The process of dying is a ubiquitous milestone that allows patients and family members a time of reconciliation, growth, and spiritual enrichment as life enters its final chapter (Rousseau 1999; Cherny 1994).
Lamentably, the dying process can also be a time of considerable suffering, precipitating physical and emotional anguish and fomenting desperate and unnecessary requests for physician-assisted death.
Even though most distressing symptoms can be adequately managed in most dying patients with quality palliative care, the current reality is that most dying patients do not get access to palliative care.
Even in those patients who do receive good palliative care, sometimes the suffering may be intractable to standard palliative measures.
When such suffering occurs, the goals of care are often modified so that the relief of symptoms may prevail over all other considerations, including the maintenance of consciousness.
For that reason, when palliative therapies have been exhausted and symptoms remain refractory, palliative sedation is a valuable therapeutic adjunct that affords a more comfortable and dignified death (Rousseau 1999).
