Ethics of Nutrition and Hydration in the Critically Ill Patient
4 Pages Posted: 15 Mar 2012
Date Written: March 14, 2012
The technological capacity to prolong life in critically ill patients through enteric, or artificial nutrition, does not result in an ethical right to do so by healthcare providers. Currently, the ethical debate over the removal of enteric support in patients for whom there is little likelihood of improvement is mediated by a lack of biomedical research demonstrating the benefits versus drawbacks of such support. Furthermore, the decision to remove support as a way of preventing suffering, as opposed to instituting death, is clouded by the concept of how to define suffering given the wide range of cultural, religious, biomedical and philosophical definitions, and what level of suffering must a patient reach before termination of support. Family wishes, the wishes of the patient, providers and the legal system all play a role in the decision to remove support. There is a need for collaboration between ethicists and healthcare providers to understand the benefits and drawbacks of enteric nutrition, and when these factors outweigh suffering, as well as understanding of how to interpret the cultural mediators of suffering that each individual patient and their support system bring to the discussion of the ethics of nutrition and hydration in the critically ill patient.
Keywords: Nutrition, Hydration, Terminally ill, End-of-life care, Decision making
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