CONCLUSION: Physicians have considerably divergent attitudes toward intravenous hydration for terminally ill cancer patients.
Many of those involved in palliative care have justifiable objections to the introduction of intravenous hydration in patients with dehydration-associated symptoms and advanced cancer. Researchers from the University of Buenos Aires carried out a randomized, comparative and prospective trail to determine the usefulness of hypodermoclysis in the control of thirst, chronic nausea and delirium...Both groups showed significant and equal improvements in relief of thirst and chronic nausea at 24 hours. After 48 hours, this improvement was maintained in the group that received hydration, but only for the relief of chronic nausea. Delirium did not improve significantly in either group during the 48-hour trial period.
Many healthcare professionals believe that dehydration is painful and uncomfortable for dying patients.
Occurrence of hyperactive delirium and the requirement for symptomatic sedation significantly correlated with hepatic failure, opioids, and steroids, while dehydration-related pathologies were significantly associated with hypoactive delirium. Complete recovery was frequently achieved in cases with medication- and hypercalcemia-induced delirium, whereas a low remission rate was related to hepatic failure, dehydration, hypoxia, and disseminated intravascular coagulation.
There is danger in referring to terminal sedation and terminal dehydration as alternative forms of euthanasia. We risk compromising care by putting additional pressures on health care professionals, patients, and families to avoid sedatives or administer fluids in the final days of life. In failing to distinguish between the deliberate use of such actions to hasten death from appropriate end-of-life care, the authors confuse the goals and approaches of palliative care, which is aimed at relieving suffering without hastening death, with deliberate forms of euthanasia.