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When a terminal patient is no longer able to eat or drink
  1. Susan Salt, Consultant in Palliative Medicine,Medical Director
  1. Trinity — The Hospice in The Fylde, Bispham, Blackpool. Email dr.salt{at}trinitypcs.org.uk; www.trinityhospiceinthefylde.org.uk

Abstract

Patients who are in the last few days or weeks of life are often too frail to take large amounts of nutrition or hydration orally. The prime goal of any treatment in the last days of life must be the comfort of the patient. Considerations around how to approach the issue of hydration and nutrition are complex and involve not only physical, psychological and social concerns, but also ethical dilemmas. A review of the literature gives conflicting views as to the role and effectiveness of artificial means of providing hydration and/or nutrition in these circumstances. This article looks at some of the evidence and proposes a decision-making framework that allows the health professional to work with patients and carers to come to an appropriate decision for the majority of clinical situations encountered in the general healthcare setting. Conflicts of interest: none

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