ArticlePalliative care2019
Reflections on palliative sedation.
Article in Palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical Practice Guidelines on Palliative Sedation Around the World: A Systematic Review.Journal of palliative care · 2025Pooled it
- Real-world ethics in palliative care: A systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice.Palliative medicine · 2021Pooled it
- What do you mean by "palliative sedation"? : Pre-explicative analyses as preliminary steps towards better definitions.BMC palliative care · 2020Pooled it
- Double-effect sedation: do physicians not intend a decrease in consciousness when it is caused by drugs that can also reduce specific symptoms?Journal of medical ethics · 2026Article
- Why administration of lethal drugs should not be the role of the doctor.Journal of medical ethics · 2026Article
- The decision-making process for sedation in specialist palliative care: a qualitative interview study with team members, relatives, and patients.BMC palliative care · 2026Article
- Healthcare professionals' perceptions of ethical issues in palliative sedation: A moral case deliberation study in eight European countries.Palliative care and social practice · 2026Article
- Variability of sedation practices in palliative care unit in France: a six units retrospective analysis.BMC palliative care · 2025Article
- Article
- Palliative use of midazolam in acute geriatric units: a multicenter ambispective study.BMC geriatrics · 2025Article
- An easier way to die?-A qualitative interview study on specialist palliative care team members' views on dying under sedation.Palliative medicine · 2025Article
- The development of a core outcome set for evaluating and enhancing palliative sedation in clinical research and practice: The COSEDATION study protocol.Palliative care and social practice · 2025Article
- Palliative sedation at the end of life: prevalence, characteristics and possible determinants.BMC palliative care · 2024Article
- Dexmedetomidine Versus Midazolam for End-of-Life Sedation and Agitation: Protocol for a Randomized Controlled Trial (The DREAMS Trial).JMIR research protocols · 2024Article
- Continuous palliative sedation until death: a qualitative study of palliative care clinicians' experiences.BMC palliative care · 2024Article
- Misconception between palliative care and euthanasia among Thai general practitioners: a cross-sectional study.BMC palliative care · 2024Observational
- Terminological Confusion About Sedation in Palliative Care: Results of an International Online Vignette Survey.Journal of palliative medicine · 2024Article
- Practices of and Perspectives on Palliative Sedation Among Palliative Care Physicians in Ontario, Canada: A Mixed-Methods Study.Palliative medicine reports · 2024Article
- Position statement of the Brazilian Palliative Care Academy on withdrawing and withholding life-sustaining interventions in the context of palliative care.Critical care science · 2024Article
- Continuous deep sedation at the end of life: a qualitative interview-study among health care providers on an evolving practice.BMC palliative care · 2023Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
'Palliation sedation' is a widely used term to describe the intentional administration of sedatives to reduce a dying person's consciousness to relieve intolerable suffering from refractory symptoms. Research studies generally focus on either 'continuous sedation until death' or 'continuous deep sedation'. It is not always clear whether instances of secondary sedation (i.e. caused by specific symptom management) have been excluded. Continuous deep sedation is controversial because it ends a person's 'biographical life' (the ability to interact meaningfully with other people) and shortens 'biological life'. Ethically, continuous deep sedation is an exceptional last resort measure. Studies suggest that continuous deep sedation has become 'normalized' in some countries and some palliative care services. Of concern is the dissonance between guidelines and practice. At the extreme, there are reports of continuous deep sedation which are best described as non-voluntary (unrequested) euthanasia. Other major concerns relate to its use for solely non-physical (existential) reasons, the under-diagnosis of delirium and its mistreatment, and not appreciating that unresponsiveness is not the same as unconsciousness (unawareness). Ideally, a multiprofessional palliative care team should be involved before proceeding to continuous deep sedation. Good palliative care greatly reduces the need for continuous deep sedation.
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