
Judith A. C. Rietjens, Johannes J. M. van Delden, Agnes van der Heide, Astrid M. Vrakking, Bregje D. Onwuteaka-Philipsen, Paul J. van der Maas, and Gerrit van der Wal
Arch Intern Med. 2006;166(18):2047-2048.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Terminal Sedation and Euthanasia: A Comparison of Clinical Practices
Judith A. C. Rietjens, Johannes J. M. van Delden, Agnes van der Heide, Astrid M. Vrakking, Bregje D. Onwuteaka-Philipsen, Paul J. van der Maas, and Gerrit van der Wal
Arch Intern Med. 2006;166(7):749-753.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Improving Prescription in Palliative Sedation: Compliance With Dutch Guidelines
Hasselaar et al.
Arch Intern Med 2007;167:1166-1171.
ABSTRACT | FULL TEXT