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Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper.
- Source :
-
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2021 Apr; Vol. 36 (2), pp. 254-267. Date of Electronic Publication: 2021 Feb 22. - Publication Year :
- 2021
-
Abstract
- The American Society for Parenteral and Enteral Nutrition (ASPEN) Position Paper focus is on applying the 4 ethical principles for clinician's decision-making in the use of artificially administered nutrition and hydration (AANH) for adult and pediatric patients. These basic principles are (1) autonomy, respect the patient's healthcare preferences; (2) beneficence, provide healthcare in the best interest of the patient; (3) nonmaleficence, do no harm; and (4) justice, provide all individuals a fair and appropriate distribution of healthcare resources. Preventing and resolving ethical dilemmas is addressed, with an emphasis on a collaborative, interdisciplinary approach. Optimizing early communication and promoting advance care planning, involving completion of an advance directive, including designation of a surrogate decision-maker, are encouraged. Clinicians achieve respect for autonomy when they incorporate the patient, family, community, country, geographical, and presumed cultural values and religious belief considerations into ethical decision-making for adults and children with a shared decision-making process. These discussions should be guided by the 4 ethical principles. Hospital committees and teams, limited-time trials, clinician obligation with conflicts, and forgoing of AANH are addressed. Specific patient conditions are addressed because of the concern for potential ethical issues: coma, decreased consciousness, and dementia; advanced dementia; cancer; eating disorders; and end-stage disease/terminal illness. Incorporated in the Position Paper are ethical decisions during a pandemic and a legal summary involving ethical issues. International authors presented the similarities and differences within their own country or region and compared them with the US perspective.<br /> (© 2021 American Society for Parenteral and Enteral Nutrition.)
Details
- Language :
- English
- ISSN :
- 1941-2452
- Volume :
- 36
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 33616284
- Full Text :
- https://doi.org/10.1002/ncp.10633