title: Palliative Sedation in Patients With Cancer.
abstract: BACKGROUND
  Palliative sedation involves the use of sedative medication to relieve refractory symptoms in patients by reducing their level of consciousness. Although it is considered an acceptable clinical practice from most ethical points of view, palliative sedation is still a widely debated procedure and merits better understanding.
  
  
  METHODS
  The relevant medical literature pertaining to palliative sedation was analyzed and reviewed from various technical, relational, and bioethical perspectives.
  
  
  RESULTS
  Proportionate palliative sedation is considered to be the most clinically appropriate modality for performing palliative sedation. However, guidelines must be followed to ensure that it is performed correctly. Benzodiazepines represent the first therapeutic option and careful monitoring of dosages is essential to avoid oversedation or undersedation.
  
  
  CONCLUSIONS
  Proportionate palliative sedation is used to manage and relieve refractory symptoms in patients with cancer during their last days or hours of life. Evidence suggests that its use has no detrimental effect on survival. A different decision-making process is used to manage the withdrawal of hydration than the process used to determine whether proportionate palliative sedation is appropriate. Communication between patients, their relatives, and the health care staff is important during this medical intervention.
authors.affiliation: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy. marcocesare.maltoni@irst.emr.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Maltoni
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Setola
mesh_terms: D003657:Decision Making; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000379:methods
chemical_list: D006993:Hypnotics and Sedatives