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However, sedation for intractable distress has raised considerable medical and ethical concerns.
Obviously it would be wrong for a baby to suffer prolonged or intractable distress.
While the ambiguous term "terminal sedation (TS)" [ 8, 9] is used most often, other terms more clearly reflect the different viewpoints: "sedation for intractable distress in the imminently dying [ 10, 11];", end-of-life sedation [ 12] "slow-euthanasia" [ 13], "palliative sedation" [ 14], "total sedation" [ 15], "sedation in the final phase", "palliative sedation therapy" [ 16].
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But the peer will not concede ground on another select committee recommendation, namely that the definition of unbearable suffering be replaced with "unrelievable" or "intractable" suffering or distress.
Deep sedation, to the point of unconsciousness, may also be used to relieve intractable suffering, and it "has caused almost as much distress and debate in the palliative care-hospice world as euthanasia has," said Dr. David Casarett, a palliative care doctor at the University of Pennsylvania, who is leading a national evaluation of end-of-life care at Veterans Affairs hospitals.
The intention is the relief of otherwise intractable and refractory distress [ 18].
In Response: We thank Iaria et al. (1 ) for their comments on our letter reporting an unusual case of fatal measles without rash in an immunocompetent woman who manifested cytopenias and an intractable acute respiratory distress syndrome (2 ).
Sedation in the terminal or final phase of life plays an increasing role in the management of intractable physical and psychological distress.
She died 50 months from time of diagnosis secondary to respiratory distress with massive intractable pleural effusions and pulmonary emboli.
The symptoms of atopic dermatitis, notably pruritus, can be intractable and lead to significant emotional distress and sleep loss [3].
Indeed, cancer pain can become intractable, particularly in the presence of psychological distress [ 12].
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