Question

A 78-year-old woman with metastatic lung cancer is approaching the end of life. She is increasingly drowsy, taking minimal oral intake, and has noisy respiratory secretions. Her family are distressed and ask you to start intravenous fluids to prevent dehydration. What is the most appropriate response?

Accepted Answer

Discuss the limited benefits of intravenous fluids at this stage and focus on symptom control and family support, considering small-volume fluids only if clear symptomatic benefit is likely

Answer

Agree to start intravenous fluids to prolong life

Answer

Explain that clinically assisted hydration is always inappropriate at the end of life

Answer

Tell the family that the decision is yours and they have no say

Answer

Start high-volume intravenous fluids to flush secretions

Practice question