1. Introduction Sigrid Sterckx, Kasper Raus and Freddy Mortier; 2. Continuous sedation until death: state of the art Sophie Bruinsma, Judith Rietjens and Agnes van der Heide; 3. Death by equivocation: a manifold definition of terminal sedation David Albert Jones; 4. Palliative sedation: clinical, pharmacological and practical aspects Josep Porta-Sales; 5. Clinical aspects of palliative sedation Nigel Sykes; 6. Understanding the role of nurses in the management of symptoms and distress in the last days of life Eleanor Wilson and Jane Seymour; 7. Principle and practice for palliative sedation: gaps between the two David Orentlicher; 8. The legal permissibility of continuous deep sedation at the end of life: a comparison of laws and a proposal Evelien Delbeke; 9. The Dutch national guideline on palliative sedation Johan Legemaate; 10. Continuous deep sedation at the end of life: balancing benefits and harms in England, Germany and France Richard Huxtable and Ruth Horn; 11. Can the doctrine of double effect justify continuous deep sedation at the end of life? Kasper Raus, Sigrid Sterckx and Freddy Mortier; 12. Palliative sedation, consciousness and personhood Timothy Holahan, Thomas Carroll, Claudia Gonzalez and Timothy Quill; 13. The ethical evaluation of continuous sedation at the end of life Johannes van Delden; 14. Terminal sedation and euthanasia - the virtue in calling a spade what it is Søren Holm; 15. Terminal sedation: recasting a metaphor as the ars moriendi changes Margaret Battin.