Ethical aspects of percutaneous endoscopic gastrostomy placement for artificial nutrition and hydratation.
Of the many decisions that family members and physicians must make about medical care in patients with advanced disease and perceived poor quality of life, none is more heart-wrenching than the decision about artificial nutrition and hydratation. The endoscopist often is placed in a precarious position when percutaneous endoscopic gastrostomy tube placement is requested in such patients. Clinical decision-making between the patient, the family and the physician should be consistent with legal and ethical principles. The purpose of this article is to provide an evaluation of medical and ethical issues regarding the decision on placing a percutaneous endoscopic gastrostomy tube for various indications, as well as suggesting strategies to optimize the decision-making process.
Arvanitakis
M
M
Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium. maarvani@ulb.ac.be
Ballarin
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A
Van Gossum
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D026686:Beneficence; D003657:Decision Making / Q000941:ethics; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000628:therapy; D004750:Enteral Nutrition / Q000941:ethics*; D005773:Gastroscopy / Q000941:ethics; D005774:Gastrostomy / Q000941:ethics* / Q000295:instrumentation; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D009422:Nervous System Diseases / Q000628:therapy; D018458:Persistent Vegetative State / Q000628:therapy; D026684:Personal Autonomy; D012935:Social Justice / Q000941:ethics; D020521:Stroke / Q000628:therapy; D014947:Wounds and Injuries / Q000628:therapy