Ethical issues in artificial nutrition and hydration: A review

Journal of Parenteral and Enteral Nutrition

Volumn 34, Issue 1, 2010, Pages 79-88

  Geppert, Cynthia M A ^a   Andrews, Maria R ^b   Druyan, Mary Ellen ^c  

^a UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE   (United States)

^b El Paso VA Health Care System   (United States)

^c Broad Spectrum Communications   (United States)

Author keywords

Bioethics; Dementia; Enteral nutrition; Nutritional support; Palliative care

Indexed keywords

BIOETHICS; CLINICAL PRACTICE; DEMENTIA; ENTERIC FEEDING; HEALTH CARE PERSONNEL; HOSPITAL POLICY; HUMAN; HYDRATION; INFORMED CONSENT; LEGAL ASPECT; MEDICAL DECISION MAKING; NUTRITIONAL SUPPORT; PALLIATIVE THERAPY; PARENTERAL NUTRITION; PATIENT GUIDANCE; PERSISTENT VEGETATIVE STATE; PRACTICE GUIDELINE; PRIORITY JOURNAL; RELIGION; RESPONSIBILITY; REVIEW; TERMINAL DISEASE; TREATMENT WITHDRAWAL;

ADOLESCENT; ADULT; CHILD; DEMENTIA; ETHICS, MEDICAL; FLUID THERAPY; HUMANS; INFANT; INFORMED CONSENT; NUTRITIONAL SUPPORT; PALLIATIVE CARE; PERSISTENT VEGETATIVE STATE; PHYSICIAN'S PRACTICE PATTERNS; PRACTICE GUIDELINES AS TOPIC; TERMINALLY ILL;

EID: 76749154987     PISSN: 01486071     EISSN: None     Source Type: Journal    
DOI: 10.1177/0148607109347209     Document Type: Review

References (91)

1. Teitelbaum D, Guenter P, Howell WH, Kochevar ME, Roth J, Seidner DL. Definition of terms, style, and conventions used in A. S. P. E. N. guidelines and standards. Nutr Clin Pract. 2005;20: 281-285.
2. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 5th ed. New York, NY: Oxford University Press; 2001.
3. Gillon R. Medical ethics: four principles plus attention to scope. BMJ. 1994;309:184-188.
4. Bouvia v Superior Court (Glenchur), 195 Cal Ann 3rd 1075, 1987.
5. Quellette A. Disability and the end of life. Oregon Law Review. 1987;85:123-175.
6. Hallenbeck J. Fast Facts and Concepts, #11: Tube Feed or Not Tube Feed? 2nd ed. End-of-Life Physician Education Resource Center: Medical College of Wisconsin; August 2005.
7. Pellegrino ED. Managed care at the bedside: how do we look in the moral mirror? Kennedy Inst Ethics J. 1997;7:321-330.
8. Bennett J, Eidsness LM, Young S. Artificial hydration and nutrition: a practical approach to discussion and decision-making. S D Med. 2008;Spec No:54-58.
9. Fetters MD. The family in medical decision making: Japanese perspectives. J Clin Ethics. 1998;9:132-146.
10. Bedolla M. Patient Self-Determination Act: a Hispanic perspective. Camb Q Healthc Ethics. 1994;3:413-417.
11. Carrese JA, Rhodes LA. Western bioethics on the Navajo reservation: benefit or harm? JAMA. 1995;274:826-829.
12. Bacon D, Williams MA, Gordon J. Position statement on laws and regulations concerning life-sustaining treatment, including artificial nutrition and hydration, for patients lacking decision-making capacity. Neurology. 2007;68:1097-1100.
13. Pope John Paul II. Life-sustaining treatments and the vegetative state: scientific advances and ethical dilemmas. Address to the participants in the International Congress on Life-Sustaining Treatments and the Vegetative State: scientific advances and ethical dilemmas. 2004. http://www.vatican. va/holy-father/john-paul-ii/speeches/2004/march/documents/hf-jp-ii-spe-20040320- congress-fiamc-en.html. Accessed August 5th, 2009.
14. O'Rourke KD. Artificial nutrition and hydration and the Catholic tradition: the Terri Schiavo case had even members of Congress debating the issue. Health Prog. 2007;88:50-54.
15. Sulmasy DP. Are feeding tubes morally obligatory? St. Anthony Messenger. 2006;113:28-32.
16. Shannon TA, Walter JJ. Implications of the papal allocution on feeding tubes. Hastings Cent Rep. 2004;34:18-20.
17. Dorff EN. Applying traditional Jewish law to PVS. NeuroRehabilitation. 2004;19:277-283.
18. Gillick MR. Artificial nutrition and hydration in the patient with advanced dementia: is withholding treatment compatible with traditional Judaism? J Med Ethics. 2001;27:12-15.
19. Andrews M, Geppert CM. Ethics. In: Gottschlich MM, ed. The A. S. P. E. N. Nutrition Support Core; Curriculum. Silver Spring, MD: American Society for Parenteral and Enteral Nutrition; 2007.
20. The President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research. Deciding to Forgo Life-Sustaining Treatment: A Report on the Ethical, Medical, and Legal Issues in Treatment Decisions. Washington, DC: U. S. Government Printing Office; 1983.
21. American Medical Association Council on Ethical and Judicial Affairs. Code of Medical Ethics: Current Opinions With Annotations. Chicago, IL: American Medical Association; 2006-2007.
22. Snyder L, Leffler C. Ethics Manual. Philadelphia, PA: Ethics and Human Rights Committee of the American College of Physicians; 2005.
23. Maillet JO, Potter RL, Heller L. Position of the American Dietetic Association: ethical and legal issues in nutrition, hydration, and feeding. J Am Diet As Soc. 2002;102:716-726.
24. Foster C, Carpenter J. Nutritional support at the end of life: the relevant legal issues. Eur J Gastroenterol Hepatol. 2007;19:389-393.
25. Mathes MM. Withholding and withdrawing artificial nutrition and hydration: a legal perspective. Medsurg Nurs. 2000;9:270-273.
26. Burck R. Feeding, withdrawing, and withholding: ethical perspectives. Nutr Clin Pract. 1996;11:243-253.
27. Meisel A. The legal consensus about foregoing life-sustaining treatment: its status and its prospects. Kennedy Inst Ethics J. 1992;2:309-345.
28. Jones BJ. Nutritional support at the end of life: the relevant ethical issues. Eur J Gastroenterol Hepatol. 2007;19:383-388.
29. Gostin LO. Ethics, the constitution, and the dying process: the case of Theresa Marie Schiavo. JAMA. 2005;293:2403-2407.
30. Gostin L, Weir RF. Life and death choices after Cruzan: case law and standards of professional conduct. Milbank Q. 1991;69:143-173.
31. Appelbaum PS, Grisso T. Assessing patients' capacities to consent to treatment. N Engl J M Ed. 1988;319:1635-1638.
32. Brett AS, Rosenberg JC. The adequacy of informed consent for placement of gastrostomy tubes. Arch Intern M Ed. 2001;161:745-748.
33. Johnson J, Mitchell C. Responding to parental requests to forego pediatric nutrition and hydration. J Clin Ethics. 2000;11:128-135.
34. Johnson JA. Withdrawal of medically administered nutrition and hydration: the role of benefits and burdens, and of parents and ethics committees. J Clin Ethics. 2004;15:307-311.
35. Levi BH. Withdrawing nutrition and hydration from children: legal, ethical, and professional issues. Clin Pediatr (Phila). 2003;42: 139-145.
36. Carter BS, Leuthner SR. The ethics of withholding/withdrawing nutrition in the newborn. Semin Perinatol. 2003;27:480-487.
37. Nelson LJ, Nelson RM. Ethics and the provision of futile, harmful, or burdensome treatment to children. Crit Care M Ed. 1992;20:427-433.
38. Fine RL. Ethical issues in artificial nutrition and hydration. Nutr Clin Pract. 2006;21:118-125.
39. Jaffe E, Knight CF. Ethical and Legal Dimensions of Treating Life-Limiting Illness. Vol Unipac Six 3rd ed. Glenview, IL: American Academy of Hospice and Palliative Care Medicine; 2008.
40. Barrocas A, Yarbrough G, Becnel PA III, Nelson JE. Ethical and legal issues in nutrition support of the geriatric patient: the can, should, and must of nutrition support. Nutr Clin Pract. 2003;18:37-47.
41. Barber v Superior Court, 195 Cal Rptr 484, 486 (Ct. App. 1983).
42. Cruzan v Director Missouri Department of Health, 2481 (110 S. Ct 1990).
43. Omnibus Reconciliation Act of 1990. Vol 101-508: Public Law (1990).
44. Ott BB. Advance directives: the emerging body of research. Am J Crit Care. 1999;8:514-519.
45. Terry PB, Vettese M, Song J, et al. End-of-life decision making: when patients and surrogates disagree. J Clin Ethics. 1999;10:286-293.
46. Miles SH, Koepp R, Weber EP. Advance end-of-life treatment planning: a research review. Arch Intern M Ed. 1996;156:1062-1068.
47. Mitchell SL, Berkowitz RE, Lawson FM, Lipsitz LA. A crossnational survey of tube-feeding decisions in cognitively impaired older persons. J Am Geriatr Soc. 2000;48:391-397.
48. Mitchell SL, Lawson FM. Decision-making for long-term tube-feeding in cognitively impaired elderly people. CMAJ. 1999; 160:1705-1709.
49. Lewis CL, Hanson LC, Golin C, et al. Surrogates' perceptions about feeding tube placement decisions. Patient Educ Couns. 2006;61:246-252.
50. Lang F, Quill T. Making decisions with families at the end of life. Am Fam Physician. 2004;70:719-723.
51. Seckler AB, Meier DE, Mulvihill M, Paris BE. Substituted judgment: how accurate are proxy predictions? Ann Intern M Ed. 1991;115:92-98.
52. Sulmasy D P, Haller K, Terry PB. More talk, less paper: predicting the accuracy of substituted judgments. Am J M Ed. 1994;96:432-438.
53. Sulmasy DP, Terry PB, Weisman CS, et al. The accuracy of substituted judgments in patients with terminal diagnoses. Ann Intern M Ed. 1998;128:621-629.
54. Jonsen AR, Seigler M, Winslade WJ. Clinical Ethics. 4th ed. New York, NY: McGraw-Hill; 1998.
55. Lloyd GER, ed. Hippocratic Writings. London: Penguin Books; 1983.
56. Lasagna L. Hippocratic oath modern version. http://www.pbs.org/wgbh/nova/ doctors/oath-modern. html. Accessed December 21, 2008.
57. Solomon MZ, O'Donnell L, Jennings B, et al. Decisions near the end of life: professional views on life-sustaining treatments. Am J Public Health. 1993;83:14-23.
58. Andrews M, Bell ER, Smith SA, Tischler JF, Veglia JM. Dehydration in terminally ill patients: is it appropriate palliative care? Postgrad M Ed. 1993;93:201-203, 206-208.
59. McCann RM, Hall WJ, Groth-Juncker A. Comfort care for terminally ill patients: the appropriate use of nutrition and hydration. JAMA. 1994;272:1263-1266.
60. Printz LA. Terminal dehydration, a compassionate treatment. Arch Intern M Ed. 1992;152:697-700.
61. Morita T, Shima Y, Miyashita M, Kimura R, Adachi I. Physicianand nurse-reported effects of intravenous hydration therapy on symptoms of terminally ill patients with cancer. J Palliat M Ed. 2004;7:683-693.
62. Ganzini L, Goy ER, Miller LL, Harvath TA, Jackson A, Delorit MA. Nurses' experiences with hospice patients who refuse food and fluids to hasten death. N Engl J M Ed. 2003;349:359-365.
63. Li I. Feeding tubes in patients with severe dementia. Am Fam Physician. 2002;65:1605-1610, 1515.
64. Burge FI. Dehydration and provision of fluids in palliative care: what is the evidence? Can Fam Physician. 1996;42:2383-2388.
65. Finucane TE. Malnutrition, tube feeding and pressure sores: data are incomplete. J Am Geriatr Soc. 1995;43:447-451.
66. Fainsinger RL, MacEachern T, Miller MJ, et al. The use of hypodermoclysis for rehydration in terminally ill cancer patients. J Pain Symptom Manage. 1994;9:298-302.
67. de Stoutz ND, Tapper M, Fainsinger RL. Reversible delirium in terminally ill patients. J Pain Symptom Manage. 1995;10:249-253.
68. Ganzini L. Artificial nutrition and hydration at the end of life: ethics and evidence. Palliat Support Care. 2006;4:135-143.
69. Zerwekh JV. Do dying patients really need i.v. fluids? Am J Nurs. 1997;97:26-30.
70. Chernoff R. Tube feeding patients with dementia. Nutr Clin Pract. 2006;21:142-146.
71. Finucane TE, Christmas C, Travis K. Tube feeding in patients with advanced dementia: a review of the evidence. JAMA. 1999; 282:1365-1370.
72. Cervo FA, Bryan L, Farber S. To PEG or not to PEG: a review of evidence for placing feeding tubes in advanced dementia and the decision-making process. Geriatrics. 2006;61:30-35.
73. Meier DE, Ahronheim JC, Morris J, Baskin-Lyons S, Morrison RS. High short-term mortality in hospitalized patients with advanced dementia: lack of benefit of tube feeding. Arch Intern M Ed. 2001;161:594-599.
74. Alvarez-Fernandez B, Garcia-Ordonez MA, Martinez-Manzanares C, Gomez-Huelgas R. Survival of a cohort of elderly patients with advanced dementia: nasogastric tube feeding as a risk factor for mortality. Int J Geriatr Psychiatry. 2005;20:363-370.
75. Murphy LM, Lipman TO. Percutaneous endoscopic gastrostomy does not prolong survival in patients with dementia. Arch Intern M Ed. 2003;163:1351-1353.
76. Gillick MR. Rethinking the role of tube feeding in patients with advanced dementia. N Engl J M Ed. 2000;342:206-210.
77. Peck A, Cohen CE, Mulvihill MN. Long-term enteral feeding of aged demented nursing home patients. J Am Geriatr Soc. 1990;38: 1195-1198.
78. Kaw M, Sekas G. Long-term follow-up of consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home patients. Dig Dis Sci. 1994;39:738-743.
79. Vitale CA, Hiner T, Ury WA, Berkman CS, Ahronheim JC. Tube feeding in advanced dementia: an exploratory survey of physician knowledge. Care Manag J. 2006;7:79-85.
80. Shega JW, Hougham GW, Stocking CB, Cox-Hayley D, Sachs GA. Barriers to limiting the practice of feeding tube placement in advanced dementia. J Palliat M Ed. 2003;6:885-893.
81. DiBartolo MC. Careful hand feeding: a reasonable alternative to PEG tube placement in individuals with dementia. J Gerontol Nurs. 2006;32:25-33.
82. Mitchell SL. Financial incentives for placing feeding tubes in nursing home residents with advanced dementia. J Am Geriatr Soc. 2003;51:129-131.
83. National Health and Medical Research Council of Australia. Ethical Guidelines for Care of People in Post-Coma Unresponsiveness (Vegetative State) or a Minimally Responsive State. Canberra, Australia: ACT; 2008.
84. Giacino JT, Ashwal S, Childs N, et al. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002;58: 349-353.
85. Giacino JT, Kalmar K. Diagnostic and prognostic guidelines for the vegetative and minimally conscious states. Neuropsychol Rehabil. 2005;15:166-174.
86. Andrews K. Medical decision making in the vegetative state: withdrawal of nutrition and hydration. NeuroRehabilitation. 2004;19:299-304.
87. Sieger CE, Arnold JF, Ahronheim JC. Refusing artificial nutrition and hydration: does statutory law send the wrong message? J Am Geriatr Soc. 2002;50:544-550.
88. Wicclair MR. Conscientious objection in medicine. Bioethics. 2000;14:205-227.
89. American Academy of Hospice and Palliative Medicine. Statement on the Use of Nutrition and Hydration. Glenview, IL: American Academy of Hospice and Palliative Medicine; 2005.
90. Casarett D, Kapo J, Caplan A. Appropriate use of artificial nutrition and hydration-fundamental principles and recommendations. N Engl J M Ed. 2005;353:2607-2612.
91. The Hastings Center. Guidelines on medical procedures for supplying nutrition and hydration. Guidelines on the Termination of Life Sustaining Treatment and the Care of the Dying. Bloomington, IN: Indiana University Press; 1987.