Intractable end-of-life suffering and the ethics of palliative sedation

Eric J. Cassell, Ben A Rich

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)435-438
Number of pages4
JournalPain Medicine
Issue number3
StatePublished - Mar 2010


  • End-of-Life care
  • Ethics
  • Palliative treatment
  • Sedation

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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