When and how to provide a palliative sedation in terminally ill patients?

When and how to provide a palliative sedation in terminally ill patients? With the introduction in the French law of sedatives practices, the professionals in palliative care are obliged to define the concepts, to name the difference kinds of sedations, to elaborate guidelines for good practice. French society of palliative care has worked to clarify the vocabulary, and to differentiate palliative sedations to their duration, their depth and the patient's consent (typology SEDAPALL). Its guidelines of 2010 have been updated in the form of three reference sheets in conjunction with a continuous deep sedation until death: how to estimate that the vital prognosis is short term? How to evaluate the refractory suffering? What are the guidelines for the pharmacological administration? The French National Authority for Health has produced a guide titled "How to realise a continuous deep sedation until death?" The present paper highlights some fundamental points of necessary steps: listening, understanding and analysing the suffering; the collegiate procedure - multi professional deliberative process, the pharmacological administration.