Which of the following best describes the use of artificial nutrition and hydration (ANH) in terminally ill patients?

• A. Those who receive ANH have a more comfortable death
• B. Those who have dysphagia survive longer with ANH
• C. Those who receive ANH have a decrease in abnormal electrolytes
• D. Those who receive no ANH do not experience more negative side effects than those who do

Answer: (D)

In terminally ill patients, the focus is on comfort and avoiding burdens from invasive interventions. The best description is that not providing artificial nutrition and hydration does not lead to more negative side effects than providing it. This reflects the understanding that ANH often does not improve comfort or extend meaningful life and can introduce risks from procedures, infections, fluid overload, or other complications. The idea that ANH would consistently make death more comfortable or extend survival isn’t reliably supported in this context, and assumptions that it lowers electrolyte abnormalities aren’t consistently observed. When care aims to minimize suffering and unnecessary burdens, withholding ANH can avoid additional procedures and their potential downsides without increasing adverse effects.