British Doctors admit to practising 'slow euthanasia' on terminally-ill patients

by Daniel Martin

Mail Online News

29th October 2009

One in five doctors admit to keeping the terminally-ill heavily sedated until they die, in what critics have dubbed 'slow euthanasia'.
A poll of nearly 3,000 doctors found that 18.7 per cent had administered drugs to keep patients suffering from painful conditions such as cancer unconscious for hours at a time.

Subjected to 'continuous deep sedation', many slip into a drug-induced coma before dying - perhaps days earlier than they would have done. It is often given without the patient or the family being fully appraised of the consequences.

The survey found that GPs and hospital consultants who were not palliative care specialists were more likely to report using high doses of sedatives or painkillers to keep patients unconscious.

Experts have called for all doctors to be properly trained in the care of dying patients.

The study in the Journal of Pain and Symptom Management also found that those who were strong supporters of assisted dying were 40 per cent more likely to use deep sedation to ease the final stretch of a patient's life.

But those with strong religious beliefs were less likely to use sedation to ease a patient's pain.

The drugs were used for just a short period of time right at the end of someone's life. But in 8 per cent of cases, deep sedation was used for more than a week.
Continuous deep sedation was used more frequently in the hospital or in people's homes than in care homes or hospices, the poll shows.

There was no evidence it was used more often amongst vulnerable groups of patients, such as older people or those with dementia. It was sued more frequently to treat younger men with cancer.

Simon Chapman, director of policy at the National Council for Palliative Care, said: 'Sedation is recognised as being an appropriate part of end-of-life care for some patients.

'However it is concerning that some doctors are not using the appropriate drugs to provide it. We believe that training in palliative medicine should become mandatory for all doctors as a vital step towards improving end of life care in Britain.'

The survey also showed that most hospital doctors used the drug midazolam, which causes memory loss and loss of consciousness. But almost a quarter used opiate painkillers such as morphine - even though palliative care specialists would never use this drug alone.

Lead researcher Clive Seale, professor of medical sociology at Queen Mary, University of London, said: 'The widely accepted view is that midazolam is the first-time choice for providing sedation at the end of life, that use of opioids alone for this purpose is to discouraged, and that a decision to provide sedation should be accompanied by advice from palliative medicine specialists.'

The National Council for Palliative Care estimates that 300,000 people die every year without specialist care which can improve their death.
Cancer patients account for 95 per cent of specialist palliative care beds, even though cancer accounts for just a quarter of all deaths.

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