Ethical issues in nutrition support of severely disabled elderly persons: A guide for health professionals

摘要

An eight-step guide is proposed with goals of establishing a process to identify components of a situation, analyzing conflicting values that develop in the ethical dilemma, and reaching a consensus for the most relevant plan of care to implement in a specific clinical situation. The classic bioethical principles of autonomy, beneficence, nonmalfeasance, distributive justice, dignity, integrity, and vulnerability are defined and discussed. The guide for ethical reflection encompassing history, context, and refraining the ethical question, care responsibilities and values of each stakeholder, ethical analysis of the clinical situation, medical options, and moral justification is performed best through a formal deliberative meeting with all health professionals involved in the care of the patient. To achieve the best outcome, participants should be aware of what the patient, as well as the patient's family, desires. An illustrative case is provided showing how to use the guide to achieve a humanistic process of medical care.