Medical officers in Acute Care Settings: Their Views on Medically Assisted Hydration at the end of Life

Abstract

This study explored the perceptions of doctors in acute care settings regarding the use of medically assisted hydration (MAH) in end-of-life care. The use of MAH at the end of life is controversial, and practice varies across health care settings. A qualitative study using discourse analysis was carried out. Eight medical practitioners in the acute care setting were interviewed individually. MAH has been associated with care, comfort, and standard medical intervention to save lives. Medical officers have some concerns about the benefits or adverse effects of MAH at the end of life. In acute care settings, it can be difficult to recognize and diagnose dying. Often, family discussions regarding end-of-life care do not occur due to pursuit of cure and, therefore, continuation of futile and burdensome treatment such as MAH can occur in the last few days of life.

Nutrition and hydration in dying patients: the perceptions of acute care nurses

“…, , , Good et al . ). In this article, we report on the findings of research we conducted in an acute care setting and show a range of concerns that mandate the urgent need for the palliative care approach and for nurses to engage in decision‐making and advocating for patients and family to ensure a comfortable and dignified death.…”

“…As a result, there continues to be disagreement regarding the provision of MN&H for terminally ill patients (Huffman & Dunn , Good et al . ). In addition, there is limited and contradictory information available to guide practice regarding MN&H and its effectiveness during the end stage of life when death is imminent.…”

The experiences of family members witnessing the diminishing drinking of a dying relative: An adapted meta-narrative literature review

“…20,24 Eight papers reported research that had collected data from doctors, nurses or both regarding the concerns of family members about intervention for diminishing drinking at the end of life (narrative B, professionals). [28][29][30][31][32][33][34][35] A single paper focused on supportive care (narrative C). 36…”

“…The literature review found 16 studies about the experiences of family members regarding interventions given to their dying relatives to address diminishing drinking and its consequences. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] All 16 studies focused on the medical intervention of clinically assisted hydration and/or nutrition. The studies did not explore any other supportive interventions, such as mouth care or sipping small amounts of fluid in depth, although these emerged within the findings of one study.…”

“…21 Eight papers reported on research that had collected data from doctors, nurses or a combination of both regarding the concerns of family members. [28][29][30][31][32][33][34][35] These were also methodically and geographically diverse and with qualitative and quantitative designs from across North America, 34 Europe, 28,33 Australasia [30][31][32][33][34][35] and Asia. 29 This narrative of research with professionals about family members shows a shift in focus over time.…”