ABSTRACT
Transient controlled sedation is routinely and uncontroversially used to manage the severe pain and anxiety associated with noxious procedures. Among patients with advanced cancer, clinical experience suggests that optimal palliative care can effectively manage the symptoms of most cancer patients during most of the course of the disease. When patients with advanced illness are at risk of intolerable suffering, physicians should discuss the option of palliative sedation at a time before the patient is in a crisis situation. Decisions regarding the administration of hydration and/or artificial nutrition therapy are independent of the decision about whether to administer palliative sedation. Sedation is a critically important therapeutic tool of last resort. It enables the clinician to provide relief from intolerable distress to the patient when other options are not adequately effective. Because sedation undermines the capacity to interact, it must be used judiciously. .
