{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:50:16Z","timestamp":1792705816687,"version":"4.5.0"},"reference-count":65,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2006,8,9]],"date-time":"2006-08-09T00:00:00Z","timestamp":1155081600000},"content-version":"unspecified","delay-in-days":69,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:p>The case of Terri Schiavo resulted in substantial media attention about the use of artificial nutrition and hydration (ANH) especially by percutaneous endoscopic gastrostomy (PEG). In this article, I review ethical and legal principles governing decisions to choose or forgo ANH at the end of life, including issues of autonomy and decision-making capacity, similarities and differences between ANH and other medical treatments, the role of proxies when patients lack decision-making capacity, and the equivalence of withholding and withdrawing treatment. Evidence for palliative or life-sustaining benefits for ANH are reviewed in three disease processes: amyotrophic lateral sclerosis (ALS), cancer, and dementias, including Alzheimer's disease. Although more recent studies suggest a possible palliative role for ANH in ALS and terminal cancer, feeding tubes do not appear to prolong survival or increase comfort in advanced dementia of the Alzheimer's type.<\/jats:p>","DOI":"10.1017\/s1478951506060196","type":"journal-article","created":{"date-parts":[[2008,4,21]],"date-time":"2008-04-21T15:23:53Z","timestamp":1208791433000},"page":"135-143","source":"Crossref","is-referenced-by-count":75,"title":["Artificial nutrition and hydration at the end of life: Ethics and evidence"],"prefix":"10.1017","volume":"4","author":[{"given":"LINDA","family":"GANZINI","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2006,8,9]]},"reference":[{"key":"S1478951506060196_ref061","doi-asserted-by":"crossref","unstructured":"Strong, M.J. , Rowe, A. , & Rankin, R.N. (1999).Percutaneous gastrojejunostomy in amyotrophic lateralsclerosis.Journal of the Neurological Sciences,169,128\u2013132.","DOI":"10.1016\/S0022-510X(99)00235-X"},{"key":"S1478951506060196_ref015","doi-asserted-by":"crossref","unstructured":"Fagerlin, A. , Ditto, P.H. , Danks, J.H. ,et al.(2001).Projection in surrogate decisions about life-sustaining medicaltreatments.Health Psychology,20,166\u2013175.","DOI":"10.1037\/0278-6133.20.3.166"},{"key":"S1478951506060196_ref057","doi-asserted-by":"crossref","unstructured":"Shega, J.W. , Hougham, G.W. , Stocking, C.B. ,et al.(2003).Barriers to limiting the practice of feeding tube placement inadvanced dementia.Journal of Palliative Medicine,6,885\u2013893.","DOI":"10.1089\/109662103322654767"},{"key":"S1478951506060196_ref012","doi-asserted-by":"crossref","unstructured":"Ciocon, J.O. , Silverstone, F.A. , Graver, L.M. ,et al.(1988).Tube feedings in elderly patients. 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(1996).Long-term outcomes of patients receiving percutaneous endoscopicgastrostomy tubes.Journal of General Internal Medicine,11,287\u2013293.","DOI":"10.1007\/BF02598270"},{"key":"S1478951506060196_ref019","doi-asserted-by":"crossref","unstructured":"Finucane, T.E. (1995).Malnutrition, tube feeding and pressure sores: Data areincomplete.Journal of the American Geriatrics Society,43,447\u2013451.","DOI":"10.1111\/j.1532-5415.1995.tb05822.x"},{"key":"S1478951506060196_ref047","doi-asserted-by":"crossref","unstructured":"Mitsumoto, H. , Davidson, M. , Moore, D. ,et al.(2003).Percutaneous endoscopic gastrostomy (PEG) in patients with ALS andbulbar dysfunction.Amyotrophic Lateral Sclerosis and Other Motor NeuronDisorders,4,177\u2013185.","DOI":"10.1080\/14660820310011728"},{"key":"S1478951506060196_ref024","unstructured":"Ganzini, L. & Johnston, W. (2006).End of life decision making. InAmyotrophic Lateral Sclerosis, Mitsumoto, H. , Przedborski, S. & Gordon, P.H. 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(1990).The sloganism of starvation.Lancet,335,278\u2013279.","DOI":"10.1016\/0140-6736(90)90084-I"},{"key":"S1478951506060196_ref016","doi-asserted-by":"crossref","unstructured":"Fainsinger, R.L. , MacEachern, T. , Miller, M.J. ,et al.(1994).The use of hypodermoclysis for rehydration in terminally ill cancerpatients.Journal of Pain & Symptom Management,9,298\u2013302.","DOI":"10.1016\/0885-3924(94)90187-2"},{"key":"S1478951506060196_ref048","doi-asserted-by":"crossref","unstructured":"Monteleoni, C. & Clark, E. (2004).Using rapid-cycle quality improvement methodology to reduce feedingtubes in patients with advanced dementia: Before and after study.British Medical Journal,329,491\u2013494.","DOI":"10.1136\/bmj.329.7464.491"},{"key":"S1478951506060196_ref044","doi-asserted-by":"crossref","unstructured":"Mitchell, S.L. , Kiely, D.K. , & Lipsitz, L.A. 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(2004).Percutaneous endoscopic gastrostomy: An effective strategy forgastrostomy feeding in patients with dementia.Clinical Medicine,4,235\u2013241.","DOI":"10.7861\/clinmedicine.4-3-235"},{"key":"S1478951506060196_ref046","doi-asserted-by":"crossref","unstructured":"Mitchell, S.L. , Tetroe, J. , & O'Connor, A.M. 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(2001).Patient outcomes related to percutaneous endoscopic gastrostomyplacement.Journal of Clinical Gastroenterology,32,49\u201353.","DOI":"10.1097\/00004836-200101000-00012"},{"key":"S1478951506060196_ref051","doi-asserted-by":"crossref","unstructured":"Pasman, H.R. , The, B.A. , Onwuteaka-Philipsen, B.D. ,et al.(2004).Participants in the decision making on artificial nutrition andhydration to demented nursing home patients: A qualitative study.Journal of Aging Studies,18,321\u2013335.","DOI":"10.1016\/j.jaging.2004.03.003"},{"key":"S1478951506060196_ref029","doi-asserted-by":"crossref","unstructured":"Huang, Z.-B. & Ahronheim, J.C. (2000).Nutrition and hydration in terminally ill patients: Anupdate.Clinics in Geriatric Medicine,16,313\u2013325.","DOI":"10.1016\/S0749-0690(05)70058-6"},{"key":"S1478951506060196_ref037","doi-asserted-by":"crossref","unstructured":"McCann, R.M. , Hall, W.J. , & Groth-Juncker, A. (1994).Comfort care for terminally ill patients: The appropriate use ofnutrition and hydration.Journal of the American Medical Association,272,1263\u20131266.","DOI":"10.1001\/jama.1994.03520160047041"},{"key":"S1478951506060196_ref039","doi-asserted-by":"crossref","unstructured":"Meier, D.E. , Ahronheim, J.C. , Morris, J. ,et al.(2001).High short-term mortality in hospitalized patients with advanceddementia: Lack of benefit of tube feeding.Archives of Internal Medicine,161,594\u2013599.","DOI":"10.1001\/archinte.161.4.594"},{"key":"S1478951506060196_ref056","doi-asserted-by":"crossref","unstructured":"Shega, J.W. , Hougham, G.W. , Cox-Hayley, D. ,et al.(2004).Advanced dementia and feeding tubes: Do physician factors contributeto state variation? (Letter) Journal of the American Geriatrics Society,52,1217\u20131218.","DOI":"10.1111\/j.1532-5415.2004.52327_2.x"},{"key":"S1478951506060196_ref041","doi-asserted-by":"crossref","unstructured":"Mitchell, S.L. (2003).Financial incentives for placing feeding tubes in nursing homeresidents with advanced dementia.Journal of the American Geriatrics Society,51,129\u2013131.","DOI":"10.1034\/j.1601-5215.2002.51021.x"},{"key":"S1478951506060196_ref063","doi-asserted-by":"crossref","unstructured":"Viola, R.A. , Wells, G.A. , & Peterson, J. (1997).The effects of fluid status and fluid therapy on the dying: Asystematic review.Journal of Palliative Care,13,41\u201352.","DOI":"10.1177\/082585979701300407"},{"key":"S1478951506060196_ref002","doi-asserted-by":"crossref","unstructured":"Ahronheim, J.C. & Mulvihill, M. (1991).Refusal of tube feeding as seen from a patient advocacyorganization: A comparison with landmark court cases.Journal of the American Geriatrics Society,39,1124\u20131127.","DOI":"10.1111\/j.1532-5415.1991.tb02880.x"},{"key":"S1478951506060196_ref004","unstructured":"Beauchamp, T.L. & Childress, J.F. (1994).Principles of Biomedical Ethics,4th ed. New York:Oxford University Press."},{"key":"S1478951506060196_ref014","doi-asserted-by":"crossref","unstructured":"Edwards, N.E. & Beck, A.M. (2002).Animal-assisted therapy and nutrition in Alzheimer'sdisease.Western Journal of Nursing Research,24,697\u2013712.","DOI":"10.1177\/019394502320555430"},{"key":"S1478951506060196_ref013","doi-asserted-by":"crossref","unstructured":"Derr, P.G. (1986).Why food and fluids can never be denied.Hastings Center Report,16,28\u201330.","DOI":"10.1002\/j.1552-146X.1986.tb02305.x"},{"key":"S1478951506060196_ref032","doi-asserted-by":"crossref","unstructured":"Lacey, D. (2005).Tube feeding, antibiotics, and hospitalization of nursing homeresidents with end-stage dementia: Perceptions of key medicaldecision-makers.American Journal of Alzheimer's Disease and OtherDementias,20,211\u2013219.","DOI":"10.1177\/153331750502000407"},{"key":"S1478951506060196_ref038","doi-asserted-by":"crossref","unstructured":"Mebane, E.W. , Oman, R.F. , Kroonen, L.T. ,et al.(1999).The influence of physician race, age, and gender on physicianattitudes toward advance care directives and preferences for end-of-lifedecision-making.Journal of the American Geriatrics Society,47,579\u2013591.","DOI":"10.1111\/j.1532-5415.1999.tb02573.x"},{"key":"S1478951506060196_ref035","unstructured":"Lo, B. (1995).Resolving Ethical Dilemmas: A Guide for Clinicians.Baltimore:Williams & Wilkins."},{"key":"S1478951506060196_ref020","doi-asserted-by":"crossref","unstructured":"Finucane, T.E. & Bynum, J.P. (1996).Use of tube feeding to prevent aspiration pneumonia.Lancet,348,1421\u20131424.","DOI":"10.1016\/S0140-6736(96)03369-7"},{"key":"S1478951506060196_ref040","doi-asserted-by":"crossref","unstructured":"Meisel, A. (1995).Barriers to forgoing nutrition and hydration in nursinghomes.American Journal of Law and Medicine,21,335\u2013382.","DOI":"10.1017\/S0098858800007486"},{"key":"S1478951506060196_ref007","doi-asserted-by":"crossref","unstructured":"Bruera, E. , Sala, R. , Rico, M.A. ,et al.(2005).Effects of parenteral hydration in terminally ill cancer patients: Apreliminary study.Journal of Clinical Oncology,23,2366\u20132371.","DOI":"10.1200\/JCO.2005.04.069"},{"key":"S1478951506060196_ref028","doi-asserted-by":"crossref","unstructured":"Howard, R.S. & Orrell, R.W. 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