Journal
JOURNAL OF GENERAL INTERNAL MEDICINE
Volume 26, Issue 9, Pages 1053-1058Publisher
SPRINGER
DOI: 10.1007/s11606-011-1659-z
Keywords
artificial nutrition and hydration; ethics; palliative care; terminal care; health policy
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INTRODUCTION: The debate over use of artificial nutrition and hydration (ANH) in terminal illness, including advanced dementia, remains contentious despite extensive ethical and empirical investigation. METHODS: For this narrative review we undertook a focused, selective review of literature reflecting ethical analysis, empirical assessment of outcomes, legal responses, and thinking within the Roman Catholic religious tradition. RESULTS: The history of the debate over the past 60 years results from a complex interplay of ethical concerns, a growing empirical database, legal changes, public opinion, and financial as well as institutional concerns. Discussions of ANH today are often conducted without any understanding of this historical context. DISCUSSION: Patients' interests could be better protected through remedial action at both the individual and the policy levels.
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