Bibliographic record
Abstract
To the Editor: Rys et al.1 report on the practice of continuous sedation until death (CSD) as reported by nursing home nurses in Flanders, Belgium. Of the residents who underwent CSD, 47% were incompetent. Life expectancy, apparently estimated by the nurses, was less than 1 week in 65% of residents. The authors acknowledge that estimates of life expectancy are generally unreliable in this situation. Of the competent residents undergoing CSD, more than one-quarter were not actively involved in the decision-making. Once CSD was begun, 38% of residents were rendered comatose and 31% stuporous. The authors cite prior work showing that sedation was not necessarily titrated to relief of symptoms but that a variety of other factors were considered, including “aesthetics.” “During the administration of CSD, 79.4% of individuals could no longer drink or eat.” Artificial hydration was provided to 7% of residents. Most of the residents died in the first week and 69% were women. There is a very important distinction between letting die and killing. If you take a group of people who are not included in the decision-making process, drug them into stupor or coma, and do not provide food and water, what are we to call this? The fact that it is primarily women who underwent this “procedure” is especially disturbing. Do the authors believe that their care teams killed any of these people? The claim could be made that this was a good death, “euthanasia.” Conflict of Interest: None. Author Contributions: The letter to the editor is completely the idea of Dr. Thomas Finucane. Sponsor's Role: N/A.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.028 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.017 | 0.026 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".