Managing terminal dyspnea: caring for the patient who refuses intubation or ventilation

Dyspnea in a dying patient is one of the most distressing symptoms challenging a critical care nurse. A humane response to terminal dyspnea, which may result when the patient chooses to forego life-sustaining intubation and ventilation, is expected by the patient. The author presents strategies for reducing the distress of dyspnea for patients who are dying when intubation and ventilation are being withheld.