Withdrawal of artificial nutrition and hydration for patients in a permanent vegetative state: Changing tack
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Bioethics 26 (3):157-163 (2012)
In the United States, the decision of whether to withdraw or continue to provide artificial nutrition and hydration (ANH) for patients in a permanent vegetative state (PVS) is placed largely in the hands of surrogate decision-makers, such as spouses and immediate family members. This practice would seem to be consistent with a strong national emphasis on autonomy and patient-centered healthcare. When there is ambiguity as to the patient's advanced wishes, the presumption has been that decisions should weigh in favor of maintaining life, and therefore, that it is the withdrawal rather than the continuation of ANH that requires particular justification. I will argue that this default position should be reversed. Instead, I will argue that the burden of justification lies with those who would continue artificial nutrition and hydration (ANH), and in the absence of knowledge as to the patient's advanced wishes, it is better to discontinue ANH. In particular, I will argue that among patients in PVS, there is not a compelling interest in being kept alive; that in general, we commit a worse violation of autonomy by continuing ANH when the patient's wishes are unknown; and that more likely than not, the maintenance of ANH as a bridge to a theoretical future time of recovery goes against the best interests of the patient
|Keywords||surrogate decision‐making artificial nutrition and hydration substituted judgment vegetative state euthanasia bioethics advance directive(s)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
Jukka Varelius (2013). Pascal's Wager and Deciding About the Life-Sustaining Treatment of Patients in Persistent Vegetative State. Neuroethics 6 (2):277-285.
Similar books and articles
Sami Alsolamy (2014). Islamic Views on Artificial Nutrition and Hydration in Terminally Ill Patients. Bioethics 28 (2):96-99.
R. Gillon (1998). Persistent Vegetative State, Withdrawal of Artificial Nutrition and Hydration, and the Patient's "Best Interests". Journal of Medical Ethics 24 (2):75-76.
Els Bryon, Bernadette Dierckx de Casterlé & Chris Gastmans (2011). 'Because We See Them Naked' – Nurses' Experiences in Caring for Hospitalized Patients with Dementia: Considering Artificial Nutrition or Hydration (Anh). Bioethics 26 (6):285-295.
Paolo Cattorini & Massimo Reichlin (1997). Persistent Vegetative State: A Presumption to Treat. Theoretical Medicine and Bioethics 18 (3).
J. Blandford (2011). An Examination of the Revisionist Challenge to the Catholic Tradition on Providing Artificial Nutrition and Hydration to Patients in a Persistent Vegetative State. Christian Bioethics 17 (2):153-164.
R. Gillon (1993). Persistent Vegetative State and Withdrawal of Nutrition and Hydration. Journal of Medical Ethics 19 (2):67-68.
J. C. Sheather (2013). Withdrawing and Withholding Artificial Nutrition and Hydration From Patients in a Minimally Conscious State: Re: M and its Repercussions. Journal of Medical Ethics 39 (9):543-546.
Gastone G. Celesia (1997). Persistent Vegetative State: Clinical and Ethical Issues. Theoretical Medicine and Bioethics 18 (3).
M. R. Gillick (2001). Artificial Nutrition and Hydration in the Patient with Advanced Dementia: Is Withholding Treatment Compatible with Traditional Judaism? Journal of Medical Ethics 27 (1):12-15.
C. Tollefsen (ed.) (2008). Artificial Nutrition and Hydration. Springer Press.
G. M. Craig (1996). On Withholding Artificial Hydration and Nutrition From Terminally Ill Sedated Patients. The Debate Continues. Journal of Medical Ethics 22 (3):147-153.
Sofia Moratti (2010). The Englaro Case: Withdrawal of Treatment From a Patient in a Permanent Vegetative State in Italy. Cambridge Quarterly of Healthcare Ethics 19 (03):372-380.
J. P. Bishop & E. L. Bedford (2011). Medically Assisted Nutrition and Hydration: The Vegetative State and Beyond. Christian Bioethics 17 (2):97-104.
A. Demertzi, E. Racine, M.-A. Bruno, D. Ledoux, O. Gosseries, A. Vanhaudenhuyse, M. Thonnard, A. Soddu, G. Moonen & S. Laureys (2013). Pain Perception in Disorders of Consciousness: Neuroscience, Clinical Care, and Ethics in Dialogue. [REVIEW] Neuroethics 6 (1):37-50.
R. Gillon (1994). Palliative Care Ethics: Non-Provision of Artificial Nutrition and Hydration to Terminally Ill Sedated Patients. Journal of Medical Ethics 20 (3):131-187.
Added to index2010-10-07
Total downloads35 ( #50,281 of 1,102,744 )
Recent downloads (6 months)4 ( #84,424 of 1,102,744 )
How can I increase my downloads?