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Adequate pain control is the hallmark of modern hospice care. I am not in any way opposed to adequate/appropriate pain control. And when pain control is appropriate, the principle of double effect comes into play. I recently discussed this principle of double effect with a hospice medical director. Here is his comment:

I have a comment about the slide stating the principle of double effect is being used to justify terminal sedation. If this is being done, it is an incorrect usage of the PDE. It was a Catholic principle formulated originally by St Thomas Aquinas and though, today, it may be 'misinterpreted', many good and orthodox Catholic theologians use it in certain cases in which an action has 2 effects - one good and one evil. 1)The action must be good in itself or at least indifferent (i.e. cannot be evil itself) and must be capable of being ordered to God and to neighbor. 2) The good effect must not be achieved through the bad effect (this would otherwise make the ends justify the means); 3) there must be proportionate good over the evil effected (this is not proportionalism which is based on relativism and which the Church rejects, but rather the good effect must greater than the evil effect; 4) the intention of the subject must be directed toward the good effect and merely foresee and tolerate the bad effect; 5) there must be no other avenues available to achieve the good effect.
Terminal sedation, from the start, is not an action that can be termed good or even indifferent - it is an evil, to kill an innocent life, therefore it is incapable of being ordered to God and to neighbor. Thus, strictly speaking, the correct usage of the PDE would disavow terminal sedation.
However, PDE is used to justify treating severe pain at the end of life. For example, when the minimally effective dose is no longer working, and the patient remains in pain, and the choice is to increase the dosage until their is adequate pain relief. This action is good per se as it is ordered to God and love of neighbor in that the effect to alleviate suffering is good and noble. The foreseen and tolerated evil effect is that it may shorten the life of the patient but this is not the intention of the physician in administering higher doses of opioids.
Treating pain for relief, even at the cost of shortening life is c/w the PDE; terminal sedation is not intended to treat pain and therefore an evil act and cannot be justified by the PDE.

We can both agree with these principles, right?

On the other hand, would you agree with this statement?

The Church rejects either the act or omission which, of itself or by intention causes death in order to eliminate suffering, therefore any omission of nutrition and hydration by itself or with the intention to cause or hasten a patient’s death must be rejected. Therefore we must hold for a presumption in favor of providing nutrition and hydration for every patient-especially the dementia or stroke patient who receives hospice, comfort or palliative care. If a patient is not able to sustain himself (herself) by oral intake of food and water, then assisted nutrition and/or hydration (eg, intravenous fluids, total peripheral nutrition {TPN} and/or a PEG tube) should be offered and should not be withheld or considered burdensome except for rare exceptions in which they could acutely worsen a person’s medical outcome (eg, giving intravenous fluids to a patient who is experiencing an acute episode of congestive heart failure). These measures are ordinary treatments and therefore cannot be based on a person’s “quality of life.”
Patients who suffer from dementia or stroke should not die due to dehydration and/or malnutrition. The symptoms of dehydration should be treated with oral or assisted fluids and not via pain medications or sedatives such as morphine or lorazepam.