Pharmacologic symptom control during the withdrawal of life support: lessons in palliative care

The withdrawal of life support is now a common practice in the critical care setting. This treatment provides patients and families with greater opportunities for positive end-of-life experiences. It also challenges critical care nurses to promote patient comfort without inducing death by overdose. Dyspnea, pain, anxiety, and excessive secretions are troubling symptoms that often occur during the withdrawal of life support. In this article, the author reviews pharmacologic interventions that control these symptoms, focusing on the titration of potentially lethal drugs using patient responses and the ethical principle of double effect to guide nursing practice.