| 日 | 月 | 火 | 水 | 木 | 金 | 土 |
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| 6 | 7 | 8 | 9 | 10 | 11 | 12 |
| 13 | 14 | 15 | 16 | 17 | 18 | 19 |
| 20 | 21 | 22 | 23 | 24 | 25 | 26 |
| 27 | 28 | 29 | 30 | 31 |
A blanket policy of artificial hydration, or of no artificial hydration, is ethically indefensible. |
Towards death, a person's desire for food and drink lessens. Study evidence is limited (see References) but suggests that artificial hydration in imminently dying patients influences neither survival nor symptom control. As such it may constitute an unnecessary intrusion. |
Thirst or dry mouth in people who are terminally ill may frequently be caused by medication. In such circumstances artificial hydration is unlikely to alleviate the symptom. Good mouth care and reassessment of medication become the most appropriate interventions. |
Appropriate palliative care will involve consideration of the option of artificial hydration, where dehydration results from a potentially correctable cause (e.g over treatment with diuretics and sedation, recurrent vomiting, diarrhoea and hypercalcaemia). |
It is a responsibility of the clinical team to make assessments concerning the relevance of hydration to the experience of individual patients. The appropriateness of artificial hydration should be judged on a day-to-day basis, weighing up the potential harms and benefits. The practicalities of appropriate provision will vary according to setting, but good practice will require that patients needing artificial hydration are transferred to a unit equipped to provide such care. |
Relatives at the bedside of dying patients frequently express concern about lack of fluid or nutrient intake. Health care professionals may not subordinate the interests of patients to the anxieties of relatives but should, nevertheless, strive to address those anxieties. |
固定リンク | コメント (0) | トラックバック (353)
コメント
コメントはまだありません。
コメントを書く