PEGs and ethics.
The ethics of dealing with the provision of nutritional therapies has been complicated by technological advances that have affected all of medical science. As a result, nurses are increasingly confronted with decisions regarding the provision of invasive treatments. Indeed, enormous faith is invested in the ability and wisdom of healthcare professionals to alleviate suffering and accomplish cure through the application of invasive therapeutic interventions such as percutaneous endoscopic gastrostomy (PEG) placement. Such decisions are often complex, present a moral dilemma, and are further complicated by prevailing politico-economic, social, and cultural influences. The insertion of tubes for artificial nutritional support in those patients who can be defined as "vulnerable" is no exception. This article explores both the clinical and ethical realities of PEG tube placement and use thereafter in vulnerable patients. The ethical principles of autonomy, beneficence, and justice are discussed within the context of PEG placement and feeding and recommendations are given for nurses practicing in the area of gastroenterology.
Mackie
S B
SB
Royal Hobart Hospital, Division of Medicine, GPO Box 1061L, Hobart 7001, Tasmania, Australia. sarah.breier@dchs.tas.gov.au
D016223:Advance Directives; D000368:Aged; D003657:Decision Making; D004750:Enteral Nutrition / Q000009:adverse effects; D004989:Ethics; D005774:Gastrostomy / Q000451:nursing; D015276:Health Care Rationing; D006801:Humans; D018447:Medical Futility; D011788:Quality of Life