Palliative sedation (sedation causing unconsciousness) as an option of last resort for intractable end-of-life suffering has been the subject of ongoing discussion and debate, as well as policy formulation. A particularly controversial issue has been whether some dying patients experience a form of intractable suffering not characterised by physical symptoms that can reasonably be described as 'existential' in nature, and therefore not an acceptable indication for palliative sedation. This is the position recently taken by the American Medical Association. In this essay, we argue that this attitude reflects a fundamental misunderstanding of the nature of human suffering, particularly at the end of life, and may deprive some dying patients of effective means of relief from their intractable terminal suffering.
http://www.ansatt.hig.no/bjoernh/Artikler/Ethics%20of%20palliative%20surgery%20PROOF bjs5104.pdf