eli5: Patients in hospice care are often unconscious due to high doses of sedative drugs, and are given no intravenous fluids, which leads to death by dehydration. Why is this done? Is there any difference between this and physician-assisted suicide?
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As a double boarded hospice physician, this question is full of misconceptions which are stated as facts. I’ll go through them as they appear in the question.
>Patients in hospice care are often unconscious due to high doses of sedative drugs
Wrong. Patients are usually unconscious because they are dying. We only give patients sedatives if they are agitated, which does happen at the end of life and is referred to as ‘terminal agitation’. If someone is anxious we will also order them a sedative as needed, but the concept of patients being unconscious due being routinely given ‘high doses of sedatives’ is erroneous.
>and are given no intravenous fluids, which leads to death by dehydration.
Again, this is simply untrue. The patient is dying, which is why they are in hospice. Giving IV fluids would do nothing except prolong the dying process (which is no kindness for the patient or their family), and in many cases would actually accelerate death from fluid overload due to poor cardiac function; the patient literally drowns in their bed. The patient dies because their illness has left them unable to eat or drink, which can lead to things like kidney failure, not from dehydration.
>Is there any difference between this and physician-assisted suicide?
Yes, there is a huge difference. Again, these people in hospice are ACTIVELY dying from their illness and are being given everything to make their deaths as easy and painless as possible. We don’t try to shorten or prolong life but instead focus on improving the quality of life however we can. Physician assisted suicide is just that- helping someone who is terminally ill but NOT actively dying and who likely has some significant amount of time left to end their life.
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