Assisted suicide is controversial, but palliative sedation is legal and offers peace

As experts continue to debate the morality and legality of aid-in-dying, terminally ill patients have another option in palliative sedation. For more than a half-century, hospice care providers have been administering enough sedatives to achieve a level of unconsciousness that alleviates end-of-life pain.

As experts continue to debate the morality and legality of aid-in-dying, terminally ill patients have another option in palliative sedation. For more than a half-century, hospice care providers have been administering enough sedatives to achieve a level of unconsciousness that alleviates end-of-life pain. Although death is not the goal, it can be the outcome: sometimes the patient simply never wakes up, especially if he or she has stopped taking food and water. Unlike assisted suicide, the practice is completely legal; but policies vary from one facility to the next, and physicians still struggle with the decision. Not only must they determine when—if ever—a patient's physical suffering becomes unbearable and palliative sedation becomes appropriate, but they must grapple with the concept of "existential suffering." There is general consensus that palliative sedation is a viable option for intractable physical pain, extreme nausea, and vomiting in the absence of other effective solutions. Opinions are split, meanwhile, over whether suffering tied to "a loss or interruption of meaning, purpose, or hope in life," as the hospice industry defines the term, is reason enough to pursue this line of care.