IV hydration in the terminally ill: ritual or therapy?

The management of dehydration is both a clinical and an ethical problem. Artificial hydration may increase pharyngeal and pulmonary secretions, which causes a choking sensation, nausea and vomiting. Food and fluid have a strong social, cultural, religious and psychological significance. Competent nursing requires expert knowledge and moral skill. The interests of the patient must always be paramount. An ethical decision-making framework provides a systematic approach to ethical problems.