“The Good Death,” a play about euthanasia, has brought the issue of “mercy killing” to Dutch theatres at a time when such deaths are falling. They dropped to 2,325, or 1.7 percent of all deaths in 2005, from 2.6 percent in 2001. Playing to packed houses throughout the Netherlands, which legalised euthanasia in 2002, the play shows the law has not removed the moral dilemma for many involved.

In fact, part of the reason for the drop in euthanasia deaths could be that agonised doctors are opting to give patients heavy sedation until they die, rather than putting an end to their lives. Even some patients who have asked for euthanasia are given continuous deep sedation instead. This feature by our Netherlands chief correspondent Emma Thomasson looks at the issues involved.

This raises the question of whether deep sedation, while being presented as palliative care that is ethically acceptable for many faiths, is not in fact “euthanasia lite.” Or at least whether it is being used as such. The British Medical Journal has suggested this in a report that prompted an editorial and a lively reader discussion. “Although the exact cause of this trend is unclear, there are indications that continuous deep sedation may in some cases be being used as a substitute for euthanasia,” a report in Science Daily said.

The fall in Dutch euthanasia deaths is sometimes cited by “death in dignity” campaigners in other European countries as a sign that legalisation is not a slippery slope towards the easy disposal of ailing patients. This suggests it might lead in another direction that could undermine the palliative care option often presented as the alternative to legalised euthanasia.

Where do you think the line should be drawn in end-of-life care?