Artificial nutrition and hydration at the end of life

ethics and evidence.

    Research output: Contribution to journalArticle

    65 Citations (Scopus)

    Abstract

    The case of Terri Schiavo resulted in substantial media attention about the use of artificial nutrition and hydration (ANH) especially by percutaneous endoscopic gastrostomy (PEG). In this article, I review ethical and legal principles governing decisions to choose or forgo ANH at the end of life, including issues of autonomy and decision-making capacity, similarities and differences between ANH and other medical treatments, the role of proxies when patients lack decision-making capacity, and the equivalence of withholding and withdrawing treatment. Evidence for palliative or life-sustaining benefits for ANH are reviewed in three disease processes: amyotrophic lateral sclerosis (ALS), cancer, and dementias, including Alzheimer's disease. Although more recent studies suggest a possible palliative role for ANH in ALS and terminal cancer, feeding tubes do not appear to prolong survival or increase comfort in advanced dementia of the Alzheimer's type.

    Original languageEnglish (US)
    Pages (from-to)135-143
    Number of pages9
    JournalPalliative & supportive care
    Volume4
    Issue number2
    StatePublished - Jun 2006

    Fingerprint

    Withholding Treatment
    Amyotrophic Lateral Sclerosis
    Ethics
    Decision Making
    Alzheimer Disease
    Ethical Review
    Gastrostomy
    Enteral Nutrition
    Proxy
    Dementia
    Neoplasms
    Survival
    Therapeutics

    ASJC Scopus subject areas

    • Medicine(all)
    • Psychiatry and Mental health
    • Clinical Psychology
    • Nursing(all)

    Cite this

    Artificial nutrition and hydration at the end of life : ethics and evidence. / Ganzini, Linda.

    In: Palliative & supportive care, Vol. 4, No. 2, 06.2006, p. 135-143.

    Research output: Contribution to journalArticle

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