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RECOMMENDATIONS
These recommendations refer specifically to imminently dying palliative patients, for whom sedation has commenced or is being considered, and may not apply in other situations. The strength of evidence is Level 1V and V.
- Nutrition and fluids should not be offered unless it is considered likely that the benefit will outweigh the harm. In a deeply sedated patient who is imminently dying, parenteral fluids are unlikely to influence either symptom control or survival time.
- Competent patients have the right to make informed decisions about their treatments. Account is taken of the views of family and significant others, but the interests of the patient have priority.
- Following discussion, the patient (if able), the family and the multi-professional team jointly make the decision to give or not give artificial nutrition and hydration
- Account is taken of cultural preferences and styles of decision-making. Although the provision of nutrition and fluids may be medically futile, there may be cultural and psychological benefits.
- When sedation is proposed in patients who are already receiving artificial feeding, it may be appropriate to recommend discontinuation (after discussion with the patient and/or their proxy).
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