Intractable end-of-life suffering and the ethics of palliative sedation Review uri icon


MeSH Major

  • Hypnotics and Sedatives
  • Pain
  • Palliative Care


  • Palliative sedation (sedation to unconsciousness) as an option of last resort for intractable end-of-life distress has been the subject of ongoing discussion and debate as well as policy formulation. A particularly contentious issue has been whether some dying patients experience a form of intractable suffering not marked by physical symptoms that can reasonably be characterized as "existential" in nature and therefore not an acceptable indication for palliative sedation. Such is the position recently taken by the American Medical Association. In this essay we argue that such a stance reflects a fundamental misunderstanding of the nature of human suffering, particularly at the end of life, and may deprive some dying patients of an effective means of relieving their intractable terminal distress.

publication date

  • March 2010



  • Review



  • eng

Digital Object Identifier (DOI)

  • 10.1111/j.1526-4637.2009.00786.x

PubMed ID

  • 20088855

Additional Document Info

start page

  • 435

end page

  • 8


  • 11


  • 3