Pain is inevitable.

Suffering is optional.

–Haruki Murakami

The quest to minimize suffering exists on a continuum from birth to death, in or out of hospitals, for acute or chronic care settings. Palliative care is medical care that “improves the quality of life of patients...who are facing challenges...with life-threatening illness, whether physical, psychological, social, or spiritual” (asamonitor.pub/3XyNsE1). Beginning in 2008, the American Board of Anesthesiology (ABA) has offered certified training in palliative and hospice medicine (asamonitor.pub/3MxARdJ).

A mass casualty incident is “an event that overwhelms the local health care system, where the number of casualties vastly exceeds the local resources and capabilities in a short period of time” (EMS Mass Casualty Management. 2022). Palliative care is often implemented in a controlled and planned setting, yet may be indicated in the acute setting of a mass casualty incident.

It may not be self-evident that there...

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