A caveat to the assumption that terminal or palliative sedation can be accepted as the norm by healthcare professionals is that patients and their relatives should be contacted and their wishes, where possible, properly obtained.1 This is not as straightforward as it sounds.

My own, previously well and robust, 92 year old father was admitted as a medical emergency with rectal haemorrhage. He had moved to live in a rest home three weeks earlier because of deteriorating health of uncertain cause, having spent all of his life living independently and in robust health (and fully lucid). On admission his haemoglobin was about 60 g/l, and initial resuscitation, blood transfusion, was …