Medically assisted hydration for adult palliative care patients

Good, Phillip; Richard, Russell; Syrmis, William; Jenkins-Marsh, Sue; Stephens, Jane

doi:10.1002/14651858.cd006273.pub3

Cited by 76 publications

(55 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in part as a result of an inconclusive finding in Good et al's (2008Good et al's ( , 2014 Cochrane review of BMedically Assisted Hydration for Adult Palliative Care Patients^and in light of prevailing sociocultural views on feeding and hydration at the end of life in Singapore (Good et al 2014;Krishna 2011aKrishna , 2011bHo, Krishna, and Yee 2010;Chai, Krishna, and Wong 2014). The prevailing sociocultural view of maintaining hydration and nutrition even in the terminal stages of life amongst local patients and families has directly influenced Singapore's Advanced Medical Directive Act 2010 and underpins the position adopted within these new guidelines.…”

Section: Continuous Deep Palliative Sedationmentioning

confidence: 95%

Addressing the Concerns Surrounding Continuous Deep Sedation in Singapore and Southeast Asia: A Palliative Care Approach

Krishna

2015

Bioethical Inquiry

View full text Add to dashboard Cite

The application of continuous deep sedation (CDS) in the treatment of intractable suffering at the end of life continues to be tied to a number of concerns that have negated its use in palliative care. Part of the resistance towards use of this treatment option of last resort has been the continued association of CDS with physician-associated suicide and/or euthanasia (PAS/E), which is compounded by a lack clinical guidelines and a failure to cite this treatment under the aegis of a palliative care approach. I argue that reinstituting a palliative care-inspired approach that includes a holistic review of the patient's situation and the engagement of a multidisciplinary team (MDT) guided by clearly defined practice requirements that have been lacking amongst many prevailing guidelines will overcome prevailing objections to this practice and allow for the legitimization of this process.

show abstract

Section: Continuous Deep Palliative Sedationmentioning

confidence: 95%

Addressing the Concerns Surrounding Continuous Deep Sedation in Singapore and Southeast Asia: A Palliative Care Approach

Krishna

2015

Bioethical Inquiry

View full text Add to dashboard Cite

show abstract

“…There are no studies that would support this assumption 17 20. A review of the best evidence, which showed a handful of high quality studies in relation to symptom relief, found that none of these studies provided ‘information on the effect hydration may have on survival.’17 Also very recently, a scientifically reliable study conducted on patients with advanced cancer showed that parenteral hydration did not improve symptoms associated with dehydration, quality of life or survival as compared with the placebo group. It did not prolong life in these patients 21…”

Section: Clinical Evidencementioning

confidence: 99%

Clinically assisted hydration and the Liverpool Care Pathway: Catholic ethics and clinical evidence

Nowarska¹

2014

J Med Ethics

View full text Add to dashboard Cite

The Liverpool Care Pathway for the Dying Patient (LCP), a framework introduced for providing comfortable care at the last stage of life, has recently become highly contentious. Among the most serious allegations levelled against it, has been that the LCP may be used as a covert form of euthanasia by withdrawal of clinically assisted hydration (CAH). This concern has been raised, in particular by a number of Catholic medical professionals, who have asserted that the LCP is incompatible with Catholic ethics. This paper examines the key Catholic ethical principles relevant to treatment and care towards the end of life (the sanctity/inviolability of life principle, the distinction between ordinary and extraordinary means). Relevant current clinical evidence regarding CAH in relation to terminal thirst, dehydration, prolongation of life and possible negative impacts on the dying is also scrutinised. It is argued that for some patients at the very end of life it may be permissible and even desirable to withhold or withdraw it. Thus, as administration of CAH may become extraordinary, forgoing it in some situations is fully compatible with Catholic ethics. The article therefore concludes that the stance of the LCP in respect of provision of CAH is fully in alignment with Catholic teaching.

show abstract

“…A Cochrane review of CAH in palliative care,1 undertaken in 2008 and updated in 2011, included five papers which varied in their methodological quality. There is limited evidence that CAH may improve sedation, myoclonus and decrease ‘dehydration’,2 ii but no evidence to suggest that it can improve symptoms such as thirst, delirium or fatigue.…”

Section: Introductionmentioning

confidence: 99%

What influences attitudes towards clinically assisted hydration in the care of dying patients? A review of the literature

Gent

Fradsham

Whyte

et al. 2014

BMJ Support Palliat Care

View full text Add to dashboard Cite

Developing international evidence suggests that cultural norms and ethical principles of a family, population or healthcare environment influence attitudes towards CAH, particularly where CAH has symbolic meaning; representing care, hope and trust. However, there is surprisingly little robust evidence regarding dying patients, or the wider general public's views, on the perceived value of CAH in the last days and hours of life. Accordingly, a need for greater understanding of the perceptions regarding CAH, and their effects, is required.

show abstract

Medically assisted hydration for adult palliative care patients

Cited by 76 publications

References 25 publications

Addressing the Concerns Surrounding Continuous Deep Sedation in Singapore and Southeast Asia: A Palliative Care Approach

Addressing the Concerns Surrounding Continuous Deep Sedation in Singapore and Southeast Asia: A Palliative Care Approach

Clinically assisted hydration and the Liverpool Care Pathway: Catholic ethics and clinical evidence

What influences attitudes towards clinically assisted hydration in the care of dying patients? A review of the literature

Contact Info

Product

Resources

About