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DOI: 10.1055/s-0033-1359862
Flüssigkeitsgabe am Lebensende
Hydration at the End of LifePublikationsverlauf
Publikationsdatum:
29. Januar 2014 (online)
![](https://www.thieme-connect.de/media/palliativmedizin/201401/lookinside/thumbnails/10.1055-s-0033-1359862-1.jpg)
Zusammenfassung
Die Flüssigkeitsgabe am Lebensende ist ein sehr kontrovers diskutiertes Thema. Da keine international gültigen Leitlinien bestehen und die Evidenz nicht eindeutig ist, wird die Entscheidung häufig nicht nur aufgrund medizinischer, sondern auch aufgrund ethischer und emotionaler Gesichtspunkte getroffen.
Anhand eines Fallbeispiels werden das Vorgehen und die Bedeutung einer Flüssigkeitssubstitution diskutiert. Bei einer Patientin mit einer zerebralen Blutung und infauster Prognose wird aufgrund einer vorliegenden Patientenverfügung und des mutmaßlichen Willens jegliche Flüssigkeitsgabe sistiert. Trotzdem verstirbt die Patientin erst nach 21 Tagen. In dieser Zeit kommt es beim Ehemann zu schwierigen und wechselnden Verarbeitungsmechanismen, in welchen die Bedeutung der Flüssigkeitsgabe deutlich wird. Es zeigt sich, dass in der Palliativmedizin das Vorgehen und die Behandlung aufgrund von biologischen, psychologischen, sozialen und spirituellen Gesichtspunkten getroffen werden muss.
Abstract
Hydration at the end of life is a very controversially discussed subject. Due to the fact that no internationally valid recommendations and guidelines exist and the evidence is uncertain, the decision is made not only on the basis of medical but also on ethical and emotional points of view.
With the help of a case report the approach and the meaning of hydration at the end of life are discussed.
Complete hydration was stopped in a patient with a cerebral bleeding and poor prognosis. This approach was decided because of the advanced directives and the presumed will of the patient. Nevertheless she died only 21 days after stopping hydration. This time was a difficult process of accepting for her husband. In this context it becomes clear that in Palliative Care the approach and the treatment must be met on the basis of biological, psychological, social and spiritual aspects.
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