Termination of Nutrition and Hydration

Terminating Nutrition and Hydration: Controversial Issues Nurses deal with moral and ethical issues daily. As health care advances with changes in legal and social issues, medical technology, and patient 's rights, more ethical concerns will arise. Nurses must learn how to respect their patients by recognizing an individual 's preference; therefore, granting them autonomy. According to Blais, Hayes, Kozier and Erb (2006), "Autonomy refers to the self-determination and the right to make one 's own decisions." By applying this principle of autonomy, patient 's decision must be respected even though their choices may not seem to be in the patient 's best interest. The Patient Self Determination Act of 1991 mandates all healthcare institutions to complete an advanced directive such as a living will or a durable power of attorney upon the patient 's request. What will happen if a patient without an advance directive is unable to express his or her own wishes due to cognitive function loss or persistent vegetative state (PVS)? The lack of legal documentation will eventually lead to an ethical dilemma. An ethical dilemma is a situation that often involves an apparent conflict between moral imperatives, in which to obey one would result in transgressing another (Longman, 1987). Termination of nutrition and hydration from patients that are in a persistent vegetative state is an example of an ethical dilemma, which will be discussed. Ethical issue has raised questions regarding quality of life, appropriate use of resources, the wishes of the family, and professional responsibilities. Before we decide whether terminating nutrition and fluids is right or wrong, we must understand its guidelines.
In Favor of Terminating Nutrition and Hydration
The Federal courts have defined artificial nutrition and hydration (ANH) as medical treatments; a conscious patient can refuse to eat and drink. Nowadays, tube feeding or PEG (percutaneous endoscopic gastrostomy) provides

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