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

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

This paper explores ethical issues relating to the management of patients who are terminally ill and unable to maintain their own nutrition and hydration. A policy of sedation without hydration or nutrition is used in palliative medicine under certain circumstances. The author argues that this policy is dangerous, medically, ethically and legally, and can be disturbing for relatives. The role o...

On withholding artificial hydration and nutrition from terminally ill sedated patients. The debate continues.

The author reviews and continues the debate initiated by her recent paper in this journal. The paper was critical of certain aspects of palliative medicine, and caused Ashby and Stoffell to modify the framework they proposed in 1991. It now takes account of the need for artificial hydration to satisfy thirst, or other symptoms due to lack of fluid intake in the terminally ill. There is also a m...

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

One has to share some of Dr Craig's anxieties. We must strive for an accurate diagnosis for those who have not long to live or we cannot provide all possible help for them. But we know that hospice physicians create more routine investigations and a balance between over-investigation and neglect in the care of the dying is not easily achieved. I remember Dame Albertine Winner saying that a cup ...

Palliative care ethics: non-provision of artificial nutrition and hydration to terminally ill sedated patients.

Responding to Intractable Terminal Suffering: The Role of Terminal Sedation and Voluntary Refusal of Food and Fluids.

When provided by a skilled, multidisciplinary team, palliative care is highly effective at addressing the physical, psychological, social, and spiritual needs of dying patients and their families. However, some patients who have witnessed harsh death want reassurance that they can escape if their suffering becomes intolerable. In addition, a small percentage of terminally ill patients receiving...