Ethical Issues in Artificial Nutrition and Hydration: A Review
Geppert, Cynthia M.A.
Andrews, Maria R.
Druyan, Mary Ellen
Journal of Parenteral and Enteral Nutrition 2010 January-February; 34(1): 79-88
Healthcare professionals often face clinical and ethical challenges when charged with making decisions related to provision or lack of provision of artificial nutrition and hydration. The intent of this review is to supply a framework of clinical practices, ethical principles, legal precedents, and professional guidelines that will impart information and can assist decision making regarding artificial nutrition and hydration. Comprehensive understanding of the theory and practice of informed consent for competent adults, decisionally incompetent adults, and minors is necessary for making valid clinical judgments and for guiding patients and their families or surrogates in choosing options related to initiating, withholding, or withdrawing artificial nutrition and hydration. The framework offered in this review can serve as a basis for evaluation of appropriateness of artificial nutrition and hydration in 3 common conditions in which decision making is particularly challenging: terminal illness, advanced dementia, and a persistent vegetative state. The framework facilitates guidance for institutional policy makers and individual nutrition support professionals dealing with situations in which personal values often create ethical dilemmas related to artificial nutrition and hydration and its utility.
Adults; Consent; Decision Making; Dementia; Evaluation; Guidelines; Informed Consent; Illness; Minors; Nutrition; Patients; Persistent Vegetative State; Review; Values; Quality of Health Care; Care of the Dying Patient; Care of Dying Minors; Prolongation of Life and Euthanasia; Allowing Minors to Die;
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