Decisions about artificial feeding arouse more controversy than those involving any other life-sustaining treatment. Because food and water are generally considered basic elements of humane care, representing love and concern for the helpless, it is often thought that they must always be provided. In a landmark decision, the Supreme Judicial Court of Massachusetts ruled that a feeding tube could be removed from a patient in a persistent vegetative state if this was consistent with his previously expressed wishes. The case of Paul E. Brophy, Sr., is part of an emerging medical and legal consensus on the withholding of artificial feeding from adult patients. The view is growing that tube and intravenous feeding should be likened to other medical interventions and not to the routine provision of nursing care or comfort. Competent patients have the right to refuse such feeding. Feeding can also be stopped incompetent patients who have earlier stated such a wish.
Source Information
Division of General Internal Medicine, University of California, San Francisco.
This article has been cited by other articles:
Bernat, J. L., Beresford, H. R.
(2006). The controversy over artificial hydration and nutrition. Neurology
66: 1618-1619
[Full Text]
Detweiler, M. B., Kim, K. Y., Bass, J.
(2004). Percutaneous endoscopic gastrostomy in cognitively impaired older adults: A geropsychiatric perspective. AM J ALZHEIMERS DIS OTHER DEMEN
19: 24-30
[Abstract]
Kunin, J
(2003). Withholding artificial feeding from the severely demented: merciful or immoral? Contrasts between secular and Jewish perspectives. J. Med. Ethics
29: 208-212
[Full Text]
Gillick, M. R
(2001). Artificial nutrition and hydration in the patient with advanced dementia: is withholding treatment compatible with traditional Judaism?. J. Med. Ethics
27: 12-15
[Abstract][Full Text]
Gillick, M. R.
(2000). Rethinking the Role of Tube Feeding in Patients with Advanced Dementia. NEJM
342: 206-210
[Full Text]
Grant, M. D., Rudberg, M. A., Brody, J. A.
(1998). Gastrostomy Placement and Mortality Among Hospitalized Medicare Beneficiaries. JAMA
279: 1973-1976
[Abstract][Full Text]
Slomka, J.
(1995). What Do Apple Pie and Motherhood Have to Do With Feeding Tubes and Caring for the Patient?. Arch Intern Med
155: 1258-1263
[Abstract]
Hyltander, A.
(1994). Invited Review: Intravenous Feeding Kinetics and Its Effects on Energy and Nitrogen Metabolism. Nutr Clin Pract
9: 51-57
[Abstract]
Weaver, J. P., Odell, P., Nelson, C.
(1993). Evaluation of the Benefits of Gastric Tube Feeding in an Elderly Population. Arch Fam Med
2: 953-956
[Abstract]
Fairman, R. P.
(1992). Withdrawing Life-Sustaining Treatment: Lessons From Nancy Cruzan. Arch Intern Med
152: 25-27
[Abstract]
Moller-Loswick, A.-C., Zachrisson, H., Bennegard, K., Sandstrom, R., Lundholm, K.
(1991). Insufficient Effect of Total Parenteral Nutrition to Improve Protein Balance in Peripheral Tissues of Surgical Patients. JPEN J Parenter Enteral Nutr
15: 669-675
[Abstract]
Johnson, G., Mcnoble, D.
(1991). Withdrawal of Nutrition Support in a Neurosurgical Patient in a Persistent Vegetative State. Nutr Clin Pract
6: 109-111
[Abstract]
Schmitz, P.
(1991). The Process of Dying with and without Feeding and Fluids by Tube. J Law Med Ethics
19: 23-26
Weir, R. F., Gostin, L.
(1990). Decisions to Abate Life-Sustaining Treatment for Nonautonomous Patients: Ethical Standards and Legal Liability for Physicians After Cruzan. JAMA
264: 1846-1853
[Abstract]
Gleeson, K.
(1990). The Do-Not-Resuscitate Order: Still Too Little Too Late. Arch Intern Med
150: 1057-1060
[Abstract]
Hurley, R. S., Campbell, S. M., Mirtallo, J. M., Wade, V. R., Murphy, C.
(1990). Outcomes of Cancer and Noncancer Patients On Hpn. Nutr Clin Pract
5: 59-62
Miller, R. J.
(1990). Commentary on the NHO ethical guidelines: Ethical guidelines for the development of patient-related policies and procedures for hospice programs. AM J HOSP PALLIAT CARE
7: 22-24
Ouslander, J. G.
(1989). Medical Care in the Nursing Home. JAMA
262: 2582-2590
[Abstract]
Miller, R. J., Aibright, P. G.
(1989). What is the role of nutritional support and hydration in terminal cancer patients?. AM J HOSP PALLIAT CARE
6: 33-38
LO, B., DORNBRAND, L.
(1989). Understanding the Benefits and Burdens of Tube Feedings. Arch Intern Med
149: 1925-1926
[Abstract]
Quill, T. E.
(1989). Utilization of Nasogastric Feeding Tubes in a Group of Chronically Ill, Elderly Patients in a Community Hospital. Arch Intern Med
149: 1937-1941
[Abstract]
Murphy, D. J.
(1988). Do-Not-Resuscitate Orders: Time for Reappraisal in Long-term-Care Institutions. JAMA
260: 2098-2101
[Abstract]
Schiedermayer, D. L.
(1988). The common clinical trilemma in Alzheimer's: Reflections on tube feeding and antibiotics after a house call to Velma D.. AM J ALZHEIMERS DIS OTHER DEMEN
3: 40-46
Previous
