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Cited by 401Palliative Care and End-of-Life IssuesEthics and bioethics in healthcareClinical Nutrition and Gastroenterology

ESPEN guideline on ethical aspects of artificial nutrition and hydration

Druml, Christiane, Ballmer, Peter E., Druml, Wilfred, Oehmichen, Frank, Shenkin, Alan, Singer, Pierre, Soeters, Peter, Weimann, Arved +1 more·2016·Clinical Nutrition
DOI 10.1016/j.clnu.2016.02.006
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Abstract

Background The worldwide debate over the use of artificial nutrition and hydration remains controversial although the scientific and medical facts are unequivocal. Artificial nutrition and hydration are a medical intervention, requiring an indication, a therapeutic goal and the will (consent) of the competent patient. Methods The guideline was developed by an international multidisciplinary working group based on the main aspects of the Guideline on "Ethical and Legal Aspects of Artificial Nutrition" published 2013 by the German Society for Nutritional Medicine (DGEM) after conducting a review of specific current literature. The text was extended and introduced a broader view in particular on the impact of culture and religion. The results were discussed at the ESPEN Congress in Lisbon 2015 and accepted in an online survey among ESPEN members. Results The ESPEN Guideline on Ethical Aspects of Artificial Nutrition and Hydration is focused on the adult patient and provides a critical summary for physicians and caregivers. Special consideration is given to end of life issues and palliative medicine; to dementia and to specific situations like nursing care or the intensive care unit. The respect for autonomy is an important focus of the guideline as well as the careful wording to be used in the communication with patients and families. The other principles of Bioethics like beneficence, non-maleficence and justice are presented in the context of artificial nutrition and hydration…

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  • In the palliative situation, covering a patient's nutritional requirements is entirely irrelevant.

    “In this situation, covering a patient's nutritional requirements is entirely irrelevant (162).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [162]

  • In patients where death is imminent, e.g. within the next four weeks, or in patients with an incurable disease which cannot be improved by any treatment including nutritional support, the patient's comfort is the highest priority.

    “Especially in patients where death is imminent, e.g.within the next four weeks, or in patients with an incurable disease which cannot be improved by any treatment including nutritional support (e.g.advanced dementia, terminal phase of malignant cancer disease), the patient´s comfort is the highest priority (162).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [162]

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Authors
Druml, C., Ballmer, P. E., Druml, W., Oehmichen, F., Shenkin, A., Singer, P., Soeters, P., Weimann, A., & Bischoff, S. C.
Affiliations
  • Medical University of Vienna (AT)
  • Kantonsspital Winterthur (CH)
  • Klinik Bavaria (DE)
  • University of Liverpool (GB)
  • Rabin Medical Center (IL)
  • Maastricht University Medical Centre (NL)
  • Klinikum St. Georg (DE)
  • University of Hohenheim (DE)
Corresponding author
  • Druml, Christiane
  • Ballmer, Peter E.
  • Druml, Wilfred
  • Oehmichen, Frank
  • Shenkin, Alan
  • Singer, Pierre
  • Soeters, Peter
  • Weimann, Arved
  • Bischoff, Stephan C.
ORCID
Venue
Clinical Nutrition
Publisher
Elsevier BV
Published
2016-06
Volume
35
Issue
3
Pages
545-556
ISSN
0261-5614 (ISSN-L)
DOI
10.1016/j.clnu.2016.02.006
OpenAlex
W2283015666
Cited by
401
References
81
Citations by year
2026: 31 · 2025: 37 · 2024: 37 · 2023: 52 · 2022: 54 · 2021: 59 · 2020: 43 · 2019: 40 · 2018: 29 · 2017: 13 · 2016: 5 · 2015: 1
FWCI
28.75
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
artificial nutrition, artificial hydration, end-of-life care, palliative care, dementia, intensive care, nursing care, patient autonomy, withholding and withdrawing treatment, hunger strikes, force-feeding, cultural and religious beliefs, bioethics, beneficence, non-maleficence, justice, patient-family communication
MeSH terms
Adult, Dietetics, Europe, Fluid Therapy, Humans, Legislation, Medical, Palliative Care, Patient Acceptance of Health Care, Professional-Family Relations, Professional-Patient Relations, Quality of Life, Societies, Scientific, Terminal Care, Nutritional Support, Evidence-Based Medicine, Personal Autonomy, Withholding Treatment, Precision Medicine, Culturally Competent Care

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