Article Text

Download PDFPDF
Palliative sedation outside a palliative care unit
  1. Sebastiano Mercadante1,
  2. Patrizia Villari2 and
  3. Fabrizio David2
  1. 1Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo, Sicilia, Italy
  2. 2Anesthesia, Private Hospital La Maddalena, Palermo, Sicilia, Italy
  1. Correspondence to Dr Sebastiano Mercadante, Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo 90146, Italy; terapiadeldolore{at}


Purpose The need of acute transition from an intensive care setting to an end-of-life setting requires collaboration and experience. Variable information exists on palliative sedation in traditional palliative care settings, including home care, hospices or palliative care units.

Materials Four cases which required a rapid decision-making to alleviate suffering in patients close to death are described.

Results Despite having different clinical pathways leading to intensive but medically non-beneficial treatments, patients were converted to a rapid transition of care in the unit where they had been admitted, due to different logistic reasons. An appropriate discussion with relatives about the short prognosis and the need to sedate for controlling suffering in the last hours of life was fundamental in preventing further suffering with intensive treatments.

Conclusions These clinical notes suggest that palliative care and end-of-life measures should be also expanded in other settings, where palliative care issues are traditionally not properly assessed, implementing the collaboration with other colleagues with different clinical extractions.

  • clinical decisions
  • end-of-life care
  • haematological disease
  • hospital care
  • terminal care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @#sebmercadante

  • Contributors All authors contributed in the same way.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.