The total number of deaths studied was 11,704 of which 1517 involved continuous deep sedation. In Dutch hospitals, CDS was significantly less often provided (11%) compared with hospitals in Flanders (20%) and U.K. (17%). In U.K. home settings, CDS was more common (19%) than in Flanders (10%) or NL (8%). In NL in both settings, CDS more often involved benzodiazepines and lasted less than 24 hours. Physicians in Flanders combined CDS with a decision to provide physician-assisted death more often. Overall, men, younger patients, and patients with malignancies were more likely to receive CDS, although this was not always significant within each country. Conclusion Differences in the prevalence of continuous deep sedation appear to reflect complex legal, cultural, and organizational factors more than differences in patients’ characteristics or clinical profiles. Further
The focus of this article is upon compassionate killings, that is, criminal cases where a parent/spouse has killed or assisted to die a child/spouse who was suffering from severe disabilities, debilitating injury, chronic or terminal illness. We argue that the partial defence of diminished responsibility, while appropriate for some cases, fails to acknowledge the compassionate and relational nature of these acts and thus fails to identify the quality of the harm committed. We also argue that the general defences of duress of circumstances and necessity, even if they were to be become available, are inappropriate. Developing the concept of ‘compassion’, which is a consideration in relation to prosecution for assisted suicide, we argue for the introduction of a partial defence of ‘compassionate killing’ which would reduce the offence from murder to manslaughter in recognition of the killing as a responsive, relational act of care.