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The aim of continuous deep sedation until death (CDSUD) is to relieve what is perceived by a patient as intolerable suffering that does not respond to any treatment, by the total elimination of awareness. The sedated patient is calm and relaxed but can no longer express himself until his death. Is this enough to say that he is not suffering ? The aim of this study was to obtain the opinions of healthcare professionals regarding the effectiveness of CDSUD against refractory symptoms. Qualitative international research, studying multiple cases based on existing data and semi-structured individual interviews, was carried out in two European countries: France and Poland. In total thirteen PCUs were included, 197 medical files studied and sixty interviews with doctors and nurses incorporated and analyzed. CDSUD was instigated for a supposedly physical refractory symptom, whereas in reality it was for mental refractory suffering. Not all healthcare professionals were convinced by the effectiveness of this treatment. The only criterium on which the effectiveness of CDSUD could be judged was based on the subjective testimonials of the healthcare professionals interviewed and not on objective scientific criteria. The results of our study show that, according to the healthcare professionals interviewed, it is, today, impossible to be sure of the effectiveness of CDSUD against refractory suffering, or to make an objective and rigorous evaluation.