Sedated to death? When "comfort care" becomes dangerous

When the unknown actual incidence of terminating awareness-or insuring unawareness-in patients with stroke, dementia or other serious illnesses is factored in, the use of terminal sedation as a form of "comfort care" may well be approaching epidemic proportions, even outside the hospice area. As a former hospice nurse and now as an ICU nurse caring for some patients who turn out to be dying, I support the appropriate use of pain and sedating medications as ethical comfort care. However, even in circumstances where such medications are necessary, I have never seen a case where a patient "needed" to be made permanently unconscious.HLA