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Intravenous Support in Dying Patients-Reply

Kenneth C. Micetich, MD; Patricia H. Steinecker, MD; David C. Thomasma, PhD
Arch Intern Med. 1984;144(2):420-421. doi:10.1001/archinte.1984.00350140254053.
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In Reply.  —We thank Ms Todd for her comments and agree with them. Patients die at home all the time without nurses, physicians, and students monitoring the death process. Intravenous support is not required in this setting. Why should it be required just because a patient is dying in the hospital rather than at home?Dr Aschoff is correct in pointing out that resuscitating terminally ill patients is inadvisable. We would go one step further and state that it is medically contraindicated. We suspect that contraindicated resuscitations still occur frequently, and we are currently reviewing our hospital's experience to determine how frequently.However, our point is that IV fluids are neither morally nor medically necessary in a comatose, terminally ill patient. Drs Solove, Donnelly, and Gotfried question the appropriateness of discontinuing IV treatment while maintaining respiratory support. We believe that there is a distinction between the two procedures.The distinction


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