![]() ![]() Due to convictions of this kind, pain and other symptoms may remain under treated. Several authors have likened palliative (terminal) sedation to a form of (slow) euthanasia, assisted suicide, or mercy killing in disguise. Intensive pain management with opioids is not the only type of pain and symptom management that is often believed to hasten death. In the Netherlands, this was the case in 14.7% of all studied deaths. ![]() ![]() In a Belgian study, the treating physician thought to have alleviated pain and symptoms with opioid doses that may have shortened the patient’s life in 17.2% of all studied deaths. Such beliefs may influence medical decision making at the end of a patient’s life. Therefore, the use of the term euthanasia for the prescription of high-dose morphine by one fifth of French home-care nurses and one sixth of French GPs seems to imply that these groups believe intensive pain control with morphine hastens death. In many publications and discussions, euthanasia is understood in a broad sense as a deliberate medical act or omission that has a life-shortening effect that is accepted or aimed at by the physician involved. Bendiane et al and Peretti-Watel et al found that 27% of French home-care nurses and 17% of general practitioners considered prescribing high-dose morphine to be euthanasia. Surveys have shown that large proportions of physicians and nurses still think intensive pain treatment and palliative sedation hasten death. Nevertheless, many medical professionals consider such intensive pain and symptom management controversial. When a patient enters the terminal stage of a disease like cancer, intensive treatment of pain and other symptoms will often be required to preserve quality of life. ![]()
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