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Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 1995 Jun;21(3):141–143. doi: 10.1136/jme.21.3.141

On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far? A reply.

R J Dunlop 1, J E Ellershaw 1, M J Baines 1, N Sykes 1, C M Saunders 1
PMCID: PMC1376688  PMID: 7545757

Abstract

Patients who are dying of cancer usually give up eating and then stop drinking. This raises ethical dilemmas about providing nutritional support and fluid replacement. The decision-making process should be based on a knowledge of the risks and benefits of giving or withholding treatments. There is no clear evidence that increased nutritional support or fluid therapy alters comfort, mental status or survival of patients who are dying. Rarely, subcutaneous fluid administration in the dying patient may be justified if the family remain distressed despite due consideration of the lack of medical benefit versus the risks. Some cancer patients who are not imminently dying become dehydrated from reversible conditions such as hypercalcaemia. This may mimic the effects of advanced cancer. These conditions should be sought and fluid replacement therapy should be given along with the specific treatments for the condition.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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