Palliative Sedation to Unconsciousness at
the End of Life
Palliative sedation to the point of unconsciousness
is a treatment of last resort when distressing
symptoms cannot be controlled despite expert
consultation.83 It is widely recognized as an
ethically appropriate approach in end-of-life
care.84 The goal is to relieve refractory suffering,
not to hasten death, and it should not be confused
with physician-assisted dying or voluntary
euthanasia. The patient or a legal surrogate must
be in agreement that such an approach is justified.
Consultation with specialists in palliative
care, ethics, psychiatry, or other areas should be
considered before a decision to initiate palliative
sedation is made.