Encyclopedia > Patient refusal of nutrition and hydration
People who feel they are near the end of their life often consciously refuse food and/or water. Published studies [1] (http://www.dyingwell.com/prnh.htm) indicate that "within the context of adequate palliative care, the refusal of food and fluids does not contribute to suffering among the terminally ill", and might actually contribute to a comfortable passage from life: "At least for some persons, starvation does correlate with reported euphoria." Food from plant sources Food is any substance normally eaten or drunk by living organisms. ... Drinking water This article focuses on water as we experience it every day. ... Palliative care is any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. ...
Fasting is the act of willingly abstaining from all food and in some cases drink, or in other cases from certain types or groups of food (e. ... A Living Will, also called Will to Live, Advance Health Directive, or Advance Health Care Directive, is a specific type of power of attorney or health care proxy or advance directive. ...
References
Patient Refusal of Nutrition and Hydration: Walking the Ever-Finer Line (http://www.dyingwell.com/prnh.htm) American Journal Hospice & Palliative Care, pp. 8-13, March/April 1995
In contrast, for a patient with severe, unrelieved suffering and advanced, incurable illness, cessation of eating and drinking might be considered part of the right to refuse treatment (31, 48, 53).
All severely ill patients who experience substantial suffering and have a poor prognosis should be informed about the potential of palliative care to address their symptoms (58, 59).
Although the patient'srefusal of food and fluids technically does not require the physician's participation, a physician should be part of the team who assesses the patient's request and provides palliative care as the process unfolds.
When a patient, or surrogate(s) acting on behalf of a patient, refuses recommended treatment, a dilemma can be created for health care professionals: respect for a patient's wishes can conflict with the obligation to help and not to harm the patient.
Patients with decisional capacity (i.e., the ability to understand the consequences of their decisions) have the right to refuse to seek or accept treatment or care for a condition or illness.
Refusal of a specific treatment does not of itself indicate that the patient lacks decision-making capacity; however, a refusal may initiate an inquiry about this capacity.
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