Palliative sedation is a comfort measure at the end of life reserved for those individuals whose suffering cannot be otherwise managed. While first described in the literature over 40 years ago, palliative sedation remains widely misunderstood by the larger medical community and may be perceived as a means by which death can be hastened in jurisdictions where medical aid in dying is not available. In this lecture, Dr. Marks will provide a case-based discussion of palliative sedation, including the criteria necessary for ethically appropriate practice and how some are advocating for so-called “expanded use” of palliative sedation in end of life care.