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Care at the Close of Life: Evidence and Experience
Stephen J. McPhee, Margaret A. Winker, Michael W. Rabow, Steven Z. Pantilat, Amy J. Markowitz
Part F Ethical Issues
Chapter 31. Palliative Sedation in Dying Patients: “We Turn to It When Everything Else Hasn’t Worked”
Bernard Lo, MD, Gordon Rubenfeld, MD, MSc

Sections:  The Patient's Story, Perspectives, Methods to Update This Chapter, Resources, References, Chapter Glossary Terms

Topics Discussed: pain management, palliative care, sedation procedure

Excerpt: "Mrs B, a 49-year-old woman with widely metastatic breast cancer, was admitted to a university hospital to control pain from bony metastases. She had been hospitalized twice during the previous 3 weeks for severe pain. At the time of her last discharge, 2 days prior, she and her husband had decided to pursue hospice care. At home, her pain worsened despite her outpatient regimen of celecoxib, amitriptyline, lorazepam, and very high doses of oxycodone hydrochloride and morphine sulfate, as well as ongoing radiation therapy that did not control the progression of her metastases. She therefore returned to the hospital...."
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