Dehydration in terminally ill patients. Is it appropriate palliative care?

Technological advances in artificial feeding and intravenous hydration play an important role in preserving life and facilitating patient recovery. In terminally ill patients, however, many hospice workers have observed that discontinuing artificial nutrition and hydration is more beneficial. This article presents three case reports from a hospice setting that demonstrate the palliative benefits of dehydration. The authors discuss possible physiologic explanations for observed dehydration-related phenomena and offer guidelines for determining when it is appropriate to decrease or discontinue nutritional support and hydration by artificial means.