Clinical and ethical considerations of fluid and electrolyte management in the terminally ill client

Modern medicine has at its disposal a vast array of technology to provide support for basic human functions that have been compromised by trauma or disease. These are frequently referred to as life-support interventions, without which life could not be sustained beyond either an immediate or relatively short period of time. This includes support for basic physiologic activities such as respiration, circulation, kidney function, and food and fluid needs. Among the many medical interventions available to circumvent life-threatening situations that jeopardize these basic functions, artificial nutrition/hydration poses the greatest challenges. Various factors must be considered and weighed in coming to a decision about the appropriateness or inappropriateness of using the technology available to provide nutrition and hydration. These factors include clinical, ethical, legal and emotional considerations.