Terminal sedation [English translation of chapter 2 from: 'Signalering ethiek en gezondheid 2004' (2004/12)]

Terminal sedation is the procedure whereby a patient is placed into a deep sleep with the expectation that this will be maintained until he or she dies. Artificial administration of food and fluid is often withdrawn at the same time. This leads to a marked decline in the patient’s consciousness up till death, and may also shorten his or her life. It is important that fundamental values and norms are not violated during this process, and that the patient continues to be treated with due care. This report indicates that opportunities for monitoring and encouraging this process will increase if terminal sedation administered on sound medical grounds is regulated by the medical profession itself on the basis of its own standards. This means that if terminal sedation has a life-shortening effect, then the physician’s ‘intention’ when taking this action is no longer a decisive factor in deciding whether or not the physician has (criminally) ended the patient’s life.