[Ethical implications in the therapeutic management of dehydrated patients at the end of life].

Background: The ethical framework for fluid management in the palliative care setting can vary.

Objectives: What are the relevant ethical implications related to dehydration during end-of-life care and what are the special requirements we need to consider as far as "terminal dehydration" is concerned?

Materials And Methods: A comprehensive literature search was conducted to identify relevant articles published in English and German.

Results: Our inferences represent an attitude rather than an evidence-based position-a fact that is due to the underlying normative and ethical references which are hardly amenable to statistical evaluation.

[Legal considerations in the care of patients with "terminal dehydration" in Germany].

Background: The legal framework for fluid management in the palliative care setting varies between continents and even between countries.

Objectives: What legal implications must be taken into account in Germany in dealing with "terminal" dehydration?

Materials And Methods: Relevant publications in English and German have been identified. Notably, German recommendations and guidelines were reviewed, whereas national mindsets were contrasted with those of other countries like the United Kingdom and Canada.

["Terminal" dehydration : Differential diagnosis and body of evidence].

Dehydration in palliative care patients can be associated with increased morbidity and mortality and is nevertheless therapeutically controversial. This article provides an overview of possible causes of dehydration at the end of life and places special emphasis on "terminal" dehydration in the dying. Empirical attitudes of healthcare professionals and persons concerned (patients and relatives) as well as evidence-based findings on "terminal" dehydration are elucidated and the limitations are described.

How to manage terminal dehydration.

Although dehydration is a serious condition associated with significant morbidity and mortality in palliative care patients, as in any other patient group, treatment remains controversial. A narrative review of the causes of dehydration during end of life was conducted paying special attention to the nature of terminal dehydration. A comprehensive search of the literature was performed to identify relevant articles published in English and German languages between 1960 and 2018.

["Terminal" dehydration, part 2 : Medical indications and therapeutic approach].

The approach in the clinical fluid management of the dying is still controversially discussed in specialist circles and also in the general population. In this article the importance of establishing the therapeutic indications is emphasized against the background of a lack of evidence. Options to achieve noninvasive objectification of assumed dehydration as well as assessment of the reversibility of the symptoms are shown and the importance of monitoring of all therapeutic actions is discussed.