Terminal dehydration is
dehydration
In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
to the point of death. Some scholars make a distinction between "terminal dehydration" and "termination by dehydration". Courts in the United States
[NL Cantor (1987). Legal frontiers of death and dying. Indiana University Press. , pp. 28-29.] generally do not recognize prisoners as having a right to die by voluntary dehydration, since they view it as
suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
.
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Progression
During terminal dehydration, the usual symptoms of dehydration, such as headache
Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches.
Headaches can occur as a result ...
and leg cramp
A cramp is a sudden, involuntary, painful skeletal muscle contraction or overshortening associated with electrical activity; while generally temporary and non-damaging, they can cause significant pain and a paralysis-like immobility of the a ...
s, can occur. Unlike many other suicide methods, it cannot be accomplished impulsively. However, a "point of no return" can eventually be reached at which, should it be desired to abort the terminal dehydration, rehydration cannot be accomplished through simple oral rehydration therapy
Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydrati ...
; rather, it will require medical assistance such as intravenous therapy
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutri ...
. Those who die by terminal dehydration typically lapse into unconsciousness before death, and may also experience delirium
Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in ...
and altered serum sodium
Sodium ions (Na) are necessary in small amounts for some types of plants,
but sodium as a nutrient is more generally needed in larger amounts by animals, due to their use of it for generation of nerve impulses and for maintenance of electrolyte ...
. Discontinuation of hydration does not produce true thirst, although a sensation of dryness of the mouth often is reported as "thirst". The evidence that true thirst does not occur is extensive, along with evidence showing that the ill feeling is not relieved by giving fluids intravenously, but rather by wetting the tongue and lips and proper care of the mouth. Patients with edema
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
tend to take longer to die of dehydration because of the excess fluid in their bodies. Dehydration has been known to cause a sense of "mild euphoria", provided no intravenous is used.
Voluntary
Terminal dehydration (also known as voluntary death by dehydration or VDD) has been described as having substantial advantages over physician-assisted suicide with respect to self-determination, access, professional integrity, and social implications. Specifically, a patient has a right to refuse treatment and it would be a personal assault for someone to force water on a patient, but such is not the case if a doctor merely refuses to provide lethal medication. Some physicians believe it might have distinctive drawbacks as a humane means of voluntary death. One survey of hospice nurses in Oregon (where physician-assisted suicide is legal) found that nearly twice as many had cared for patients who chose voluntary refusal of food and fluids to hasten death as had cared for patients who chose physician-assisted suicide. They also rated fasting and dehydration as causing less suffering and pain and being more peaceful than physician-assisted suicide. Patients undergoing terminal dehydration can often feel no pain, as they are often given sedatives and care such as mouth rinses or sprays There can be a fine line between terminal sedation In medicine, specifically in end-of-life care, palliative sedation (also known as terminal sedation, continuous deep sedation, or sedation for intractable distress of a dying patient) is the palliative practice of relieving distress in a terminall ...
that results in death by dehydration and euthanasia
Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering.
Different countries have different eut ...
.
Studies have shown that for terminally ill patients who choose to die, deaths by terminal dehydration are generally peaceful, and not associated with suffering, when supplemented with adequate pain medication.
All ages may feel sudden head rushes, dizziness, and loss of appetite, as well.
Members of the Buddhist Sokushinbutsu
are a kind of Buddhist mummy. In Japan the term refers to the practice of Buddhist monks observing asceticism to the point of death and entering mummification while alive. Mummified monks are seen in a number of Buddhist countries. Only in Japa ...
sect of Japan historically practiced a form of self-mummification which in part was achieved by the forgoing of all food and liquid until death.
Involuntary
In the Netherlands
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debate has broken out about terminal dehydration, which is referred to as '. There have been accusations that involuntary dehydration takes place in nursing home
A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to in ...
s. Another doctoral thesis found no evidence of forced-upon "versterving" in nursing homes. There was, however, voiced vehement opposition considering assistance for those who voluntarily abstained from food and drink.
See also
* Heat illness
Heat illness is a spectrum of disorders due to increased body temperature. It can be caused by either environmental conditions or by exertion. It includes minor conditions such as heat cramps, heat syncope, and heat exhaustion as well as the mo ...
* Hypovolemia
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. This may be due to either a loss of both salt and water or a decrease in blood volume. Hypovolemia refers to the los ...
* Hypovolemic shock
Hypovolemic shock is a form of shock caused by severe hypovolemia (insufficient blood volume or extracellular fluid in the body). It could be the result of severe dehydration through a variety of mechanisms or blood loss. Hypovolemic shock is a ...
* Fasting
Fasting is the abstention from eating and sometimes drinking. From a purely physiological context, "fasting" may refer to the metabolic status of a person who has not eaten overnight (see " Breakfast"), or to the metabolic state achieved after ...
* Medical food
Medical foods are foods that are specially formulated and intended for the dietary management of a disease that has distinctive nutritional needs that cannot be met by normal diet alone. In the United States they were defined in the Food and Drug A ...
* Terri Schiavo case
The Terri Schiavo case was a series of court and legislative actions in the United States from 1998 to 2005, regarding the care of Theresa Marie Schiavo (née Schindler) (; December 3, 1963 – March 31, 2005), a woman in an irreversible ...
References
{{Water-electrolyte imbalance and acid-base imbalance
Euthanasia
Suicide methods
Dehydration