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 language | English (US) |
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Pages (from-to) | 135-143 |
Number of pages | 9 |
Journal | Palliative & supportive care |
Volume | 4 |
Issue number | 2 |
DOIs | |
State | Published - Jun 2006 |
ASJC Scopus subject areas
- General Nursing
- Clinical Psychology
- Psychiatry and Mental health