title: [Nutrition and hydration at the end of life].
abstract: At the end of life the pleasure function of alimentation is to be preferred to its nutritive function. Artificial nutrition and hydration in an enteral or parenteral way are artificial life support techniques. Artificial nutrition and hydration are systematically justified for patients in curative phase that require it but not for patients in a terminal or agonal phase. The fear of death from hunger and thirst is not justified. It is more relevant of a symbolic and phantasmic dimension than of an objective reality. The practice of oral care is much more effective than installing an artificial hydration to improve the comfort of a patient at the very end of life. Withdrawing or withholding an artificial nutrition and hydration can prevent an unreasonable obstinacy prohibited by law.
authors.affiliation: Centre hospitalier René-Dubos, service de médecine palliative, 95300 Pontoise, France. Electronic address: bernard.devalois@gmail.com.
authors.forename: Bernard
authors.initials: B
authors.lastname: Devalois
authors.affiliation: AP-HP, hôpital Paul-Brousse, unité de soins palliatifs, 94800 Villejuif, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Broucke
mesh_terms: D005440:Fluid Therapy; D006801:Humans; D018529:Nutritional Support; D013727:Terminal Care / Q000592:standards