The use of continuous opioid infusions at the end of life remains a clinically and ethically sensitive area in acute hospital practice[1,2]. International recommendations emphasize that opioids are essential for the relief of moderate to severe symptoms—such as pain, dyspnea, and cough—when used proportionally, with careful assessment and titration, and with explicit attention to adverse effects[1,2]. Nonetheless, concerns persist that continuous morphine infusions (CMI) may sometimes be initiated without clear symptom-driven indications, potentially blurring the boundary between proportional symptom control and practices that resemble unintended or undocumented sedation[1,3].
