• Livia Anquinet, Kasper Raus, Sigrid Sterckx, Tinne Smets, Luc Deliens, and Judith A C Rietjens.
• End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel, Brussels, Belgium. Livia.Anquinet@vub.ac.be
• Palliat Med. 2013 Jun 1;27(6):553-61.

BackgroundAccording to various guidelines about continuous sedation until death, this practice can and should be clearly distinguished from euthanasia, which is legalized in Belgium.AimTo explore professional caregivers' perceptions of the similarities and differences between continuous sedation until death and euthanasia.DesignQualitative data were gathered through focus groups. Questions pertained to participants' perceptions of continuous sedation. The focus groups were recorded and transcribed verbatim. Analyses were conducted by a multidisciplinary research team using constant comparison analyses.Setting/ParticipantsWe did four focus groups at Ghent University Hospital: two with physicians (n = 4 and n = 4) and two with nurses (n = 4 and n = 9). The participants could participate if they were ever involved in the use of continuous sedation until death.ResultsAlthough the differences and similarities between continuous sedation until death and euthanasia were not specifically addressed in the questions addressed in the focus groups, it emerged as an important theme in the participants' accounts. Many caregivers elaborated on the differences between both practices, particularly with regard to patients' preferences and requests, decision-making and physicians' intentions. However, some stated that the distinction between the two sometimes becomes blurred, especially when the sedating medication is increased disproportionally or when sedation is used for patients with a longer life expectancy.ConclusionsThe differences and similarities between continuous sedation until death and euthanasia is an issue for several Flemish professional caregivers in their care for unbearably suffering patients at the end of life. Although guidelines strictly distinguish both practices, this may not always be the case in Flemish clinical practice.

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