Retirement and nursing homes In other retirement and nursing homes visited by the commissions, there are farewell rooms and prayer rooms. Some facilities are taking part in hospice projects. There are palliative care plans that include emergency and treatment plans, and are regularly evaluated by all those involved (medical and nursing staff, relatives, and if possible the residents as well). Palliative care is a focal point in further training there. Alleviation of fears through Care Dialogue In 2017, the Care Dialogue (Vorsorgedialog) became an important and integral component of hospice culture and palliative care projects. Facilities that are working on or have already implemented this reported about their experience to the commissions. Addressing this topic is perceived as a relief because it alleviates the fears of residents and their representatives and, at the same time, supports the care staff in ethically difficult decisions at the end of a life. Palliative care affirms the finite nature of life and advocates as peaceful a death as possible for residents. This includes possible ways of dying and the differentiated use of passive euthanasia options (dispensing with life-prolonging intervention). The Care Dialogue thus encourages the self-determination of residents with regard to dying too and guarantees an individual end-of-life care as a measure of respect for the inseparable dignity of human beings in the final phase of their life. The Care Dialogue is also anchored in the 2nd Adult Protection Law that will come into effect on 1 July 2018. Legally speaking, this is equivalent to a substantial patient decree, provided that the resident is sufficiently able to reason and make decisions during the dialogue. Guidelines for palliative sedation therapy The NPM considers the Austrian guideline for palliative sedation therapy (PST) a progress. There was no standardised ethically grounded guideline for this therapy in Austria until 2017. On the recommendation of the Bioethics Commission, a multi-professional working group created a guideline for palliative sedation therapy on behalf of the Austrian Palliative Association (Österreichische Palliativgesellschaft). The guideline was published as an open source in Vienna Medical Weekly (Wiener Medizinische Wochenschrift) in 2017. PST is important when caring for terminally ill residents who are experiencing intolerable suffering. It is not a standard medical measure but the last medical way of controlling intense pain, which cannot be otherwise treated in therapy, with a pharmacological lowering of consciousness. The legally effective execution of PST requires the same legitimation criteria as other medical therapies: a corresponding indication and a legally effective consent to the treatment. 34