of course this is only my opinion but after working w/pts @ end stage life,who are we to determine whether they are suffering or not just because they may not exhibit the text book s/s if i were this pts nurse he would have been given the roxanol in fact i have worked w/hospice nurses who also feel this way to me it is not only dying w/dignity but a way to let this person go without laying in a bed wasting away every hour that goes by. i do empathize with your situation as it seems you may feel some conflict ie this,but do not feel alone there are many of us who have been thru this before and though it is not easy to accept these issues, i would ask myself if it was me what would i want hospice or the md to do for me,i can say i certainly would not want to be laying there in that state. sincerely coop62