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Euthanasia and palliative sedation in Belgium
  1. Raphael Cohen-Almagor1 and
  2. E Wesley Ely2,3,4
  1. 1 School of Law and Politics, University of Hull, Hull, UK
  2. 2 Geriatric Research, VA Tennessee Valley Healthcare System, Education and Clinical Center (GRECC), Nashville, Tennessee, USA
  3. 3 Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
  4. 4 Center for Health Services Research, Vanderbilt University, Nashville, Tennessee, USA
  1. Correspondence to Prof Raphael Cohen-Almagor, School of Law and Politics, The University of Hull, Hull HU6 7RX, UK; R.Cohen-Almagor{at}


The aim of this article is to use data from Belgium to analyse distinctions between palliative sedation and euthanasia. There is a need to reduce confusion and improve communication related to patient management at the end of life specifically regarding the rapidly expanding area of patient care that incorporates a spectrum of nuanced yet overlapping terms such as palliative care, sedation, palliative sedation, continued sedation, continued sedation until death, terminal sedation, voluntary euthanasia and involuntary euthanasia. Some physicians and nurses mistakenly think that relieving suffering at the end of life by heavily sedating patients is a form of euthanasia, when indeed it is merely responding to the ordinary and proportionate needs of the patient. Concerns are raised about abuse in the form of deliberate involuntary euthanasia, obfuscation and disregard for the processes sustaining the management of refractory suffering at the end of life. Some suggestions designed to improve patient management and prevent potential abuse are offered.

  • end of life care
  • pain
  • terminal care
  • hospital care
  • quality of life
  • symptoms and symptom management

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.