Study signals Dutch switch to drugs from euthanasia

LONDON (Reuters) - Terminally-ill patients in theNetherlands increasingly receive drugs to render themunconscious until death, according to a study that suggestspeople are substituting deep sedation for legal euthanasia.

The researchers found that 1,800 people -- 7.1 percent ofall deaths in the Netherlands in 2005 -- were drugged intoso-called continuous deep sedation shortly before dying. Thiscompares with 5.6 percent of cases in 2001.

At the same time, the use of euthanasia fell from 2.6percent of all deaths to 1.7 percent, representing a decreaseof 1,200 cases, the researchers reported in the British MedicalJournal on Friday.

"The increased use of continuous deep sedation for patientsnearing death in the Netherlands and the limited use ofpalliative consultation suggests that this practice isincreasingly considered as part of a regular medical practice,"Judith Rietjens of Erasmus University Medical Centre inRotterdam and colleagues wrote.

In 2001, the Netherlands became the first country tolegalise adult euthanasia, a move condemned by the RomanCatholic Church. It has since been adopted by Belgium, andother European states are investigating allowing it.

While euthanasia is regulated by law and carries strictconditions, deep sedation is considered part of regular medicalpractice and typically used in the last few weeks in life,Rietjens said.

"The practice of sedating medicines is used in othercountries not just the Netherlands," she said. "It is used inthe last phase of life for people with symptoms that can't betreated."

The researchers looked at more than 6,500 deaths across theNetherlands in 2005 and found that about one in ten people whoreceived continuous deep sedation had previously requestedeuthanasia or assisted suicide, but been rejected.

The people most likely to request deep sedation were thosewith terminal cancer treated by a family doctor, a group alsolikely to choose euthanasia -- suggesting patients may beswapping one practice for another, Rietjens added.

Further research is needed to learn why people are turningto sedation and whether factors such as increasing mediaattention or religious views are playing a role, she said.

"The findings really indicate the increase in continuousdeep sedation is partly related to a decrease in euthanasia,"she said. "There may be some sort of substitution takingplace."

Ira Byock, Director of Palliative Medicine at DartmouthMedical School in New Hampshire in the United States, noted ina commentary there was some concern continuous deep sedationcould enable doctors to evade requirements for euthanasia.

He called for further research into deep sedation thatincorporates the views of patients and families, health careprofessionals as well as experts in law and ethics.

(Reporting by Michael Kahn; Editing by Maggie Fox andMatthew Jones)