Even with high-quality palliative care, some dying patients have intolerable pain, severe breathing problems, and other symptoms that they fear more than death itself. In these circumstances, if patients ask that death be hastened, physicians may consider offering terminal sedation and voluntary refusal of food and fluids to patients and their families as last resorts for relief.
In the March 7 Annals of Internal Medicine, end-of-life care experts Timothy Quill, MD, and Ira Byock, MD, define both practices, offer potential guidelines for their use, and explore their moral and legal status. Quill and Byock wrote the report for the American College of Physicians–American Society of Internal Medicine End-of-Life Care Consensus Panel.
Voelker R. The Last Resort. JAMA. 2000;283(12):1557. doi:10.1001/jama.283.12.1557-JQU00001-4-1