Responding to intractable terminal suffering.

TO THE EDITOR: Quill and Byock’s paper (1) is a significant contribution to the end-of-life care discussion. However, I continue to question the use of the phrase terminal sedation by the medical profession, particularly in light of Quill and Byock’s paper favoring this treatment. Whether used to describe the purposeful administration of sedation under the clinical guidelines summarized in this paper or to describe the unintended side effect of high-dose opioid therapy (a scenario that the authors choose to distinguish from their guidelines), the phrase implies intent. For health care providers who are understandably fearful of judicial interpretation and who therefore may underprescribe in the treatment of intractable terminal suffering, I submit that the alternative phrase palliative sedation would be far less conflicting and thus far more desirable.