Doctors overlook living wills

In patients with advanced dementia, doctors' decisions to withhold the artificial administration of fluids and food are based more on the medical condition of the patient, the family's wishes, and care providers' interpretations of the patient's quality of life than they are on living wills and policy agreements. In an ethnographic study, The and colleagues (p 1326) studied the practice of withholding the artificial administration of fluids and food from patients with advanced dementia in two nursing homes in the Netherlands. Fluids and food were mainly given artificially when there was an acute illness or a condition that needed medical treatment and required hydration to be effective. When faced with uncertainties about what the patient wanted, doctors tried to create the broadest possible basis for the decision making process by involving the family.

(Credit: LEHTIKUVA OY/REX)

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Relevant Article

Withholding the artificial administration of fluids and food from elderly patients with dementia: ethnographic study

Anne-Mei The, Roeline Pasman, Bregje Onwuteaka-Philipsen, Miel Ribbe, and Gerrit van der Wal
BMJ 2002 325: 1326. [Abstract] [Full Text] [PDF]