Are We Putting the Cart Before the Horse?

Hasselaar et al¹ report that a national guideline in the Netherlands improves the pattern of drug prescribing to achieve sedation at the end of life. The guideline addresses the problem of prescribing opiates alone as a sedative, although the literature^2,3 suggests that benzodiazepines are better. It also addresses the value of including patients in the decision-making process.