Tag: Patient autonomy

Historically, hunger strikes have been used for centuries as a potent form of non-violent resistance, with pre-Christian Irish activists utilizing a form known as 'troscad' to shame wrongdoers. To properly hunger strike in a modern context, participants must navigate significant medical and ethical considerations, prioritizing safety and a clear understanding of the severe physical risks involved.

The human body's resilience is remarkable, with some individuals surviving for extended periods with only water, and in rare, medically supervised cases, for over a year. The question of how long can a patient last without eating, however, is not a simple one, as the answer depends on numerous individual factors and the patient's specific health context, particularly in end-of-life care scenarios.

According to the International Dysphagia Diet Standardisation Initiative (IDDSI), a Level 4 diet is defined as 'puréed food'. Understanding what is level 4 risk feeding involves navigating the complex intersection of this dietary requirement with an individual's right to choose, even when swallowing difficulties pose significant safety risks.

According to the World Health Organization (WHO), malnutrition—encompassing both undernutrition and overnutrition—presents significant threats to human health and can severely impact patient outcomes during hospitalization. For nurses, understanding the ethical dimensions of nutrition and diet is crucial to providing comprehensive, patient-centered care that aligns with their professional responsibilities. This involves respecting patient choices, ensuring access to adequate nutrition, and navigating difficult decisions, such as end-of-life care.

According to the Academy of Nutrition and Dietetics, practitioners are guided by a robust Code of Ethics to ensure public trust and safety. Exploring what are the ethics of nutrition and dietetics is crucial for maintaining integrity and providing high-quality, patient-centered care in a complex field.

Recent research in Switzerland estimated that voluntary stopping eating and drinking (VSED), a form of voluntary starvation, accounted for 1.7% of deaths in nursing homes, highlighting its growing presence in end-of-life planning. This deliberate act is a complex end-of-life option chosen by a competent adult seeking to control the timing and manner of their death due to unbearable suffering from a terminal or incurable illness.

According to a study published in the *Cleveland Clinic Journal of Medicine*, the decision to withhold or withdraw artificial nutrition for terminally ill patients involves complex clinical and ethical issues. Understanding the guidelines regarding withholding and withdrawing tube feeding is crucial for patients, families, and healthcare providers to navigate these sensitive end-of-life choices with dignity and clarity.

Studies show that successfully transitioning off enteral feeding often occurs when a patient can meet at least 50-75% of their nutritional needs orally. Knowing when to discontinue enteral nutrition is a complex decision involving clinical assessment, patient readiness, and multidisciplinary planning.

According to the American Society for Parenteral and Enteral Nutrition, providing artificially administered nutrition is a medical intervention that requires ethical consideration. The question, **'Is TPN considered life support?'**, does not have a simple 'yes' or 'no' answer, and its classification is dependent on the clinical context, patient prognosis, and specific goals of care.