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March 9, 2009

Are We Putting the Cart Before the Horse?

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Intern Med. 2009;169(5):429. doi:10.1001/archinternmed.2008.617

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 literature2,3 suggests that benzodiazepines are better. It also addresses the value of including patients in the decision-making process.