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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It is quite simple actually. If someone is not peeing huge amounts of urine, not having diarrhea and not having profuse sweat, the water loss is quite small. People in hospice care often have constipation, reduced muscle mass, heart failure and a reduced hypothalamic activity (meaning loss of appetite and reduced capacity for fever reaction). They have no reason to get severe dehydration simply because they are not given parenteral fluids.
Consistent with that, research shows that people in hospice care that are evaluated to be in their last days of life that are given parenteral fluids (even subcutaneous fluids can be admininstered actually) have no better outcome than people who were not given fluids.
If there is not an objective end point that is improved, it means such therapy is futile. If admininstering IV fluids doesn’t lead to improved outcome, then not admininstering it doesn’t mean that care was withhold because IV fluids doesn’t even qualify as “care” at this period of time. This is different from withholding care say, for example, in a DNR scenario, where it is presumed that not doing resuscitative measures such as not initiating mechanical ventilation will certainly lead to a quicker death.
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