A national guideline for palliative sedation in the Netherlands

J Pain Symptom Manage. 2007 Dec;34(6):666-70. doi: 10.1016/j.jpainsymman.2007.01.005. Epub 2007 Jul 9.


The first national guideline on palliative sedation in The Netherlands has been adopted by the General Board of the Royal Dutch Medical Association. By law, the physician is obliged to take this guideline into consideration. In this paper, we present the main principles of the guideline. Palliative sedation is defined as the intentional lowering of consciousness of a patient in the last phase of his or her life. The aim of palliative sedation is to relieve suffering, and lowering consciousness is a means to achieve this. The indication for palliative sedation is the presence of one or more refractory symptoms that lead to unbearable suffering for the patient. Palliative sedation is given to improve patient comfort. It is the degree of symptom control, not the level to which consciousness is lowered, which determines the dose and the combinations of the sedatives used and duration of treatment. Palliative sedation is normal medical practice and must be clearly distinguished from the termination of life.

MeSH terms

  • Conscious Sedation / standards*
  • Health Policy*
  • Humans
  • Netherlands
  • Palliative Care / standards*
  • Practice Guidelines as Topic*