Arguments for hydration |
Provides a basic human need |
Provides comfort and prevents uncomfortable symptoms: confusion, agitation, and neuromuscular irritability |
Prevents complications (eg, neurotoxicity with high-dose narcotics) |
Relieves thirst, recognized as a sign of fluid needs |
Does not "artificially" prolong life to any meaningful degree |
Allows providers to continue their efforts to find ways to improve comfort and life quality, despite the perception of a poor quality of life |
Provides minimum standards of care; not doing so would break a bond with the patient |
Denying hydration may set a precedent to withhold therapies from other patients who are compromised |
Arguments against hydration |
Interferes with acceptance of the terminal condition |
Intravenous therapy is painful and intrusive |
Prolongs suffering and the dying process |
Unnecessary since unconscious patients do not experience uncomfortable symptoms, such as pain or thirst |
Less urine output means less need for bed pan, urinal, commode, or catheter |
Less fluid in the gastrointestinal tract and less vomiting |
Less pulmonary secretions and less cough, choking, and congestion |
Minimizes edema and ascites |
Ketones and other metabolic by-products in dehydration act as natural anesthetics for the central nervous system, causing decreased levels of consciousness and decreased suffering |