Is the ANA guilty of paternalism in its guidelines on withdrawing or withholding food and fluid?
The ANA Committee on Ethics's Guidelines on Withdrawing or Withholding Food and Fluid (1988) delineates those circumstances under which withholding is normally permissible. The Guidelines direct nurses to respect the wishes of competent adults. What of adults who are considered incompetent? Can they make decisions to refuse food and fluids? The Guidelines ask nurses to judge patient competence and the merit of the reasons behind the decisions. This suggests paternalism. A more appropriate role of the nurse might be to focus on helping the patient to make a decision, rather than on the merit of the decision itself.
Light
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Department of Nursing, Incarnate Word College, San Antonio, TX.
Connelly
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D000575:American Nurses' Association; D003657:Decision Making; D004644:Emotions; D004993:Ethics, Nursing; D006801:Humans; D007258:Informed Consent; D007587:Job Description; D007857:Leadership; D009732:Nursing Care; D010344:Patient Advocacy; D026684:Personal Autonomy; D011367:Professional Staff Committees; D011640:Public Policy; D012297:Right to Die; D018570:Risk Assessment; D014481:United States; D028761:Withholding Treatment