Terri Schiavo and the use of artificial nutrition and fluids: 
Insights from the Catholic tradition on end-of-life care

The recent events surrounding the case of Terri Schiavo have highlighted the moral implications of end-of-life care. Among the issues raised by Terri's parents against the withdrawal of her feeding tube was that doing so would be “euthanasia” and, as such, would violate their daughter's Roman Catholic religious beliefs. The emotionally charged rhetoric and the political posturing in this case drowned out both rational discourse and historical memory. Politicians and even a few bishops and cardinals were quick to join the parents in denouncing the removal of Terri Schiavo's feeding tube as “euthanasia” or “murder.” However, the interpretation of the Catholic position on the sanctity of life that led to that moral judgment is not in line with the centuries-long Catholic position on end-of-life care.

Download Full-text

Ethical considerations at the end-of-life care

SAGE Open Medicine ◽

10.1177/20503121211000918 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110009

Author(s):

Melahat Akdeniz ◽

Bülent Yardımcı ◽

Ethem Kavukcu

Keyword(s):

End Of Life ◽

End Of Life Care ◽

Assisted Suicide ◽

Healthcare Professionals ◽

Ethical Decision Making ◽

Biomedical Ethics ◽

Artificial Nutrition ◽

Life Care ◽

Ethical Challenges ◽

Physician Assisted Suicide

The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patients’ desires. However, physicians face many ethical challenges in end-of-life care. Since the decisions to be made may concern patients’ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process. Understanding the principles underlying biomedical ethics is important for physicians to solve the problems they face in end-of-life care. The main situations that create ethical difficulties for healthcare professionals are the decisions regarding resuscitation, mechanical ventilation, artificial nutrition and hydration, terminal sedation, withholding and withdrawing treatments, euthanasia, and physician-assisted suicide. Five ethical principles guide healthcare professionals in the management of these situations.

Download Full-text

Aging and Advanced Dementia Matters: End-of-Life Care in Nursing Homes

Innovation in Aging ◽

10.1093/geroni/igaa057.1679 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 520-521

Author(s):

Ruth Lopez ◽

Ellen McCarthy ◽

Meghan Hendricksen ◽

Susan McLennon ◽

Anita Rogers ◽

...

Keyword(s):

Nursing Home ◽

End Of Life ◽

Racial Differences ◽

End Of Life Care ◽

Feeding Tube ◽

Nursing Home Care ◽

Life Care ◽

Advanced Dementia ◽

Southeastern Us ◽

Intensity Of Care

Abstract Over 5 million Americans have dementia, and the majority will die in nursing home (NHs). While comfort is the main goal of care for most NH residents with advanced dementia, they commonly receive burdensome and costly interventions such as hospital transfers and feeding tubes that are of little clinical benefit. Despite 20 years of research and numerous experts and associations advocating a palliative approach to care, quantitative studies continue to demonstrate striking and persistent regional, facility, and racial differences, including: greater intensity care among African American versus White residents; greater intensity of care in the Southeastern US; and wide variation in care among NHs in the same region of the country. The reasons for these differences are poorly understood. Assessment of Disparities and Variation for Alzheimer’s disease in Nursing home Care at End of life (ADVANCE) is a 3-year, NIA funded qualitative study of 16 NHs in 4 regions of the country which aims to explain regional and racial factors influencing feeding tube and hospital transfer rates. The purpose of this presentation is to present the methodology established in this study and to highlight factors challenging and enabling implementation of the study protocol. To date, data have been collected in 11 NHs, and include 135 staff interviews, 40 proxy interviews, and nearly 800 hours of observation. These findings demonstrate that although challenging, large qualitative research is possible and holds promise as an effective method to illuminate complex processes influencing end-of-life care for NH residents with advanced dementia.

Download Full-text