[Symptom control in the terminal phase]

An appropriate medical treatment and care during the final phase can make a calm and peaceful dying possible. Aim of this review is to show the symptoms and treatment of patients with a far advanced disease in the last three days of life and to standardise terms used to describe the last period of life. There are definitions worked out for rehabilitation in palliative medicine, for the terminal phase and the final phase. We know that the final phase is a very dynamic process with sometimes a lot of symptoms and problems. Reasons for an "active" medical treatment in the last three days of life are, that new symptoms may occur or previous good controlled symptoms like pain, dyspnoea, vomiting, fear etc. can reappear, which could make a change or finishing of treatment necessary. The aim of palliative medicine is to improve the quality of life especially in the terminal phase. If we focus on the terminal phase most patients - even with cancer pain - can die peacefully and under good symptom control. The dynamic situation in the final phase and the ethical decisions force us to draw our attention to these patients and stay with them until they die. Humanity is besides a funded medical care essential in accompanying the patient in his last days of life. Until now there are not many clinical studies which can help us to find guidelines for the treatment in the last three days of live.