Define palliative sedation and its distinction from euthanasia or physician-assisted suicide.

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Palliative sedation is the intentional lowering of consciousness to relieve refractory distress in a seriously ill patient when other symptom-relief options have failed, with the primary goal being comfort rather than shortening life. It is distinguished from euthanasia or physician-assisted suicide by its purpose: not to end life, but to alleviate suffering. If death occurs, it is not the intended outcome. Euthanasia involves actively causing death to relieve suffering, and physician-assisted suicide provides the means for the patient to end their own life. Palliative sedation uses sedatives to reduce consciousness, not lethal agents. It is about symptom relief within the broader goals of care, and it can be considered in terminal or near-terminal situations when symptoms are truly refractory.