Forum.
Other considerations
Determining the goals of treatment is an essential component of decision-making and guides selection of interventions. For terminal restlessness, the goal may be maximum tranquilization with minimum sedation (Heyse; Sachs in Tansjo). For the patient with severe symptoms, for whom death appears imminent, and who has stopped eating and drinking, deep continuous sedation may be indicated (Rousseau). For the patient with existential distress, temporary sedation may provide sufficient rest that other interventions can become effective upon lightening or stopping sedation (somebody in Tansjo; Cherny; Morita). Sleep/rest, tranquilization, and sedation may be a blurred continuum in clinical practice but the aim is symptom management, not maintenance of sedation (32). Selecting a form of sedation based on clear goals also helps to relieve any anxiety about sedation hastening death (Morita;) or practicing euthanasia (13).
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