Nutrition and hydration in terminally ill patients

Abstract

Many patients or families raise the possibility of using total parenteral nutrition (TPN) when a patient with advanced cancer is eating poorly and losing weight. Generally, in these situations, a clear, careful, discussion should take place to explain why TPN is only an option for rare selected cases, given that the vast majority of patients with advanced cancer die from the cancer process, not starvation. Loss of appetite, fatigue, and weight loss can, in fact, be part of the dying process. Randomized studies of nutritional support in patients with advanced cancer have failed to show any benefit in improving either survival or quality of life.If it is justified on the best clinical grounds, then it is ethically right to give ……… if not, it should not be done.