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The National Catholic Bioethics Quarterly

Volume 11, Issue 4, Winter 2011

Richard P. Becker, RN
Pages 649-659

Hypodermoclysis and Proctoclysis as Basic Care
Avoiding Unnecessary Terminal Dehydration

A wide variety of clinical situations can lead to the implementation of assisted nutrition and hydration (ANH). Both enteral ANH and parenteral assisted nutrition and hydration (PNH) serve to nourish and hydrate those who are incapable of normal eating and drinking. Although PNH via the intravenous (IV) route is comparable to enteral ANH in its intention, IV PNH bypasses the relevant body system—the digestive tract—entirely. Consequently, IV PNH is ethically comparable to mechanical ventilation and thus can be withheld or withdrawn following the ethical criteria that apply to any other extraordinary therapeutic measure. However, other alternatives to oral and enteral hydration that are proportionately less challenging than IV PNH (i.e., hypodermoclysis and proctoclysis) should be further evaluated as potentially ordinary means of keeping patients adequately hydrated at the end of life. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 649–659.