These four errors below are contained in the NICE (National Institute for Clinical Excellence) Guidelines for Care of dying adults “in last days of life”. (Dec 2015)
1. The body needs less fluids when it is “shutting down”
There are no scientific grounds for this statement. It is wrong. It is the result of symptom based research not on fluid balance physiological research. There is no such thing as the body “shutting down” physiologically. It also presupposes you can diagnose imminent death.
2. The risk of intravenous hydration balances its benefits
Stopping hydration will kill. The main risk of hydration is giving too much fluid and the person becoming breathless. This is easily recognisable and treated with diuretics.
3. Giving hydration may prolong the “dying process” (an irreversible process that once started cannot be stopped)
There is no evidence that a “dying process” exists or that it can be diagnosed. If it is diagnosed, then the person who diagnoses it is making a prediction that becomes a “self-fulfilling prophecy”. If hydration is withdrawn then it will cause death. No person should die in a dehydrated state, as dehydration can accelerate or cause death.
4. Uncertain if not giving hydration will hasten death
This is totally untrue. Not giving fluids causes death by dehydration. A large number of end of life pathway deaths are due to dehydration.