Artificial nutrition and hydration at the end of life

Journal of Nutrition for the Elderly

Volumn 29, Issue 4, 2010, Pages 347-385

  Heuberger, Roschelle A ^a  

^a CENTRAL MICHIGAN UNIVERSITY   (United States)

Author keywords

Artificial hydration; End of life; Nutrition support; Older adult

Indexed keywords

AGED; ETHICS; HUMAN; LEGAL ASPECT; MEDICAL ETHICS; NUTRITIONAL SCIENCE; NUTRITIONAL SUPPORT; PALLIATIVE THERAPY; PASSIVE EUTHANASIA; PATIENT ADVOCACY; REVIEW;

AGED; AGED, 80 AND OVER; ETHICS, MEDICAL; EUTHANASIA, PASSIVE; HUMANS; NUTRITIONAL SCIENCES; NUTRITIONAL SUPPORT; PALLIATIVE CARE; PATIENT ADVOCACY;

EID: 78649472162     PISSN: 01639366     EISSN: 15408566     Source Type: Journal    
DOI: 10.1080/01639366.2010.521020     Document Type: Review

References (211)

1. Blackhall LJ, Frank G, Murphy ST, Michel V, Palmer JM, Azen SP. Ethnicity and attitudes towards life sustaining technology. Soc Sci Med. 1999; 48:1779-89.
2. Drane JF. Stopping nutrition and hydration technologies: a conflict between traditional Catholic ethics and church authority. Christian Bioethics. 2006; 12:11-28.
3. Becker R. Providing hydration at the end of life: ethics and practice. Nurs Rev. 2008; 104(Suppl. 9):15.
4. Cantor NL. The straight route to withholding hand feeding and hydration. Am J Bioeth. 2009; 9:57-8.
5. Limerick MH. The process used by surrogate decision makers to withhold and withdraw life-sustaining measures in an intensive care environment. Oncol Nurs Forum. 2007; 34:331-9.
6. Emanuel LL. Re-examining death. Hastings Cent Rep. 1995; 25:27-38.
7. Morrison RS, Chichin E, Carter J, Burack O, Lantz M, Meier DE. The effect of a social work intervention to enhance advance care planning documentation in the nursing home. J Am Geriatr Soc. 2005; 53:290-4.
8. Parkman CA, Calfee BE. Advance directives. Nurs. 1997; 4:48-53.
9. Camhi SL, Mercado AF, Morrison RS, Du Q, Platt M, et al. Deciding in the dark: advance directives and continuation of treatment in chronic critical illness. Crit Care Med. 2009; 37:919-25.
10. British Medical Association. The Ethics of Caring for Older People. 2nd ed. Oxford, UK: Wiley-Blackwell; 2009.
11. American Academy of Hospice and Palliative Medicine. Position statement: physician assisted death. J Pain Palliat Care Pharmacother. 2007; 21:55-7.
12. American Dietetic Association. Position of the American Dietetic Association: ethical and legal issues in nutrition, hydration and feeding. J Am Dietet Assoc. 2008; 108:873-82.
13. American Speech-Language-Hearing Association. The Roles of SpeechLanguage Pathologists Working With Individuals With Dementia-Based Communication Disorders: Position Statement [Position Statement]. 2005.
14. Morrison RS, Morris J. When there is no cure-palliative care for the dying patient. Geriatrics. 1995; 50:45-53.
15. Back A, Arnold R. Dealing with conflict in caring for the seriously ill. J Am Med Assoc. 2005; 293:1374-81.
16. Fetter MS. End of life care: the nursing role. MEDSURG Nurs. 2000; 9:230-1.
17. McKee RJ. Clarifying advanced directives. Nurs. 1999; 5:52-3.
18. Ashby M, Stofell B. Artificial hydration and alimentation at the end of life: a reply to Craig. J Med Ethics. 1995; 21:135-40.
19. George R, Dimond B. Ethics and the law: artificial hydration at the end of life. End Life Care. 2009; 3:66-70.
20. Bernat JL. Ethical and legal issues in palliative care. Neurol Clinics. 2001; 19:969-87.
21. Miller F, Fins J, Snyder L. Assisted suicide compared with refusal of treatment: a valid distinction? Ann Intern Med. 2000; 132:470-5.
22. Orentlicher D, Callahan CM. Feeding tubes, slippery slopes, and physician-assisted suicide. J Legal Med. 2004; 25:389-409.
23. Rothschild A. Gardner. Re BWV: resolved and unresolved issues at the end of life. J Law Med. 2004; 11:292-311.
24. Sahm S. Palliative care versus euthanasia. The German position: German General Medical Council's principles for medical care of the terminally ill. J Med Philos. 2000; 25:195-219.
25. Tucker KL. The campaign to deny terminally ill patients information and choices at the end of life. J Legal Med. 2009; 30:314-495.
26. Zuckerman C. Looking beyond the law to improve end of life care. Generations. 1999; 2:30-5.
27. Byock I. The art of dying in America. Am J Hosp Palliat Care. 1995; 12:6-7.
28. Bozetti F, Amadori D, Bruera E, Cozzaglio L, Corli O, et al. Guidelines on artificial nutrition versus hydration in terminal cancer patients. Nutr. 1996; 12:164-7.
29. Hanson LC, Eckert JK, Dobbs D, et al. Symptom experience of dying long term care residents. J Am Geriatr Soc. 2008; 56:91-8.
30. McCann R, Hall W, Groth-Juncker A. Comfort care for terminally ill patients: the appropriate use of nutrition and hydration. J Am Med Assoc. 1994; 272:1263-6.
31. Mackelprang RW, Mackelprang RD. Historical and contemporary issues in end-of-life decisions: implications for social work. Social Work. 2005; 50:315-24.
32. Hanson LC, Garrett JM, Lewis C, et al. Physician's expectations of benefit from tube feeding. J Palliat Med. 2008; 11:1130-4.
33. Phillips JL, Davidson PM, Ollerton R, Jackson D, Kristjanson LK. A survey of commitment and compassion in residential aged care. Int J Palliat Nurs. 2007; 13:282-90.
34. Baumrucker SJ. Ethics roundtable. Am J Hosp Palliat Care. 2005; 22:153-7.
35. Craig GM. Sedation without hydration can seriously damage your health. Int J Palliat Nurs. 2005; 11:333-4.
36. Zerwekh JV. Do dying patients really need IV fluids? Am J Nurs. 1997; 97(3):28.
37. Quill T, Byock I. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. Ann Intern Med. 2000; 132:408-14.
38. Gillon R. Palliative care ethics: non-provision of artificial nutrition and hydration to terminally ill sedated patients. J Med Ethics. 1994; 20:131-87.
39. Craig GM. On withholding artificial hydration and nutrition from terminally ill sedated patients. The debate continues. J Med Ethics. 1996; 22:147-53.
40. Craig GM. Thirst and hydration in palliative care. J Med Ethics. 1996; 22:361.
41. Dunlop RJ, Ellershaw JE, Baines MJ. On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far. A reply to Craig. J Med Ethics. 1995; 21:141-3.
42. Stinson CK, Godkin J, Robinson R. Ethical dilemma: voluntarily stopping eating and drinking. Dimens Crit Care Nurs. 2004; 23:38-43.
43. Gevers JKM. Terminal sedation: between pain relief, withholding treatment and euthanasia. Med Law. 2006; 25:747-51.
44. Hoefler JM. Making decisions about tube feeding for severely demented patients at the end of life: clinical, legal, and ethical considerations. Death Stud. 2000; 24:233-54.
45. Cameron ME. Older persons' ethical problems involving their health. Nurs Ethics. 2002; 9:537-56.
46. Byrd L. Artificial hydration and nutrition in elders with advanced dementia: an ethical dilemma. Mississippi RN. 2004; 2:7.
47. Pasman HRW, The BAM, Onwuteaka-Philipsen BD, Van der Wal G, Ribbe MW. Feeding nursing home patients with severe dementia: a qualitative study. J Adv Nurs. 2003; 42:304-11.
48. Wilmot S, Legg L, Barratt J. Ethical issues in the feeding of patients suffering from dementia: a focus group study of hospital staff responses to conflicting principles. Nurs Ethics. 2002; 9:599-611.
49. Post SG. Tube feeding advanced progressive dementia. Hastings Cent Rep. 2001; 31:36-42.
50. Teno JM, Mitchell SL, Skinner J, et al. Churning: the association between health care transitions and feeding tube insertion for nursing home residents with advanced cognitive impairment. J Palliat Med. 2009; 12:359-62.
51. Flacker JM, Marcantonio ER. Delirium in the elderly. Drugs Aging. 1998; 13:119-30.
52. Ganzini L. Artificial nutrition and hydration and the end of life: ethics and evidence. Palliat Support Care. 2006; 4:135-43.
53. Young J, Fawcett T. Artificial nutrition in older people with dementia: moral and ethical dilemmas. Nurs Older People. 2002; 14:19-21.
54. Panke JA, Volicer L. Caring for persons with dementia: a palliative approach. J Hosp Palliat Nurs. 2002; 4:143-52.
55. Mousavi SR. An ethical approach to providing palliative care to patients with cancer who lack decision making capacity. J Pain Symptom Control Palliat Care. 2005; 4:7-13.
56. Monteleoni C, Clark E. Using rapid-cycle quality improvement methodology to reduce feeding tubes in patients with advanced dementia: before and after study. Br Med J. 2004; 329:491-4.
57. Cusveller B, Jochemsen H. Life terminating actions with severely demented patients: critical assessment of a report of the Royal Dutch Society of Medicine. Issues Law Med. 1996; 12:31-41.
58. Von Wild K. Neuroethics with regard to treatment limiting and withdrawal of nutrition and hydration in long lasting irreversible full state apallic syndrome and minimal conscious state. J Med Life. 2008; 1:443-53.
59. Sharp HM, Shega JW. Feeding tube placement in patients with advanced dementia: the beliefs and practice patterns of speech language pathologists. Am J Speech Lang Pathol. 2009; 18:222-230.
60. Post SG. Special care units: end of life ethics in advanced Alzheimer's disease. Alzheim Care Quarter. 2001; 2:67-9.
61. Vitale CA, Hiner T, Ury WA, Berkman CS, Abronheim JC. Tube feeding in advanced dementia: an exploratory survey of physician knowledge. Case Manage J. 2006; 7:79-85.
62. Merl H. End-stage dementia: rocky journey or tranquil passage. J Comm Nurse. 2006; 11:7-8.
63. Nazarkop L. A time to live and a time to die: palliative care in dementia. Nurs Resid Care. 2009; 11:399-402.
64. Evans BD. Improving palliative care in the nursing home: from a dementia perspective. J Hosp Palliat Nurs. 2002; 4:91-9.
65. Cervo FA, Bryan L, Farber S. To PEG or not to PEG: a review of evidence for placing feeding tubes in advanced dementia and decision making process. Geriatrics. 2006; 61:30-5.
66. Eggenberger SK, Nelms TP. Artificial hydration and nutrition in advanced Alzheimer's disease: facilitating family decision-making. J Clin Nurs. 2004; 13:661-7.
67. Candy B, Sampson E, Jones L. Enteral tube feeding in older people with advanced dementia: findings from a Cochrane Systematic Review. Int J Palliat Nurs. 2009; 15:396-405.
68. Perkins EM, Jacobs L, Cestero B, Walter J, DeLorm S, et al. Withdrawing fluids and nutrition: a comfortable death? J Gerontol Nurs. 1999; 25:7.
69. Amella EJ. Feeding and hydration issues for older adults with dementia. Nurs Clin North Am. 2004; 39:607-23.
70. Ferguson M, Cook A, Bender S, Rimmasch H, Voss A. Diagnosing and treating involuntary weight loss. MEDSURG Nurs. 2001; 10:165-77.
71. Bavin L. Artificial re-hydration in the last days of life: is it beneficial? Int J Palliat Nurs. 2007; 13:445-9.
72. Dyck MJ. Nursing staffing and resident outcomes in nursing homes. Weight loss and dehydration. J Nurs Care Qual. 2007; 22:59-65.
73. Volkert D, Berner YN, Berry E, et al. ESPEN guidelines on enteral nutrition: geriatrics. Clin Nutr. 2006; 25:330-60.
74. Smith SA, Andrews M. Artificial nutrition and hydration at the end of life. MEDSURG Nurs. 2000; 9:233-47.
75. Pennington C. To PEG or not to PEG. Clin Med. 2002; 2:250-5.
76. Lubart E, Leibovitz A, Dror Y, Katz E, Segal R. Mortality after nasogastric tube feeding initiation in long term care elderly with oropharyngeal dysphagia: the contribution of refeeding syndrome. Gerontology. 2009; 55:393-7.
77. Beer KT, Krause KB, Zuercher T, Stanga Z. Early percutaneous endoscopic gastrostomy insertion maintains nutritional state in patients with aerodigestive tract cancer. Nutr Cancer. 2005; 52:29-34.
78. Suter PM, Rogers J, Strack C. Artificial nutrition and hydration for the terminally ill: a reasoned approach. Home Healthc Nurse. 2008; 26:23-9.
79. Sobotka L, Schneider SM, Berner YN, Cederholm T, Krznaic Z, et al. ESPEN guidelines on parenteral nutrition: geriatrics. Clin Nutr. 2009; 28:461-6.
80. Hickman SE, Tolle SW, Brummel-Smith K, Carley MM. Use of physician orders for life-sustaining treatment program in Oregon nursing facilities: beyond resuscitation status. J Am Geriatr Soc. 2004; 52:1424-9.
81. Skelly RH. Are we using percutaneous endoscopic gastrostomy appropriately in the elderly? Curr Opin Clin Nutr Metab Care. 2002; 5:35-42.
82. Donnini LM, Savina C, Ricciardia LM, Coletti C, Paolini M, et al. Predicting the outcome of artificial nutrition by clinical and functional indices. Nutr. 2009; 23:11-9.
83. De Veer AJ, Francke AL, Poortvleit EP. Nurses involvement in end of life decisions. Cancer Nurs. 2008; 33:222-8.
84. Daly BJ. Special challenges of withholding artificial nutrition and hydration. J Gerontol Nurs. 2000; 26:25-31.
85. Cox MJ. A compassionate response towards providing nutrition and hydration in vulnerable populations. J Gerontol Nurs. 1998; 24:8-13.
86. Greifzu S. Caring for the chronically ill. RN. 2002; 65:42-9.
87. Gordon M. Ethical challenges in end-of-life therapies in the elderly. Drugs Aging. 2002; 19:321-9.
88. Gordon M, Sheehan K. Artificial intelligence: making decisions about artificial nutrition and hydration. J Nutr Health Aging. 2004; 8:254-6.
89. Castellanos VH. Food and nutrition in nursing homes: food and nutrition for healthier aging. Generations. 2004; 4:65-71.
90. Mentes JC. A typology of oral hydration: problems exhibited by frail nursing home residents. J Gerontol Nurs. 2006; 1:13-21.
91. Narhi TO, Meurman JH, Ainamo A. Xerostomia and hyposalivation. Drugs Aging. 1999; 15:103-16.
92. Roy L. The role of hydration and nutrition and the end of life: hospice and palliative care at a crossroads. J Palliat Care. 2007; 23:201-2.
93. Wildiers H, Menten J. Death rattle: prevalence, prevention and treatment. J Pain Symptom Manage. 2002; 23:310-7.
94. Fainsinger R. Non-oral hydration in palliative care #133. J Palliat Med. 2006; 9:206-7.
95. Fainsinger RL, Bruera E. When to treat dehydration in a terminally ill patient. Support Care. 1997; 5:205-11.
96. Vullo-Navich K, Smith S, Andrews M, Levine AM, Tischler JF, et al. Comfort and incidence if abnormal serum sodium, BUN, creatinine and osmolality in dehydration of terminal illness. Am J Hosp Palliat Care. 1998; 2:77-84.
97. Soden K, Hoy A, Hoy W, Clelland S. Artificial hydration during the last week of life in patients dying in a district hospital. Palliat Med. 2002; 16:542-3.
98. Frisoli A Jr., de Paula AP, Feldman D, Nasri F. Subcutaneous hydration by hypodermoclysis. Drugs Aging. 2000; 16:313-9.
99. Mercadante S, Ferrera P, Girelli D, Casuccio A. Patients' and relatives' perceptions about intravenous subcutaneous hydration. J Pain Symptom Manage. 2005; 30:354-8.
100. Fainsinger R. Non-oral hydration in palliative care #134. J Palliat Med. 2006; 9:207-8.
101. Good P, Cavenaugh J, Mather M, Ravenscroft P. Medically assisted hydration for adult palliative care patients: review. Cochrane Database of Systematic Reviews. 2008; Issue 2. Art No. CD006273. DOI: 10.1002=14651858. CD006273.pub2.
102. Musgrave CF, Bartal N, Opstad J. The sensation of thirst in dying patients receiving IV hydration. J Palliat Care. 1995; 11:17-21.
103. Yamagischi A, Tanaka F, Morita T. Artificial hydration therapy for terminally ill cancer patients: a nurse-education intervention. J Pain Symptom Manage. 2009; 38:358-64.
104. Gilmore L, Jones J, Holman C. Bridging the IV gap to: two case studies. J Gerontol Nurs. 2003; 4:13-17.
105. McKinlay AW. Nutritional support in patients with advanced cancer. Proc Nutr Soc. 2004; 63:431-5.
106. Reddy SK, Rajagopal A, Govidraj N. Palliative medicine-Part II. Pain Pract. 2002; 2:56-64.
107. Ersek M. Artificial nutrition and hydration. J Hosp Palliat Nurs. 2003; 5:221-30.
108. Okon TR. Spiritual, religious and existential aspects of palliative care. J Palliat Med. 2005; 8:392-414.
109. Koenig HG. Religious beliefs and practices of hospitalized medically ill older adults. Int J Geriatr Psychiatry. 1998; 13:213-24.
110. Hamel RP, Lysaught T. Choosing palliative care: do religious beliefs make a difference? J Palliat Care. 1994; 10:61-6.
111. Portenoy RK, Coyle N, Kash KM, Brescia F, Scanton C, et al. Determinants of the willingness to endorse assisted suicide. A survey of physicians, nurses, and social workers. Psychosomatics. 1997; 38:277-87.
112. Lo B, Ruston D, Kates LW, Arnold RM, Cohen CB, et al. Discussing religious and spiritual issues at the end of life. J Am Med Assoc. 2002; 287:749-54.
113. Saxena S, O'Connell K, Underwood L. A commentary: cross-cultural quality of life assessment at the end of life. Gerontologist. 2002; 42(Suppl 3):81-5.
114. Cadge W, Freese J, Christakis N. The provision of hospital chaplaincy in the US: a national overview. South Med J. 2008; 101:626-30.
115. Cavalieri T. Ethical issues at the end of life. J Am Osteopath Assoc. 2001; 101:616-22.
116. Daalman TP, Usher BM, Williams SW, Rawlings J, Hanson LC. An exploratory study of spiritual care at the end of life. Ann Fam Med. 2008; 6:406-11.
117. Sulmasy I. Spiritual issues in the care of dying patients: "... it's okay between me and god." J Am Med Assoc. 2006; 296:385-92.
118. Engelhardt HT. Generic chaplaincy: providing spiritual care in a post Christian age. Christian Bioethics. 1999; 4:231-315.
119. Thobaben JR. A United Methodist approach to end of life decisions. Christian Bioethics. 1997; 3:222-48.
120. UMC. Book of Resolutions-The United Methodist Church. Nashville, TN: The United Methodist Publishing House; 1996.
121. Engelhardt Jr. HT, Iltis AS. End-of-life: the traditional Christian view. Lancet. 2005; 366:1045-9.
122. Stempsey WE. End of life decisions: Christian perspectives. Christian Bioethics. 1997; 3:249-61.
123. Evangelista M. The catholic churches commitment to suitable palliative care. J Pain Palliat Care Pharmacother. 2008; 22:165-6.
124. Connors RB. U.S. Catholic bishops on nutrition and hydration: a second opinion. J Clin Ethics. 1993; 4:253-5.
125. Bradley CT. Roman Catholic doctrine guiding end of life care: a summary of recent discourse. J Palliat Med. 2009; 12:373-7.
126. Catholic Health Association. Care of the dying: a Catholic perspective. Health Prog. 1993; 3:16-21, 41
127. Evans M. Moral obligations: Catholic officials differ over Vatican feeding-tube rules. Mod Healthc. 2007; 37:17-8.
128. Finucane TE, Christmas C, Travis K. Tube feeding in patients with advanced dementia: a review of the evidence. J Am Med Assoc. 1999; 282:1365-70.
129. US Conference of Catholic Bishops. Ethical and Religious Directives for Catholic Health Care Services. 4th ed. Washington, DC: US Conference of Catholic Bishops; 2001: No. 27.
130. Donovan GK. Decisions at the end of life: Catholic tradition. Christian Bioethics. 1997; 3:188-203.
131. Kinzbrunner BM. Jewish medical ethics in end of life care. J Palliat Med. 2004; 7:558-73.
132. Rosner F, Abramson N. Fluids and nutrition: perspectives from Jewish law (Halachah). Southern Med J. 2009; 102:248-50.
133. Dorff EN. End-of-life: Jewish perspectives. Lancet. 2005; 366:862-5.
134. Clarfield AM, Gordon M, Markwell H, Alibhai SMH. Ethical issues in end of life geriatric care: the approach of three monotheistic religions-Judaism, Catholicism and Islam. J Am Geriatr Soc. 2003; 51:1149-54.
135. Neuberger J. Judaism and palliative care. Europ J Palliat Care. 1999; 6:166-8.
136. Bodell J, Weng MA. The Jewish patient and terminal dehydration: a hospice ethical dilemma. Am J Hosp Palliat Med. 2000; 17:185-8.
137. Clarfield A, Monette J, Bergman H, Monette M, Ben-Israel Y, et al. Enteral feeding in end-stage dementia: a comparison of religious, ethnic, and national differences in Canada and Israel. J Gerontol. 2006; 61A:621-7.
138. Dennis G. Love is as strong as death: Meeting the pastoral needs of the Jewish hospice patient. Am J Hosp Palliat Care. 1999; 16:598-604.
139. Freedman B. Respectful service and reverent obedience: a Jewish view on making decisions for incompetent parents. Hastings Cent Rep. 1996; 26:31-7.
140. Sheikh A. Death and dying: a Muslim perspective. J Royal Soc Med. 1998; 91:138-40.
141. Al-Shahri MZ, Al-Khenaizan A. Palliative care for Muslim patients. J Support Oncol. 2005; 3:432-6.
142. Cheraghi MA, Payne S, Salsali M. End of life care for Muslim patients: experiences from Iran. Int J Palliat Nurs. 2005; 11:468-74.
143. Zahedi F, Larijani B, Bazzaz J. End of life ethical issues and Islamic views. Iran J Allergy Asthma Immunol. 2007; 6(Suppl 5):5-15.
144. Chandrakanthan J. Dying in Canada; end of lifecare in multi-cultural and multi-religious society. J Palliat Care. 2009; 25:234-4.
145. Chandran SV. Dying a good death; Hindu death and funeral customs. J Palliat Care. 2006; 22:249.
146. Gatrad R, Choudhury PP, Brown E, Sheikh A. Palliative care for Hindus. Int J Palliat Nurs. 2003; 9:442-8.
147. Sharma K. A question of faith for the Hindu patient. Europ J Palliat Care. 2000; 7:99-100.
148. Smith-Stoner M. End of life needs in patients who practice Tibetan Buddhism. J Hosp Palliat Nurs. 2005; 7:228-33.
149. Keown D. End of life: the Buddhist view. Lancet. 2005; 366:952-5.
150. Ke L, Chiu T, Lo S, Hu W. Knowledge, attitudes and behavioral intentions of nurses towards providing artificial nutrition and hydration for terminal patients in Taiwan. Cancer Nurs. 2008; 31:67-76.
151. Bruce A. Timelessness: Buddhist perspectives on end of life. Nurs Philos. 2007-2008; 8:151-7.
152. Puchaleski CM. Spirituality and the care of patients at the end of life: an essential component of care. J Death Dying. 2007; 56:33-46.
153. Vess M, Arndt J, Cox CR, Routledge C, Goldenberg JL. Exploring the existential function of religion: the effect of religious fundamentalism and mortality salience on faith based medical refusals. J Person Social Psychol. 2009; 97:334-50.
154. Beauchamp TL. Methods and principles: biomedical ethics. J Med Ethics. 2003; 29:269-274.
155. Vincent JL. Cultural differences in end of life care. Crit Care Med. 2001; 29:N52-5.
156. Braun UK, Beyth RJ, Ford ME, McCullough LB. Voices of African American, Caucasian and Hispanic surrogates on the burdens of end of life decision making. J Gen Intern Med. 2008; 23:267-74.
157. Shrank WH, Kutner JS, Richardson T, Mularski RA, Fischer S, et al. Focus group findings about the influence of culture on communication preferences in end of life care. J Gen Intern Med. 2005; 20:703-9.
158. Hopp FP, Duffy S. Racial variations in end of life care. J Am Geriatr Soc. 2000; 48:658-63.
159. Duffy SA, Jackson FC, Schim SM, Ronis DL, Fowler KE. Racial-ethnic preferences, sex preferences and perceived discrimination related to end of life care. J Am Gerontol Soc. 2006; 54:130-7.
160. Perkins HS, Cortez JD, Hazuda HP. Advance care planning: does gender make a difference. Am J Med Sci. 2004; 327:25-32.
161. Kwak J, Haley WE. Current research findings on end of life decision making among racially or ethnically diverse groups. Gerontol. 2005; 45:634-41.
162. Gessert CE, Curry NM, Robinson A. Ethnicity and end of life care: the use of feeding tubes. Ethnicity Dis. 2001; 11:97-106.
163. Chiu T, Hu W, Chuang R, Cheng Y, Chen C, Wakai S. Terminal cancer patients'wishes and influencing factors toward the provision of artificial nutrition and hydration in Taiwan. J Pain Symptom Manage. 2004; 27:206-14.
164. Chiu T, Hu W, Chuang R, Chen CY. Nutrition and hydration for terminal cancer patients in Taiwan. Support Care Cancer. 2002; 10:630-6.
165. Stein S, Bonuck K. Attitudes on end of life care and advance care planning in the lesbian and gay community. J Palliat Med. 2001; 4:173-90.
166. Mitchell BL, Mitchell LC. Review of the literature on cultural competence and end of life treatment decisions: the role of the hospitalist. J Nat Med Assoc. 2009; 101:920-926.
167. Schmidlin E. Artificial hydration: the role of the nurse in addressing patient and family needs. Int J Palliat Nurs. 2008; 14:485-9.
168. Coppola KM, Bookwala J, Ditto PH, Lockhart LK, Danks JH, Smucker WD. Elderly adults' preferences for life-sustaining treatments: the role of impairment, prognosis, and pain. Death Stud. 1999; 23:617-34.
169. AHRQ Research Group. Researchers examine the factors influencing choices in end of life care. AHRQ Res Activities. 1997; 208:2-3.
170. Bito S, Asai A. Attitudes and behaviors of Japanese physicians concerning with holding and withdrawal of life-sustaining treatment for end-of life patients: results from an Internet survey. BMC Med Ethics. 2007; 8:7-16.
171. Broeckaert B, Gielen J, Van Iersel T, Van den Brenden S. Palliative care physician's religious world view and attitudes towards euthanasia: a quantitative study among Flemish palliative care physicians. Indian J Palliat Care. 2009; 15:41-50.
172. Gallo JJ, Straton JB, Klag MJ, Meoni LA, Sulmasy DP, Wang N, Ford DE. Life-sustaining treatments: what do physicians want and do they express their wishes to others? J Am Geriatr Soc. 2003; 51:961-9.
173. Straton JB, Wang N, Meoni LA, Ford DE, Klag MJ, Casarett D, Gallo JJ. Physical functioning, depression, and preferences for treatment at the end of life: the Johns Hopkins precursor study. J Am Geriatr Soc. 2004; 52:577-82.
174. Van der Riet P, Good P, Higgins I, Sneesby L. Palliative care professionals' perceptions of nutrition and hydration at the end of life. Int J Palliat Nurs. 2008; 14:145-51.
175. Brotherton AM, Abott J, Hurley MA, Aggett PJ. Home percutaneous endoscopic gastrostomy feeding: perceptions of patients, carers, nurses and dietitians. J Adv Nurs. 2007; 59:388-97.
176. Bryon E, Gastmans C, de Casterle BD. Decision making about artificial feeding in end of life care: literature review. J Adv Nurs. 2008; 63:2-14.
177. Munn JC, Hanson LC, Zimmerman S, Sloane PD, Mitchell CM. Is hospice associated with improved end of life care in nursing homes and assisted living facilities?. J Am Geriatr Soc. 2006; 54:490-5.
178. Byock I. Patient refusal of nutrition and hydration: walking the ever-finer line. Am J Hosp Palliat Care. 1995; 12:8-13.
179. Derse AR. Limitation of treatment at the end of life: withholding and with drawal. Clin Geriatr Med. 2005; 21:223-8.
180. Maldonado N, Callahan K, Efinger J. Spiritual reflections concerning end of life caring decisions: a qualitative case study. Int J Human Caring. 2003; 7:13-26.
181. Martin VC, Roberto KA. Assessing the values and health care preferences of older adults. J Gerontol Nurs. 2006; 11:23-30.
182. Winter L, Parker B, Schneider M. Imagining the alternatives to life prolonging treatments: elders' beliefs about the dying experience. Death Stud. 2007; 31:619-31.
183. Nahm E, Resnick B. End-of-life treatment preferences among older adults. Nurs Ethics. 2001; 8:533-43.
184. Werner P, Carmel S, Ziedenberg H. Nurses' and social workers' attitudes and beliefs about and involvement in life-sustaining treatment decisions. Social Work. 2004; 29:27-35.
185. McFarland KF, Rhoades DR. End of life care: a retreat format for residents. J Palliat Med. 2006; 9:82-9.
186. Pugh E, Song R, Whittaker V, Blenkinsopp J. A profile of the belief system and attitudes to end-of-life decisions of senior clinicians working in a National Health Service Hospital in the United Kingdom. Palliat Med. 2009; 23:158-64.
187. Seymour JE, Janssens R, Broeckaert B. Relieving suffering at the end of life: practitioners' perspectives on palliative sedation from three European countries. Soc Sci Med. 2007; 64:1679-91.
188. Miyashita M, Morita T, Shima Y, Kimura R, Takahashi M, Adachi I. Nurse views of the adequacy of decision making and nurse distress regarding artificial hydration for terminally ill cancer patients: a nationwide survey. Am J Hosp Palliat Med. 2007; 24:463-9.
189. Miyashita M, Morita T, Shima Y, Kimura R, Takahashi M, Adachi I. Physician and nurse attitudes toward artificial hydration for terminally ill cancer patients in Japan: results of 2 nationwide surveys. Am J Hosp Palliat Med. 2007; 24: 383-9.
190. Miyashita M, Sato K, Morita T, Suzuki M. Effect of a population-based educational intervention focusing on end-of-life homecare, life-prolonging treatment and knowledge about palliative care. Palliat Med. 2008; 22:376-82.
191. Morita T, Miyashita M, Shibagaki M, Hirai K, Ashiya T, et al. Knowledge and beliefs about end-of-life care and the effects of specialized palliative care: a population-based survey in Japan. J Pain Symptom Manage. 2006; 31:306-16.
192. Morita T, Shima Y, Miyashita M, Kimura R, Adachi I. Physician and nurse-reported effects of intravenous hydration therapy on symptoms of terminally ill patients with cancer. J Palliat Med. 2004; 7:683-93.
193. Morita T, Bito S, Koyama H, Uchitomi Y, Adachi I. Development of a national clinical guideline for artificial hydration therapy for terminally ill patients with cancer. J Palliat Med. 2007; 10:770-80.
194. Chao LW, Pagan JA, Soldo BJ. End of life medical treatment choices: do survival chances and out of pocket costs matter? Med Decis Making. 2008; 28:511-23.
195. Pan CX, Chai E, Farber J. Myths of the high medical costs of old age and dying. Int J Health Serv. 2008; 38:253-75.
196. McGarry K, Shoeni RF. Widow poverty and out of pocket medical expenditures near the end of life. J Gerontol B Psychol Sci Soc Sci. 2005; 60:S160-8.
197. Fan JX, Zick CD. The economic burden of health care, funeral and burial expenditures at the end of life. J Consum Affairs. 2004; 38:35-55.
198. Fassbender K, Fainsinger RL, Carson M, Finegan BA. Cost trajectories at the end of life: the Canadian experience. J Pain Symptom Manage. 2009; 38:75-80.
199. Payne G, Laporte A, Deber R, Coyte PC. Counting backward to health care's future: using time to death modeling to identify changes in end of life morbidity and the impact of aging on health care expenditures. Milbank Quarterly. 2007; 85:213-57.
200. Daly G. Ethics and economics. Nurs Econ. 2000; 18:194-201.
201. De Conno F, Panzeri C, Brunelli C, Saita L, Ripamonti C. Palliative care in a national cancer center: results in 1987 vs. 1993 vs. 2000. J Pain Symptom Manage. 2003; 25:499-511.
202. O'Mahony S, McHenry J, Blank A, Snow D, Karakas S, et al. Preliminary report of the integration of a palliative care team into an intensive care unit. Palliat Med. 2010; 24:154-65.
203. Falls CE. Palliative healthcare: cost reduction and quality enhancement using end of life survey methodology. J Gerontol Soc Work. 2008; 51:53-76.
204. Gabany J. Factors contributing to the quality of end-of-life care. J Am Acad Nurs Pract. 2000; 12:472-4.
205. Avila D. Medical treatment rights of older persons and persons with disabilities. Issues Law Med. 1995; 10:385-90.
206. Schrader SL, Nelson ML, Eideness LM. South Dakota's dying to know: a state wide survey about end of life. J Palliat Med. 2009; 12:695-705.
207. Allari BH. When the ordinary becomes extraordinary: food and fluids at the end of life. Food and Nutrition for Healthier Aging. Generations. 2004; 4:86-91.
208. Australian Society Geriatric Medicine. Position Statement No. 12. Dysphagia and aspiration in older people. Australasian J Aging. 2004; 23:198-202.
209. Van der Riet P, Higgins I, Good P, Sneesby L. A discourse analysis of difficult clinical situations in relation to nutrition and hydration during end of life care. J Clin Nurs. 2009; 18:2104-11.
210. Yee CM. End of Life care for the oncology patient. Singapore Nurs J. 2006; 3:9-13.
211. Van der Riet P, Brooks D, Ashby M. Nutrition and hydration at the end of life: pilot study of a palliative care experience. J Law Med. 2006; 14:182-98.