Clinical nutrition and human rights. An international position paper

Abstract

The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.

Utilization and validation of the Global Leadership Initiative on Malnutrition (GLIM): A scoping review

“…It must be acknowledged that if health is a human rights issue and conversely, human rights are a health issue, then well-designed clinical studies are at the core of assuring patients' right to evidenced-based nutrition care [11]. Therefore, following the scientific method in clinical research is paramount to remedying the gaps in research related to the GLIM framework and its validation: 1) Generate the research hypothesis and study objective(s); 2) Select the patient population, randomize to avoid selection bias, and stratify to minimize the effects of confounding variables; 3) Determine the required sample size to assure adequate power to detect statistical significance; 4) Analyze the data using appropriate statistical methods to prevent collinearity; and 5) Interpret the findings and draw conclusions based on the correct study design method [102].…”

“…Since its publication, the GLIM criteria have been included in numerous studies. However, an understanding of their application in clinical practice and validation in research is needed, as the practice of sound science is foundational to providing evidence-based nutrition care for human health and as a human right [11].…”

C-reactive protein and white blood cell count are adverse prognostic markers for patients with advanced cancer on parenteral nutrition in a palliative care unit setting: A retrospective cohort study

“…Provision of adequate fluid and nutrients is basic care and perceived as a fundamental human right. 25 On the other hand parenteral and enteral feeding is defined as a medical treatment. Therefore, the legal principles which apply to parenteral nutrition are the same which apply to all other medical treatments like medication or ventilation.…”

Kulturna kompetentnost v slovenski bolnišnični prehrani

“…Pridružujemo se mnenjem strokovnjakov, ki pravijo, da so možnosti prehranskega ukrepanja in potrebni človeški viri v ustanovah, kjer ni zavedanja o pomembnosti prehrane, pogosto omejeni. Ustvariti je treba institucionalno kulturo, v kateri vsi ključni deležniki cenijo prehranske storitve (Tappenden et al, 2013;Cardenas et al, 2021). Ne nazadnje je prehrana v bolnišnici del spoštovanja človeškega dostojanstva in avtonomije posameznika (Cardenas et al, 2021).…”