Evidence map›Paper›PMID 37559116›Full record

ArticleBMC medical ethics2023

Ethical challenges around thirst in end-of-life care -experiences of palliative care physicians.

Maria Friedrichsen, Caroline Lythell, Nana Waldréus, Tiny Jaarsma, Helene Ångström, Micha Milovanovic, Marit Karlsson, Anna Milberg, Hans Thulesius, Christel Hedman and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMC medical ethics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Maria FriedrichsenPalliative Education and Research Centre, Vrinnevi hospital, Norrköping, Sweden. maria.friedrichsen@regionostergotland.se.
Caroline LythellPalliative Education and Research Centre, Vrinnevi hospital, Norrköping, Sweden.
Nana WaldréusDepartment of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
Tiny JaarsmaDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Helene ÅngströmPalliative Education and Research Centre, Vrinnevi hospital, Norrköping, Sweden.
Micha MilovanovicDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Marit KarlssonDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Anna MilbergDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Hans ThulesiusDepartment of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden and Region Kronoberg, Växjö, Sweden.
Christel HedmanDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Anne Söderlund SchallerDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Pier JaarsmaDivision of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Linköping University · SEVrinnevisjukhuset i Norrköping · SEKarolinska Institutet · SELinnaeus University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThirst and dry mouth are common symptoms in terminally ill patients. In their day-to-day practice, palliative care physicians regularly encounter ethical dilemmas, especially regarding artificial hydration. Few studies have focused on thirst and the ethical dilemmas palliative care physicians encounter in relation to this, leading to a knowledge gap in this area.

aimThe aim of this study was to explore palliative care physicians' experiences of ethical challenges in relation to thirst in terminally ill patients.

methodsA qualitative interview study with an inductive approach was conducted. Sixteen physicians working in four different specialised palliative care units and one geriatric care unit in different hospitals in Sweden were interviewed. The interviews were transcribed verbatim and analysed with a reflexive thematic analysis.

resultsWhen presented with an ethical challenge relating to thirst, physicians attempted to balance benefits and harms while emphasizing respect for the patient's autonomy. The ethical challenges in this study were: Starting, continuing or discontinuing drips; lack of evidence and traditions create doubt; and lack of interest and time may result in patient suffering.

conclusionsAll physicians in this study reported that "Starting, continuing or discontinuing drips" was the main ethical challenge they encountered, where some were so accustomed to the decision that they had a standard answer ready to offer patients and families. Physicians reported that drips were a symbol of thirst quenching, life and survival but were not necessary in end-of-life care. Others questioned the traditions regarding thirst and emphasised drips in particular.

Indexed as

PhysiciansTerminal CareAgedHumansPalliative CareQualitative ResearchSwedenThirstEthical challengesPalliative carePhysiciansThematic analysisThirst

Identifiers

PMID37559116
PMCPMC10413708
OpenAlexW4385708611

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.