Sedation can be defined as the pharmacological induction of a state of impaired consciousness in which the patient is not fully unconscious, and can be aroused verbally or by applying a mild painful stimulus. In both the United States and the Netherlands, sedation is described in diverse terms, and there are agreements among American and Dutch physicians on the various possibilities in the use of sedation. Many Dutch physicians justify its use, because they state that it does not hasten death in their patients, while most American doctors believe that it might do so, but that its use would be justifiable, provided that the primary intention is not to end the patient’s life.
Most Dutch doctors are in favour of discussing the use of sedation with their patients; American doctors are less inclined to do so, and many delay it until the later stages of the patient’s life.
Most Dutch doctors defend the use of sedation when death is imminent, even commenting that it should only be used in the last two weeks of life.
These results were obtained in a survey carried out with 36 doctors (18 Dutch and 18 American) between 2007 and 2008, and are published in the Journal of Medical Ethics (2014; 40,235-240).