Tube-Feeding Decisions in the Elderly

Prospective Cohort Study Comparing the Effects of Different Artificial Nutrition Methods on Long‐Term Survival in the Elderly

“…The proportion of elderly people requiring long‐term artificial nutrition who die within 1 year after the initiation of artificial nutrition was 30% for PEG, 40% for nasal tube feeding, and 60% for PN. The disadvantages of each artificial nutrition method that are associated with human dignity or pain should also be considered 31 , 32 . For the initiation or withdrawal of long‐term artificial nutrition, it is important that the decision be based on an ethical and evidence‐based viewpoint.…”

ACE Inhibition in Cardiovascular Disease

“…A few observers have suggested that maintaining hydration promotes comfort by preventing delirium, 25 but most clinicians find that, on balance, hydration without nutrition causes discomfort, because it prolongs the process of dying and increases the production of urine and sputum. 26 Not only do gastrostomy tubes fail to prevent suffering, they may actually cause it. The percutaneous insertion of a gastrostomy tube, the most common method used, requires upper endoscopy, an incision in the abdominal wall, and intravenous sedation.…”

Artificial hydration and nutrition in advanced Alzheimer's disease: facilitating family decision‐making

“…, 2000). Another framework for examining AHN is the obligatory vs. optional treatment perspective based on an analysis of benefits and burden (Beauchamp & Childress, 1994; Hodges & Tolle, 1994). The optional treatment perspective requires consideration of both the patient's interests and the patient's wishes.…”

“…Ethicists suggest that extraordinary treatments constitute those that are unusual, difficult, or offer no reasonable hope of benefits and have labelled AHN as such (Beauchamp & Childress, 1994;Ahronheim et al, 2000). Another framework for examining AHN is the obligatory vs. optional treatment perspective based on an analysis of benefits and burden (Beauchamp & Childress, 1994;Hodges & Tolle, 1994). The optional treatment perspective requires consideration of both the patient's interests and the patient's wishes.…”