llerkl, ADN 42 Posts Specializes in Non-Oncology Infusion currently. Has 39 years experience. Feb 5, 2011 "Terminal illness is often accompanied by severe pain and other unpleasant symptoms that cause undue suffering. The fundamental principle of palliative care is to alleviate suffering causes by intractable symptoms such as pain, dyspnea, agitation, and anxiety. The relief of these symptoms is not considered passive euthanasia or assisted suicide".**From American Society of Pain Management Nurses (ASPMN) Position Statement on End-of-Life Care*I totally understand concerns though.....even though you want to keep your patient comfortable, you may feel like you don't want to be "the one" who gives "the dose" that ends up being the last one. We have an obligation to provide comfort/relief from pain, especially at the end of life. Sometimes it is just a difficult situation for all.