The Brussels Statement on use of sedation in palliative care

At the Palliative Sedation project policy symposium in Brussels on 16th April 2024, consortium members, international experts, and clinicians in the field of palliative care endorsed this statement on good practice in palliative sedation.
The statement is as follows:

Palliative sedation aims to relieve refractory suffering through the monitored proportional use of medications intended to reduce consciousness in patients with life-limiting disease. Palliative sedation has major social and ethical implications requiring specific considerations by patients, significant others, and care providers.

The revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation can help to support the development of national guidelines with agreed terminology to optimise practice and prevent misconceptions in its use.

1. The level of sedation should be that needed to relieve suffering and may be light or deep, and intermittent or continuous.
2. Shared decision making around values and desires and effective communication is essential.
3. Conversations about palliative sedation should be initiated early where a potential need is anticipated.
4. Training, guidance and support including the use of moral case deliberation, should be provided to all those working in the multidisciplinary team involved in palliative sedation delivery.
5. Decisions about whether not to initiate artificial hydration and nutrition should be made independently of decisions regarding palliative sedation.
6. Palliative sedation differs from euthanasia as it aims to relieve suffering and not to end life.

Some questions to consider:

• What are your thoughts on these points?

• Which, if any, of these points do you think is the most important?

• If you are a health professional, how might you incorporate aspects of the Brussels Statement into your personal care delivery and into the practice of your team?