Position of the American Dietetic Association: ethical and legal issues in nutrition, hydration, and feeding.
It is the position of the American Dietetic Association that the development of clinical and ethical criteria for the nutrition and hydration of persons through the life span should be established by members of the health care team. Registered dietitians should work collaboratively to make nutrition, hydration, and feeding recommendations in individual cases. Registered dietitians have an active role in determining the nutrition and hydration requirements for individuals throughout the life span. When patients choose to forgo artificial nutrition and hydration, or when patients lack decision-making capacity, and others must decide whether or not to provide artificial nutrition and hydration, the registered dietitian has an active and responsible professional role in the ethical deliberation around that decision. There is strong clinical, ethical, and legal support both for and against the administration of food and water when issues arise regarding what is or is not wanted by the patient and what is or is not warranted by empirical clinical evidence. When a conflict arises, the decision to administer or withhold nutrition and hydration requires ethical deliberation. The registered dietitian's understanding of nutrition and hydration within the context of nutritional requirements and cultural, social, psychological, and spiritual needs provides an essential basis for ethical deliberation on issues of nutrition and hydration.
Maillet
Julie O'Sullivan
JO
School of Health Related Professions, University of Medicine and Dentistry of New Jersey, Newark, USA.
Potter
Robert L
RL
Heller
Linda
L
D016223:Advance Directives / Q000331:legislation & jurisprudence; D004046:Dietetics / Q000592:standards*; D004992:Ethics, Medical; D005066:Euthanasia, Passive / Q000331:legislation & jurisprudence; D005440:Fluid Therapy; D017408:Guidelines as Topic; D006801:Humans; D008020:Life Support Care / Q000592:standards*; D016743:Mental Competency; D009747:Nutritional Physiological Phenomena; D018529:Nutritional Support / Q000523:psychology / Q000592:standards*; D010344:Patient Advocacy; D010347:Patient Care Planning / Q000592:standards*; D018458:Persistent Vegetative State; D026684:Personal Autonomy; D012068:Religion and Medicine; D012952:Societies; D013727:Terminal Care / Q000592:standards*; D016312:Treatment Refusal; D014481:United States; D026712:Value of Life; D028761:Withholding Treatment