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Extraordinary nutritional support: a case study and ethical analysis
Journal of the American Geriatrics Society
|March 1, 1984
Summary
Ethical decisions about limiting treatment, like nutritional support for frail elderly patients, require careful consideration of individual circumstances. Sometimes, artificial nutrition may be considered extraordinary, not ordinary, care.
Area of Science:
- Geriatric Medicine
- Bioethics
- Clinical Nutrition
Background:
- Ethical considerations in limiting medical treatment often center on complex, high-tech interventions.
- Less dramatic therapies, such as nutritional support, may warrant closer ethical examination, particularly in vulnerable populations.
Observation:
- Nutritional support is vital for elderly patients, especially the very frail.
- The appropriateness of nutritional therapy must be individualized.
- In cases of irreversible severe illness, artificial nutrition can be viewed as extraordinary life-prolonging means.
Findings:
- This case study explores the ethical dilemmas of respecting a severely debilitated geriatric patient's refusal of nutritional support.
- It highlights the tension between providing potentially life-sustaining treatment and honoring patient autonomy.
Implications:
- The findings necessitate a nuanced ethical approach to nutritional support in geriatric care.
- It underscores the importance of assessing whether nutritional interventions constitute ordinary or extraordinary means in end-of-life scenarios.
- Respecting patient refusal of nutrition requires careful ethical deliberation, especially in frail elderly individuals.
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