Use of Artificial Nutrition and Hydration
ACOI Ethics Committee
ACOI Task Force for Palliative Care
ACOI Board of Directors
Adopted: April 7, 2005
The ACOI is committed to optimizing care of patients throughout adult life, including life’s final stages. Death is an expected, natural outcome in the cycle of life. The ACOI supports a patient’s/surrogate’s right to autonomy in decision-making through all realms of healthcare. Excellent care at the end-of-life involves individualized attention to symptom management, including physical, spiritual and emotional suffering for both the patient and the family. Artificial nutrition and hydration are often routine components of good medical care provided with a goal of patient benefit. Often, though, for a patient facing the end of his or her life, artificial nutrition and hydration may add to patient and family discomfort by worsening symptoms and prolonging the dying process. Each patient/surrogate has the right to define individual goals of care, including the right to comfort and dignity.
The ACOI believes it is medically, morally and ethically appropriate to withhold or stop artificial nutrition and hydration if, in conjunction with the patient’s/surrogate’s goals of care, it is not beneficial. The ACOI would oppose cessation of artificial nutrition and hydration when it is not burdensome, is inconsistent with the patient’s/surrogate’s wishes, or for the sole intent of ending the patient’s life.
As with any medical intervention, clinical assessment of each individual patient is paramount in deciding whether artificial nutrition and hydration is beneficial to provide.