Patients with advanced illness sometimes experience severe and debilitating physical and psychological symptoms at the end of life that may be refractory to all kinds of conventional treatments available for symptom relief. In such situations, palliative sedation therapy (PST) may be indicated. However, its utilization has been subject to debate. One viewpoint is that PST may hasten death. However, some studies have indicated otherwise. This chapter discusses a multicenter, prospective, observational, nonrandomized population-based study that compared the overall survival of a cohort of terminally ill patients who received PST with a similar group of patients who did not. The study showed that PST does not shorten life when used to relieve refractory symptoms. The chapter also presents a clinical case scenario to illustrate who should receive PST.