Artificial Nutrition and HydrationArtificial Nutrition and Hydration

This collection of essays by some of the most prominent Catholic bioethicists addresses the Pope’s statements, the moral issues surrounding artificial feeding and hydration, the refusal of treatment, and the ethics of care for those at ...

Author: Christopher Tollefsen

Publisher: Springer Science & Business Media

ISBN: 1402062079


Page: 235

View: 925

Pope John Paul II surprised much of the medical world in 2004 with his strongly worded statement insisting that patients in a persistent vegetative state should be provided with nutrition and hydration. This collection of essays featuring some of the most prominent Catholic bioethicists addresses the Pope’s statements, the moral issues surrounding artificial feeding and hydration, the refusal of treatment, and the ethics of care for those at the end of life.

Artificial Nutrition and Hydration and the Permanently Unconscious PatientArtificial Nutrition and Hydration and the Permanently Unconscious Patient

A valuable resource for students and scholars, this teachable volume invites theological dialogue and ethical discussion on one of the most contested issues in the church today.

Author: Ronald P. Hamel

Publisher: Georgetown University Press

ISBN: 1589012429


Page: 304

View: 743

During the past few decades, high-profile cases like that of Terry Schiavo have fueled the public debate over forgoing or withdrawing artificial nutrition and hydration from patients in a persistent vegetative state (PVS). These cases, whether involving adults or young children, have forced many to begin thinking in a measured and careful way about the moral legitimacy of allowing patients to die. Can families forgo or withdraw artificial hydration and nutrition from their loved ones when no hope of recovery seems possible? Many Catholics know that Catholic moral theology has formulated a well-developed and well-reasoned position on this and other end-of-life issues, one that distinguishes between "ordinary" and "extraordinary" treatment. But recent events have caused uncertainty and confusion and even acrimony among the faithful. In his 2004 allocution, Pope John Paul II proposed that artificial nutrition and hydration is a form of basic care, thus suggesting that the provision of such care to patients neurologically incapable of feeding themselves should be considered a moral obligation. The pope's address, which seemed to have offered a new development to decades of Catholic health care ethics, sparked a contentious debate among the faithful over how best to treat permanently unconscious patients within the tenets of Catholic morality. In this comprehensive and balanced volume, Ronald Hamel and James Walter present twenty-one essays and articles, contributed by physicians, clergy, theologians, and ethicists, to reflect the spectrum of perspectives on the issues that define the Catholic debate. Organized into six parts, each with its own introduction, the essays offer clinical information on PVS and feeding tubes; discussions on the Catholic moral tradition and how it might be changing; ecclesiastical and pastoral statements on forgoing or withdrawing nutrition and hydration; theological and ethical analyses on the issue; commentary on Pope John Paul II's 2004 allocution; and the theological commentary, court decisions, and public policy resulting from the Clarence Herbert and Claire Conroy legal cases. A valuable resource for students and scholars, this teachable volume invites theological dialogue and ethical discussion on one of the most contested issues in the church today.

Hard DecisionsHard Decisions

In Hard Decisions, Eileen P. Flynn, a respected Roman Catholic moral theologian, presents through and balanced answers to today's questions about tube feeding.

Author: Eileen Patricia Flynn

Publisher: Rowman & Littlefield

ISBN: 1556123043


Page: 106

View: 458

What are feeding tubes? Why are they used? Must they always be used? What does Catholic teaching have to say about tube feeding? How can relatives reach sound moral decisions about using, forgoing, or withdrawing tube feeding from incompetent loved ones? Why do courts, state legislatures, and well-informed citizens disagree about whether or not tube feeding is ordinarily required? In Hard Decisions, Eileen P. Flynn, a respected Roman Catholic moral theologian, presents through and balanced answers to today's questions about tube feeding.

Nutrition and Hydration in Hospice CareNutrition and Hydration in Hospice Care

The decision to withdraw or withhold nutrition or hydration life support is
generally a difficult one unless the patient meets brain death criteria (President's

Author: Charlette Gallagher-Allred

Publisher: Routledge

ISBN: 9781317826910


Page: 174

View: 294

This scholarly book enables health care professionals to appropriately address hospice patients’and families’concerns about nutrition and hydration. Nutrition and Hydration in Hospice Care is a comprehensive resource that provides hands-on practical information that readers can use in everyday hospice practice. The chapters identify problems, solutions, and ethical issues of nutrition and hydration in hospice care. The contributing authors provide the way for health care professionals, especially those in nursing, dietary, and pharmacy units, to jointly and effectively manage troublesome symptoms and ethical issues. The following topics are included in the scope of coverage: nutrition/hydration needs during end-stage disease nursing and dietary roles in identifying nutrition/hydration problems and implementing treatment how needs of dying children and adults are different legal and ethical dilemmas of withholding or withdrawing nutrition and hydration appropriate and inappropriate uses of enteral and parenteral nutrition support during end-stage diseases food service considerations in inpatient hospice facilities appetite stimulant use in palliative care Because Nutrition and Hydration in Hospice Care is comprehensive, all members of hospice staffs can find practical information to use each day. The authors cover issues not found in other books for nurses, dietitians, pharmacists, and physicians. They will find the information ready to apply at their work settings.

Diet and Nutrition in Palliative CareDiet and Nutrition in Palliative Care

The patient's well being in terms of mobility, anxiety, stress, social interaction, and pain control needs expert focus and attention. Furthermore, there is an increasing awareness that diet and nutritional sup

Author: Victor R. Preedy

Publisher: CRC Press

ISBN: 9781439819333


Page: 464

View: 138

Optimal terminal and palliative care requires consideration of the patient and family unit as well as cultural and religious sensitivities. The patient’s well being in terms of mobility, anxiety, stress, social interaction, and pain control needs expert focus and attention. Furthermore, there is an increasing awareness that diet and nutritional support plays an integral part of the patient’s holistic well being. The interface between nutritional, emotional, cultural, and medicinal support challenges terminal and palliative care providers to recognize the right thing to do, often in the face of considerable uncertainty. Currently, there is no comprehensive book on nutrition in terminal or palliative care that is suitable for novices and experts alike. Diet and Nutrition in Palliative Care addresses this deficiency in the literature. Designed for doctors, nurses, caregivers, and those working within the palliative or end of life domain, each chapter contains sections on applications to other areas of terminal or palliative care, practical methods and techniques, guidelines, key points and ethical issues. The book is divided into six sections: Setting the Scene Cultural Aspects General Aspects Cancer Non-Cancer Conditions Pharmacological Aspects Despite the complexity of the correlation between diet and disease, there is now a sufficient body of evidence to encourage applying nutritional science in everyday clinical practice. Increasingly, a strong interest and up-to-date knowledge and understanding of scientific studies on nutrition enables clinicians to help patients under their care more effectively at every stage of their illness. In response to this need, this handbook presents important information on the holistic use of nutrition and diet therapy in palliative care.

Reading Packet on Withholding Or Withdrawing Artificial Nutrition and HydrationReading Packet on Withholding Or Withdrawing Artificial Nutrition and Hydration

Lo B , Dornbrand L. Understanding the Benefits and Burdens of Tube Feeding .
Archives of Internal Medicine 1984 ... Principles in Regard to Withholding or
Withdrawing Artificially Assisted Nutrition / Hydration . Issues in Law and
Medicine ...

Author: Reinhard Priester


ISBN: MINN:31951D008622081


Page: 25

View: 546

Nutrition Care of the Older Adult a Handbook for Dietetics Professionals Working Throughout the Continuum of CareNutrition Care of the Older Adult a Handbook for Dietetics Professionals Working Throughout the Continuum of Care

Withholding and withdrawing nutrition support have the same ethical significance
. 2. Artificial nutrition and hydration is considered medical therapy and can be
refused by competent clients and surrogates of incompetent clients under certain

Author: Kathleen C. Niedert

Publisher: American Dietetic Associati

ISBN: 9780880913324


Page: 323

View: 758

Completely revised with new chapters and sections covering everything the health-care provider needs to know when working with the older adult either at home or in nursing and long-term care facilities. Chapters cover factors affecting nutrition, nutrition and disease, nutritional assessment, dining challenges and regulatory compliance. This scientifically sound and practical resource for new and experienced nutrition professionals includes new forms, resources, the food guide pyramid for older adults and an index of tales.

Contemporary Issues in BioethicsContemporary Issues in Bioethics

15 Artificial Nutrition and Hydration : Assessing the Papal Statement Thomas A.
Shannon and James J. Walter In addressing an international congress on Life -
Sustaining Treatments and Vegetative State : Scientific Advances and Ethical ...

Author: James J. Walter

Publisher: Rowman & Littlefield

ISBN: 0742550613


Page: 293

View: 127

"Contemporary Issues in Bioethics: A Catholic Perspective applies the best of the Roman Catholic theological and ethical tradition to some of the most controversial and complex bioethical topics that confront contemporary society. Walter and Shannon offer a fresh analysis of the Catholic tradition, and show how a distinctively Catholic perspective can inform public discussion of these issues. In an age where religion is often excluded from ethical discussions on bioethical issues, this book shows that the Catholic tradition has something very important to offer." --Book Jacket.

Palliative Care E BookPalliative Care E Book

Another small study examined the cost of caring for 11 severely demented U.S.
nursing home patients with artificial nutrition and hydration versus another 11
patients without artificial nutrition and hydration. Items assessed included nursing

Author: Linda L. Emanuel

Publisher: Elsevier Health Sciences

ISBN: 9781437735970


Page: 640

View: 891

Find out all you need to know about providing high-quality care to patients with serious illnesses from the 2nd edition of Palliative Care: Core Skills and Clinical Competencies. Drs. Linda L. Emanuel and S. Lawrence Librach, leaders in the field, address the clinical, physical, psychological, cultural, and spiritual dimensions that are integral to the care of the whole patient. They give you a broad understanding of the core clinical skills and competencies needed to effectively approach patient assessment, care of special populations, symptom control, ethical issues, and more. Clearly written in a user-friendly, high-yield format, this resource is your ultimate guidebook to the burgeoning practice of palliative medicine. Improve your pain management and symptom management skills with a better understanding of best practices in palliative care. Quickly review specific treatment protocols for both malignant and non-malignant illnesses, including HIV/AIDS, heart failure, renal failure, pulmonary disease, and neurodegenerative disease. Better understand and manage the common and unique challenges associated with delivering palliative care in various social settings, such as the ICU, hospice, and the home; and to diverse populations, such as children, elders, and vulnerable members of society. Expand your knowledge of palliative care issues with new chapters on Veterans, Special Populations, Prognostication, Delirium, Working with Families, Wound Care, Home Care, and Dealing with Economic Hardship. Find the information you need quickly and easily with a templated, high-yield format.

Legal and Ethical Aspects of CareLegal and Ethical Aspects of Care

This is especially important when addressing care at end-of-life including artificial nutrition and hydration, withdrawal of life-sustaining therapies and palliative sedation as well as requests for assistance in hastening death.

Author: Nessa Coyle

Publisher: Oxford University Press

ISBN: 9780190258061


Page: 136

View: 734

Effective palliative care that rests on a sound ethical foundation requires ongoing discussions about patient and family values and preferences. This is especially important when addressing care at end-of-life including artificial nutrition and hydration, withdrawal of life-sustaining therapies and palliative sedation as well as requests for assistance in hastening death. The eighth volume in the HPNA Palliative Nursing Manuals series, Legal and Ethical Aspects of Palliative Care, provides an overview of critical communication skills and formal organizational mechanisms, such as ethics committees and interdisciplinary rounds, required for decisions in ethical dilemmas which respect diversity in the views of colleagues, as well as patients. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice.

Nutrition and HydrationNutrition and Hydration

The bishops apply moral principles to questions frequently asked.

Author: Catholic Church. National Conference of Catholic Bishops. Committee for Pro-Life Activities

Publisher: USCCB Publishing

ISBN: 155586516X


Page: 11

View: 175

The bishops apply moral principles to questions frequently asked.

Terminal Sedation Euthanasia in Disguise Terminal Sedation Euthanasia in Disguise

It is hard to imagine that anyone would have tried to invent technologically
sophisticated artificial nutrition and hydration technology exclusively to prolong
the lives of those in irreversible comas, and especially if the patient was so
treated to ...

Author: Torbjörn Tännsjö

Publisher: Springer Science & Business Media

ISBN: 9781402021244


Page: 148

View: 667

TERMINAL SEDATION DURING THE 1990s During the 1990s a discussion took place in scholarly journals concerning a measure within palliative care that had earlier attracted little attention, to wit, the sedation of dying patients. There seem to have been two main reasons why the practice came under debate. On the one hand, some people felt that, when palliative medicine had advanced and methods to control symptoms had improved, it was no longer justified to sedate the patients in a manner that had often been done in the past. The system of 1 terminal sedation had turned into ‘euthanasia in disguise’ or ‘slow euthanasia’. On the other hand, there were people sympathetic to the recently established Dutch system of euthanasia, people who agreed that terminal sedation was euthanasia in disguise, but who felt that, if it is not objectionable to sedate dying patients at their request, then why should it not be permitted for doctors to kill dying patients at 2 request? From these two motives a discussion about terminal sedation gained momentum. The intention behind this anthology is to continue and deepen this discussion. The anthology starts off with a chapter where an influential article from the 1990s has been reprinted.

Advancing Dietetics and Clinical Nutrition E BookAdvancing Dietetics and Clinical Nutrition E Book

Ethical issues surrounding the appropriateness of artificial nutrition and hydration
for patients with palliative care needs can be explored using the four main
principles of healthcare ethics: respect for autonomy, nonmaleficence,
beneficence ...

Author: Anne Payne

Publisher: Elsevier Health Sciences

ISBN: 9781455725243


Page: 424

View: 519

This book provides a comprehensive account of the relevant physiology, pathophysiology, nutritional therapy and dietetic application for each specialist dietetic area. All major specialist areas involved in the the treatment of adults are covered. The first section deals with clinical governance, for example patient-centred care, clinical decision-making and developing evidence-based practice. The second section on advanced clinical practice describes 18 clinical conditions or dietetic areas in detail. There is detailed coverage of 18 clinical conditions or dietetic areas: The control of food intake and absorption of nutrients Drug nutrient interactions Food allergy – allergy and intolerance Irritable bowel disease (IBD) and colorectal cancer Short bowel syndrome Enteral nutrition Parenteral nutrition Thermal injury Nutrition and liver disease HIV Palliative care Renal disease Diabetes Obesity Cardiovascular disease Stroke Neurological conditions Mental health. Each chapter concludes with a section on possible future developments in the specialty, providing insight into 'hot topics', making this an essential text for all working in the field of Dietetics and Clinical Nutrition. Each clinical chapter follows a standard structure: Learning objectives Key points summarise important aspects Case studies with questions and answers help link theory to practice References and further reading suggestions encourage wider research.

The Moral Challenge of Alzheimer DiseaseThe Moral Challenge of Alzheimer Disease

It is sometimes reassuring for family members to assist in oral feeding when
visiting the nursing home or assisted living facility. On the basis of humane
concerns and quality of life, however, artificial nutrition and hydration should be
neither ...

Author: Stephen G. Post

Publisher: JHU Press

ISBN: 9780801870156


Page: 176

View: 525

Society today, writes Stephen Post, is "hypercognitive": it places inordinate emphasis on people's powers of rational thinking and memory. Thus, Alzheimer disease and other dementias, which over an extended period incrementally rob patients of exactly those functions, raise many dilemmas. How are we to view—and value—persons deprived of what some consider the most important human capacities? In the second edition of The Moral Challenge of Alzheimer Disease, Post updates his highly praised account of the major ethical issues relating to dementia care. With chapters organized to follow the progression from mild to severe and then terminal stages of dementia, Post discusses topics including the experience of dementia, family caregiving, genetic testing for Alzheimer disease, quality of life, and assisted suicide and euthanasia. New to this edition are sections dealing with end-of-life issues (especially artificial nutrition and hydration), the emerging cognitive-enhancing drugs, distributive justice, spirituality, and hospice, as well as a critique of rationalistic definitions of personhood. The last chapter is a new summary of practical solutions useful to family members and professionals.

Palliative CarePalliative Care

Actively dying patients are not always capable of taking in and utilizing nutrients
and • water. The balance of benefit and burden with natural and artificial nutrition
and hydration is com• plex and dynamic. Effective communication with the ...

Author: Jane E. Loitman

Publisher: Springer Science & Business Media

ISBN: 9781607615903


Page: 83

View: 687

A clinical case-based handbook has a role in general clinicians’ practice of caring for patients with serious or life-limiting illness. The explosion of the field of Hospice and Palliative Medicine impacts all physicians and healthcare providers. Fellowship trained s- cialists graduate in greater numbers annually. These and more seasoned specialists are now certified by the American Board of Medical Specialties as subspecialists. Research in this field is expanding in scope and quantity, and peer reviewed journals devoted to this work are multiplying. Moreover, peer reviewed journals in primary care and other subspecialties of medicine regularly include papers that focus on end-of-life care, quality of life issues, and symptom management. Overall then, access to clinical information necessary to care for patients with life-limiting illness is not only essential, but also increasingly available. This case-based clinical book aims to help with the actual practice of caring for patients with life-limiting illness. Numerous texts and journals exist to provide the data to inform care, yet there remains a need to find practical points and information about the practical application of the principles of palliative care. Thus, we hope that the cases, key points, and practical tips will help health care providers who are not experts already in palliative care in the care of patients with serious illness and challenging problems. Some chapters follow one patient through the course of an illness to highlight the applicability of palliative care throughout the disease process.

The Law of Later life Health Care and Decision MakingThe Law of Later life Health Care and Decision Making

(The artificial provision of nutrition and hydration is considered the provision of
medical care.127) Kentucky and South Dakota require a surrogate to permit
artificial nutrition and hydration if necessary for the comfort of the patient.128
However, ...

Author: Lawrence A. Frolik

Publisher: American Bar Association

ISBN: 1590317599


Page: 298

View: 558

Directives - which include living wills and health care powers of attorney (or proxies) are unique in a heretofore unknown way. They draw heavily on the knowledge and skills of practitioners from all three of the noble professions: law, medicine, and spirit. That's precisely why Advance Health Care Directives: A Handbook for Professionals is such an exceedingly important work. Authored by a lawyer and a physician, this far ranging volume deals with the difficult and sensitive issues faced by professionals - lawyers, doctors, nurses, clerics, spiritual advisors, chaplains, social workers, palliative caregivers, and all allied walks - in helping clients and patients plan, write, execute, and implement these utterly essential "personal contingency plans" for health care decision-making. Book jacket.

Patient centred Ethics and Communication at the End of LifePatient centred Ethics and Communication at the End of Life

10 Water , water everywhere ' : Artificial nutrition and hydration at the end of life
Men so noble , However faulty , yet should find respect For what they have been :
' tis a cruelty To load a falling man . King Henry VIII , V , iii . Background The ...

Author: David Jeffrey

Publisher: Radcliffe Publishing

ISBN: 1857756215


Page: 171

View: 804

In this volume ethical analysis is linked with practical advice on how to broach difficult decisions, handling uncertainty and facilitating patient choice. It links the ethical debate to the clinical problems of communication.

Conscious in a Vegetative State A Critique of the PVS ConceptConscious in a Vegetative State A Critique of the PVS Concept

ruling referred to artificial nutrition and hydration and there is no consensus on
what this is " . This April 1999 comment in an interview with the chair of the B.M.A.

Author: Peter McCullagh

Publisher: Springer Science & Business Media

ISBN: 1402026293


Page: 354

View: 876

Having been originally introduced as a term to facilitate discussion of a specific group of patients regarded as entering a state of unawareness following coma, the ‘Persistent Vegetative State’ (PVS) has established itself as an apparently discrete medical condition with clear-cut implications for ethicists and lawyers that exceed any scientifically based understanding. As a consequence of this upgrading, conclusions drawn about the status and hence the management of this uncommon condition have been increasingly extended to other patients with much more common forms of disability. This book traces the origins of prevailing perceptions about PVS and submits these to critical examination. In doing this it comes to the conclusion that inadequate attention has been paid to acknowledging what is not known about affected individuals and that assumptions have consistently come to be traded as facts. Re-examination of the basis of the PVS and the adoption of a more scientific approach is long overdue and is owed to the community at large which has generally been provided by many medical practitioners with a ‘dumbed-down’ account of the condition. The book will be of interest to philosophers, medical graduates and neuroscientists but is also intended to remain accessible to the general reader with an interest in the wider implications of trends in medical thinking for attitudes towards many classes of patient. It has an extensive bibliography and will be of specific interest to bioethicists and lawyers with professional interests in PVS.

Practical Reasoning in BioethicsPractical Reasoning in Bioethics

While these considerations probably indicate that continued artificial feeding is
best in most cases , there may be ... feel strongly that no medical procedures
should be applied to provide nutrition and hydration and the caregivers are
willing to ...

Author: James F. Childress

Publisher: Indiana University Press

ISBN: 0253112869


Page: 400

View: 667

"This is a valuable clarification, re-statement and defence of principlism as an approach to applied ethics. It is strongly recommended to many teachers of bioethics..." -- Journal of the American Medical Association "Childress' book deserves careful study by all concerned with the ethical aspect of contemporary biomedical challenges." -- Science Books & Films "An ideal supplement for a graduate seminar on bioethics or for upper-division undergraduates needing more information in this area." -- Choice In these revised and updated essays, renowned ethicist James F. Childress highlights the role of imagination in practical reasoning through various metaphors and analogies. His discussion of ethical problems contributes to a better understanding of the scope and strength of different moral principles, such as justice, beneficence, and respect for autonomy. At the same time, Childress demonstrates the major role of metaphorical, analogical, and symbolic reasoning in biomedical ethics, largely in conjunction with, rather than in opposition to, principled reasoning.