We read with great interest the article by Takla et al.

which discussed extending general anaesthesia for the relief of suffering in palliative care.

As anaesthetists and intensivists with experience in providing procedural sedation and end-of-life care, we would like to share our view on this controversial topic.

Sedation is a continuum which extends from normal alert consciousness to complete unresponsiveness.

The International Committee for the Advancement of Procedural Sedation has highlighted the difference between procedural sedation and general anaesthesia.

It stated that general anaesthesia targets an unarousable state in which airway intervention is often required and spontaneous ventilation is frequently inadequate.

Procedural sedation, on the other hand, targets a state during which airway patency, protective airway reflexes, spontaneous ventilation and haemodynamic stability are preserved.

Indeed, the American Society of Anaesthesiologists also shared similar definitions in regard of sedation vs.

general anaesthesia [3]. Although procedural sedation may not be entirely the same as palliative sedation, we believe they do share many similarities.