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Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues in Feeding and Hydration

      Abstract

      It is the position of the Academy of Nutrition and Dietetics that individuals have the right to request or refuse nutrition and hydration as medical treatment. Registered dietitians (RDs) should work collaboratively as part of the interprofessional team to make recommendations on providing, withdrawing, or withholding nutrition and hydration in individual cases and serve as active members of institutional ethics committees. RDs have an active role in determining the nutrition and hydration requirements for individuals throughout the life span. When individuals choose to forgo any type of nutrition and hydration (natural or artificial), or when individuals lack decision-making capacity and others must decide whether or not to provide artificial nutrition and hydration, RDs have a professional role in the ethical deliberation around those decisions. Across the life span, there are multiple instances when nutrition and hydration issues create ethical dilemmas. There is strong clinical, ethical, and legal support both for and against the administration of food and water when issues arise regarding what is or is not wanted by the individual and what is or is not warranted by empirical clinical evidence. When a conflict arises, the decision requires ethical deliberation. RDs' understanding of nutrition and hydration within the context of nutritional requirements and cultural, social, psychological, and spiritual needs provide an essential basis for ethical deliberation. RDs, as health care team members, have the responsibility to promote use of advanced directives. RDs promote the rights of the individual and help the health care team implement appropriate therapy. This paper supports the “Practice Paper of the Academy of Nutrition and Dietetics: Ethical and Legal Issues of Feeding and Hydration” published on the Academy website at: www.eatright.org/positions.
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      Linked Article

      • Erratum
        Journal of the Academy of Nutrition and DieteticsVol. 113Issue 12
        • Preview
          In the “Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues in Feeding and Hydration,” which appeared in the June 2013 issue of the Journal of the Academy of Nutrition and Dietetics (828-833), there is an error. On page 833, the institution listed for Alice Fornari, EdD, RD, is “Nofstra North Shore-LIJ School of Medicine.” It should be listed as “Hofstra North Shore-LIJ School of Medicine.”
        • Full-Text
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      • Erratum
        Journal of the Academy of Nutrition and DieteticsVol. 113Issue 7
        • Preview
          There was an error in the June 2013 Journal article, “Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues in Feeding and Hydration” (pp 828-833). In the author bylines on page 833, the credential CNSC was mistakenly omitted for Denise Baird Schwartz. Her byline should be listed as “Denise Baird Schwartz, MS, RD, FADA, CNSC.”
        • Full-Text
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      • Erratum
        Journal of the Academy of Nutrition and DieteticsVol. 117Issue 5
        • Preview
          In the June 2013 issue of the Journal of the Academy of Nutrition and Dietetics, on page 829 of “Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues in Feeding and Hydration,” Figure 1 mistakenly claims that Cruzan v. Harmon took place in the Maryland Supreme Court. The case took place in the Missouri Supreme Court. The Journal regrets this error.
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