Patient refusal of nutrition and hydration: Walking the ever-finer line

@article{Byock1995PatientRO,
  title={Patient refusal of nutrition and hydration: Walking the ever-finer line},
  author={Ira R. Byock},
  journal={American Journal of Hospice and Palliative Medicine},
  year={1995},
  volume={12},
  pages={13 - 8}
}
  • I. Byock
  • Published 1 March 1995
  • Medicine
  • American Journal of Hospice and Palliative Medicine
In the midst of an increasingly heateddebateover physician-assistedsuicide(PAS) anotheroption availableto patientswho are determinedto endtheir livesis receiving seriousattention—theconsciousrefusalof nutrition andhydration.Patient refusalof nutrition andhydration (PRNH) is hardly new, indeed, virtually all hospiceclinicians rememberpeoplewhocametoapoint in their illness when theycould be describedas having“lost their will to live” and who recognizedthat continuedeatingand drinking was… 

Responding to Intractable Terminal Suffering: The Role of Terminal Sedation and Voluntary Refusal of Food and Fluids

Terminal sedation and voluntary refusal of hydration and nutrition as potential last-resort responses to severe, unrelievable end-of-life suffering are discussed.

Voluntarily Stopping Eating and Drinking

This volume’s integrated, multi-professional, multidisciplinary character makes it useful for a wide range of readers: patients considering end-of-life options and their families, clinicians of all kinds, ethicists, lawyers, and institutional administrators.

Dehydration in terminally ill patients. Perceptions of long-term care nurses.

The debate concerning the benefits of TD continues and remains an important topic for the LTC nurse, and a positive correlation between age and positive perception of TD is found.

Voluntary refusal of food and fluids: attitudes of Oregon hospice nurses and social workers.

It is suggested that perceptions regarding VRFF are significantly different from those regarding PAS, which may have important clinical implications for nurses and social workers involved in end-of-life care who encounter patients who wish to hasten their deaths.

Voluntary Stopping Eating and Drinking

An organized system for evaluating individual appropriateness for VSED, anticipatory guidance, and management of symptoms associated with VSED is proposed.

Ethical Decisions Regarding Nutrition and the Terminally Ill

  • A. Schwarte
  • Medicine
    Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
  • 2001
Various ethical perspectives in relation to nutrition cessation in the terminally ill are discussed and basic physiologic changes that occur in the terminal patient will also be addressed.

Voluntary stopping of eating and drinking (VSED) as an unknown challenge in a long-term care institution: an embedded single case study

This embedded single case study explored the experiences of registered nurses and relatives who accompanied a 49-year-old woman suffering from multiple sclerosis during VSED in a Swiss long-term care institution to develop an attitude on the institutional and personal level.

‘I’ just not interested in eating’: When nutrition becomes an issue in palliative care

A case study and a take longitudinal view of illness are used in addressing the nursing aspects of assisting a person’s nutrition, firstly in the early stages of illness and then in considering nutritional needs in care towards the end of life.

On Kamisar, killing, and the future of physician-assisted death.

During the same period law and culture have effectively accepted a variety of ways for stricken people to hasten death, with physicians involved in diverse roles, it is shown that these extensions are a salutary part of making death with dignity a genuine possibility for fatally stricken persons.

References

SHOWING 1-10 OF 10 REFERENCES

Comfort care for terminally ill patients. The appropriate use of nutrition and hydration.

In this series, patients terminally ill with cancer generally did not experience hunger and those who did needed only small amounts of food for alleviation, and food and fluid administration beyond the specific requests of patients may play a minimal role in providing comfort.

Patient refusal of hydration and nutrition : an alternative to physician-assisted suicide or voluntary active euthanasia

It is suggested that educating chronically and terminally ill patients about the feasibility of patient refusal of hydration and nutrition (PRHN) can empower them to control their own destiny without requiring physicians to reject the taboos on PAS and VAE that have existed for millennia.

Dehydration symptoms of palliative care cancer patients.

  • F. Burge
  • Medicine, Psychology
    Journal of pain and symptom management
  • 1993

Patient refusal of hydration and nutrition. An alternative to physician-assisted suicide or voluntary active euthanasia.

It is suggested that educating chronically and terminally ill patients about the feasibility of PAS and VAE is a viable option and has fewer associated practical problems in its implementation.

Accepting death without artificial nutrition or hydration

For mos t s u c h i nd iv idua l s , r ecove ry is i m p o s s i b l e, and careg ivers n e e d to u n d e r s t a n d its eff icacy in each s i t ua t ion.

Dehydrationsymptomsof palliative care cancerpatients

  • JPain Sympt Management
  • 1993

Patient refusalof hydration andnutrition: An alternativeto physician-assistedsuicideor voluntary active euthanasia.Arch

  • Intern Med,Dec27,
  • 1993

Acceptingdeathwithout artificial nutrition or hydration.J GenIntern Med,April

  • 1993

Groth-JunckerA: Comfortcarefor terminally ill patients:The appropriateuse of nutrition and hydration

  • JAMA, October26,
  • 1994