Academic journal article Issues in Law & Medicine

E. Bryon et Al., Nurses' Attitudes towards Artificial Food or Fluid Administration in Patients with Dementia and in Terminally 111 Patients: A Review of the Literature

Academic journal article Issues in Law & Medicine

E. Bryon et Al., Nurses' Attitudes towards Artificial Food or Fluid Administration in Patients with Dementia and in Terminally 111 Patients: A Review of the Literature

Article excerpt

E. Bryon et al., Nurses' Attitudes Towards Artificial Food or Fluid Administration in Patients with Dementia and in Terminally 111 Patients: A Review of the Literature, 34 J. Med. Ethics 431 (2009).

End-of-life decisions often concern withholding or withdrawing potential life-prolonging treatments. Tube feeding and fluid administration are two of the most frequently withheld life-sustaining treatments. Studies conducted in six European countries (Denmark, Switzerland, Belgium, The Netherlands, Sweden and Italy) found that, of all life-sustaining treatments forgone, withholding or withdrawing food and fluids occurred between 14 percent and 38 percent of the time.

Studies have shown that physicians have the primary responsibility in initiating tube feeding and fluid administration. But in 42 percent to 97 percent of the occurrences, physicians discussed starting or forgoing tube feeding and fluid administration with nurses. Several studies have also shown that nurses play an important role in the decision-making process. Nurses often initiate the decision-making process by informing family members and physicians about a patient's condition. Furthermore, nurses try to influence physicians' decisions by questioning them and expressing their concerns. …

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