Table 1

Guidelines for the use of sedation in patients near death in PCU Havelhoehe


Otherwise refractory and burdensome symptoms In terminal or final stages of the life of patients with Incurable disease – If death can be expected within the next 48 hrs


Informed consent of patient, surrogates and palliative care team


Continuous or Intermittent innfusion of sedatives (iv or sc e.g. midazolam 0,5 -mg/h +/- analgesics + co-medlcatlon). Lowest possible, adequate dosage to control symptoms under permanent observation and careful monitoring. Reduction of dosage In agony. Maintenance of all necessary medical and nursing support. Documentation.

Intention and ethics:

Reduction of distress, good sleep at night, adequate communication at daytime. Comfort and tolerance In the final phase – not to hasten death.

Muller-Busch et al. BMC Palliative Care 2003 2:2   doi:10.1186/1472-684X-2-2

Open Data