title: End-of-life sedation: is there an alternative?
abstract: OBJECTIVE
  To evaluate the place and the usefulness of sedation in medical practice at the end of life.
  
  
  RESULTS
  Continuous sedation is an acknowledged medical practice for the management of refractory symptoms at the end of life. Guidelines and recommendations have been proposed in palliative care. Although considered as a good medical practice at the end of life, sedation is neither the only option nor the best.
  
  
  CONCLUSIONS
  This article presents the state-of-the-art (definitions, indications, and technical aspects) about continuous sedation, followed by an ethical reflection essentially based on the 'Principle of Double Effect', the impact on life expectancy, and the concept of 'natural death'.
authors.affiliation: Supportive Care Unit, Department of Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Lossignol
mesh_terms: D001293:Attitude to Death; D054810:Deep Sedation / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology / Q000523:psychology; D010166:Palliative Care; D013727:Terminal Care