This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Fine, R. L. Search for Related Content PubMed PubMed Citation Articles by Fine, R. L. Pubmed/NCBI databases Medline Plus Health Information Nutritional Support Social Bookmarking                   What's this?

Ethical Issues in Artificial Nutrition and Hydration

Office of Clinical Ethics, Baylor Health Care System; Palliative Care Consultation Service, Baylor University Medical Center, Dallas, Texas

Correspondence: Robert L. Fine, MD, FACP, Director, Office of Clinical Ethics, Baylor Health Care System; Director, Palliative Care Consultation Service, Baylor University Medical Center, 3434 Swiss Avenue, Suite 205, Dallas, TX 75204. Electronic mail may be sent to robertf{at}baylorhealth.edu.

From the time of Hippocrates, approximately 2500 years ago, medical ethics has been seen as an essential complement to medical science in pursuit of the healing art of medicine. This is no less true today, not only for physicians but also for other essential professionals involved in patient care, including clinical nutrition support practitioners. One aspect of medical ethics that the clinical nutritionist must face involves decisions to provide, withhold, or withdraw artificial nutrition and hydration. Such a decision is not only technical but often has a strong moral component as well. Although it is the physician who writes any such order, the clinical nutritionist as fellow professional should be a part not only of the scientific aspects of the order but of the moral discourse leading to such an order and may certainly be involved in counseling physicians, other healthcare providers, patients, and families alike. This paper is intended to give the clinical nutritionist a familiarity with the discipline of medical ethics and its proper relationship to medical science, politics, and law. This review will then offer a more specific analysis of the ethical aspects of decisions to initiate, withhold, or withdraw artificial nutrition and hydration (ANH) and offer particular commentary on the ethically significant pronouncements of Pope John Paul II in March of 2004 related to vegetative patients and artificial or "assisted" nutrition and hydration.

Nutrition in Clinical Practice, Vol. 21, No. 2, 118-125 (2006)
DOI: 10.1177/0115426506021002118


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. Monturo The Artificial Nutrition Debate: Still an Issue... After All These Years Nutr Clin Pract, April 1, 2009; 24(2): 206 - 213. [Abstract] [Full Text] [PDF]

				L J. Hoffer Tube feeding in advanced dementia: the metabolic perspective BMJ, December 9, 2006; 333(7580): 1214 - 1215. [Full Text] [PDF]

				A. Barrocas Nutrition Support and the Troubling Trichotomy: A Call to Action Nutr Clin Pract, April 1, 2006; 21(2): 109 - 112. [Full Text] [PDF]

				M. P. Fuhrman and V. M. Herrmann Bridging the Continuum: Nutrition Support in Palliative and Hospice Care Nutr Clin Pract, April 1, 2006; 21(2): 134 - 141. [Abstract] [Full Text] [PDF]