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June 26, 1995

What Do Apple Pie and Motherhood Have to Do With Feeding Tubes and Caring for the Patient?

Author Affiliations

The Cleveland Clinic Foundation Department of Bioethics, P-31 9500 Euclid Ave Cleveland, OH 44195-5185

Arch Intern Med. 1995;155(12):1258-1263. doi:10.1001/archinte.1995.00430120025003

MEDICAL AND ethical guidelines state that the forgoing of artificial nutrition and hydration is no different from the forgoing of any other medical treatment. Yet a significant number of health care professionals believe that artificial nutrition and hydration must always be continued, even when the burdens of this treatment outweigh the benefits of prolonging life. I believe that health care professionals should accept the premise that artificial nutrition and hydration are medical treatment (which may be forgone under justifiable clinical and ethical conditions) rather than "basic care" (which morally cannot be forgone) because of (1) social meanings that create humans symbolically as "persons"; and (2) the permission medicine is given by society to touch the human body in various antisocial, but medically necessary, ways.

While any decision to forgo life-supporting treatment may cause anxiety and anguish for even the most experienced physician,1 the withholding or withdrawal of artificial nutrition