[Tube-feeding in advanced dementia. An evidence-based ethical analysis].
Lacking clear empirical evidence and ethical obligations, decision-making about tube-feeding in patients with advanced dementia often presents as a difficult problem in clinical routine. Based on the principles of beneficence, non-maleficence and autonomy, an ethical analysis of the empirical evidence shows that tube-feeding should be avoided in many patients with advanced dementia: Recent studies demonstrate (1) that there is no proof of any benefit, (2) that tube-feeding often results in further harm to the dementia patient and (3) that the patient's will is not sufficiently taken into consideration. A practical model for interdisciplinary decision-making can account for these various difficulties and might improve the empirically and ethically highly complex process of decision-making about tube feeding in patients with advanced dementia.
Synofzik
M
M
Institut für Ethik und Geschichte in der Medizin, Universität Tübingen, Schleichstrasse 8, 72074 Tübingen. matthis.synofzik@uni-tuebingen.de
D003704:Dementia / Q000523:psychology* / Q000534:rehabilitation*; D004750:Enteral Nutrition / Q000941:ethics* / Q000523:psychology*; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D016743:Mental Competency / Q000523:psychology; D028701:Patient Rights / Q000941:ethics*; D026684:Personal Autonomy; D011788:Quality of Life / Q000523:psychology*