This Week In The Bmj

Doctors overlook living wills

BMJ 2002; 325 doi: (Published 07 December 2002) Cite this as: BMJ 2002;325:c

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.

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