Trends and reasons of palliative sedation in cancer patients with and without pending requests of euthanasia in Dutch general practice.

Background: Little is known about the quantity and reasons for use of palliative sedation in cancer patients in general practice at the end of life and the reason to perform palliative sedation when also a request for euthanasia is pending. Aim: To gain more insight into the trends of and reasons for palliative sedation at the end of life, also when a request for euthanasia is pending in cancer patients in Dutch general practice. Design and setting: Dynamic cohort study using registrations and questionnaire data of Dutch GPs. Method: Trends and reasons for use of palliative sedation in cancer patients were analysed using multilevel analyses in the years from 2005 until 2014 in the Sentinel Practices of NIVEL Primary Care database. Results: From 2005–2014, 220 cancer cases dying after palliative sedation were reported from 62 general practices. The incidence of palliative sedation increased in 2014 threefold compared to the nine years before (P<0.001). Patient involvement in decision making before the start of palliative sedation (91%) was less frequently present in patients with delirium and in older patients (≥75 years, 87%) than in the group <75 years of age (94%, P