Eating and drinking in later life
Food and drink are vital to life and have a special place in human culture: providing and receiving food has significance beyond sustaining body physiology. Sudden premature death is becoming less common and people experiencing a slow decline before death with frailty and/or dementia is more common. When patients develop swallowing difficulties and disinterest in food and drink, this presents challenges to healthcare workers and families. Should medically assisted (artificial) nutrition and hydration be started? Evidence suggests that it usually makes little or no impact on physical comfort or clinical outcomes but its emotional and cultural role may be great and ethical decision-making must take this into account. In the chapter we discuss various cultural, ethical, and legal perspectives on this situation and the judgements and practical decisions that arise, specifically focusing on those different standpoints from parts of the world where Buddhism, Christianity, Hinduism, Islam, and Judaism are predominant.