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Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper
- Source :
- Nutrition in Clinical Practice. 36:254-267
- Publication Year :
- 2021
- Publisher :
- Wiley, 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.
- Subjects :
- Advance care planning
030309 nutrition & dietetics
media_common.quotation_subject
Decision Making
education
Medicine (miscellaneous)
Advance Care Planning
03 medical and health sciences
Enteral Nutrition
0302 clinical medicine
Nursing
Health care
Humans
Medicine
Obligation
Justice (ethics)
Child
media_common
0303 health sciences
Nutrition and Dietetics
business.industry
Communication
Beneficence
Directive
Position paper
030211 gastroenterology & hepatology
Advance Directives
business
Autonomy
Subjects
Details
- ISSN :
- 19412452 and 08845336
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Nutrition in Clinical Practice
- Accession number :
- edsair.doi.dedup.....823299b9dbcd3ed58ffcc1626ced7994