{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:44:08Z","timestamp":1791319448050,"version":"4.3.1"},"reference-count":8,"publisher":"S. Karger AG","issue":"3-4","license":[{"start":{"date-parts":[[2002,1,1]],"date-time":"2002-01-01T00:00:00Z","timestamp":1009843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2002,1,1]],"date-time":"2002-01-01T00:00:00Z","timestamp":1009843200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Dis"],"published-print":{"date-parts":[[2002]]},"abstract":"<jats:p>Percutaneous endoscopic gastrostomy (PEG) is a popular technique for long-term enteral nutrition. However it is not beneficial in all cases, and may even prolong the process of dying. The present article discusses the main indications for PEG insertion, and the ethical considerations involved. Three main questions need to be answered: (1) for what purposes should PEG be used; (2)\u00a0for what type of patients, and (3) when should PEG be inserted in the natural history of the patient\u2019s illness? PEG is used in patients unable to maintain sufficient oral intake. It has been found to improve quality of life and\/or to increase survival in patients with head and neck cancer, acute stroke, neurogenic and muscle dystrophy syndrome, growth failure (children) and gastric decompression. It led to no improvement in nutritional or functional status in patients with cachexia, anorexia, aspiration (and aspiration pneumonia), and cancer with a short life expectancy. Several court decisions have stipulated that PEG need be offered in patients in a persistent vegetative state or patients with senile dementia who have lost the ability for self-determination. Since the 30-day mortality after PEG insertion is very high for patients hospitalized in a general medical center, a \u2018cooling off\u2019 period of 30\u201360 days should be scheduled from the time of the PEG request to actual insertion.<\/jats:p>","DOI":"10.1159\/000067676","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T21:05:40Z","timestamp":1050440740000},"page":"253-256","source":"Crossref","is-referenced-by-count":32,"title":["Indications for Percutaneous Endoscopic Gastrostomy Insertion: Ethical Aspects"],"prefix":"10.1159","volume":"20","author":[{"given":"Yaron","family":"Niv","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galia","family":"Abuksis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2003,1,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07369-2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200107000-00010"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03369-7"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.14.1365"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001203420312"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900440"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.24.1973"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(99)00731-5"}],"container-title":["Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/67676","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/67676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:26:48Z","timestamp":1745465208000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000067676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002]]},"references-count":8,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2002,7,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000067676","archive":["Portico"],"relation":{},"ISSN":["0257-2753","1421-9875"],"issn-type":[{"value":"0257-2753","type":"print"},{"value":"1421-9875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002]]}}}