Palliative Sedation

Due to the rise in cancer and multiple chronic diseases, the number of patients with refractory symptoms where conventional treatment options fail is likely to increase. In such cases, palliative sedation (PS) can be indicated, and involves the intentional lowering of consciousness at the end of life. However, PS is too often restricted to continuous deep sedation and is often confused with hastening death. The Palliative Sedation project aims to test the concept of proportional PS, where sedatives are titrated to the point of symptom control, with the goal of improving the patient’s overall comfort.

The project is investigating current practices and guidelines, as well as conducting a clinical study into PS, measuring patient comfort as the primary outcome, which is being carried out at five European palliative care centres. Furthermore, the Palliative Sedation project is formulating recommendations for an updated framework for the use of sedation in palliative care, working towards producing a free online educational programme and an e-book, and helping organise a policy workshop for further development and implementation, along with a closing conference to support the final dissemination of project results.

ECPC sits on the Palliative Sedation Scientific, Clinical and Ethical Advisory Board to encourage policy-makers, researchers, doctors and industry to recognise cancer patients as co-creators of their own health. ECPC directly engages with expert patient representatives to ensure research is designed and adapted to better respond to patient needs. Through its members, ECPC contributes to a PS country survey and supportive interviews that reveal the level of integration of clinical sedation guideline recommendations in healthcare practice across Europe. ECPC also supports the revision of the current European Association for Palliative Care (EAPC) framework for PS, and the design of the PS educational programme and e-book containing clinical and ethical guidance that can adopted for PS.