Acute respiratory failure produces gasping and abnormal respiration, which can last for minutes or hours in the dying process. These agonal breaths appear to be very uncomfortable, and the Journal of Medical Ethics states that the patient should be treated with sedation.
Abnormal respiration in the final moments of life is often viewed by both physicians and observers as suffering, according to the Journal of Medical Ethics. Because of the uncertainty as to whether a patient is aware of suffering, it is suggested that the gasping respiration finalizing life should be treated with palliative measures.
The administration of a neuromuscular blocking agent halts agonal gasping and allows a peaceful death, according to R.M. Perkin, The Brody School of Medicine, East Carolina University. However, he reports that there is some question of ethics regarding the suppression of respiratory response in a person's final moments because this measure may be regarded as active euthanasia.
In light of the conflict between a person's perceived final suffering in respiratory failure and the ethical need to alleviate suffering, it is suggested by The Journal of Medical Ethics that the patient or legal spokesperson make decisions prior to death regarding administrations of medications that minimize pain and discomfort without hastening the death of an individual.