Ethics Of PN

Question 1

Principles from key guidelines relevant to artificial nutrition and hydration (ANH)

Answer 1

Autonomy
Beneficence
Non-maleficence
Justice

Question 2

Prerequisites of ANH

Answer 2

Indication for medical treatment
Definition of a therapeutic goal to be achieved
Will of the patient and their informed consent

Question 3

Patient and family perspective in ANH

Answer 3

Psychological benefit at end of life
Enhancing comfort, dignity, and QOL
Considered basic care, not medical treatment

Question 4

Religious considerations in ANH

Answer 4

Withholding/withdrawing ANH
Catholicism: okay
Islam: includes informed consent, clinical context, patient/family/religious scholar input
Judaism: no (considered euthanasia)

Question 5

Distributive and procedural justice in ANH

Answer 5

Establish triage committees and develop protocols for the management of limited resources

Question 6

Medical indication in discontinuation

Answer 6

Do not use if harms outweigh benefits or to prolong dying phase

Question 7

Therapeutic goal in discontinuation

Answer 7

When there is no longer a treatment goal, ANH is no longer appropriate

Question 8

Will of the patient in informed consent

Answer 8

Competent patient has the right to refuse/discontinue patient
—this does not count for eating disorders