Earlier in Japan, as in many industrialized countries, the only ethical position in this situation was the sanctity of life and therefore the clinically right action was always to give treatment. Now, with more advanced medical technology and national decade on these issues, a more recent concept quality of life, especially for dying patients, has gained influence. The lack of knowledge that scientifically justifies giving or not giving AFF to terminally ill patients also prevails internationally (Konishi, Davis & Aiba, 2002). As controversial and sensitive ethical issues continue to challenge nurses and other health care professionals, many of them have begun to develop a unique appreciation for the diverse ethical viewpoints of others.
ANH is not categorized as a treatment that must always be provided, and in coming to a decision about forgoing or continuing ANH, the patient's surrogates are allowed to either use their knowledge about the patient's desires and values or weigh the costs and benefits of tube feeding against the costs and benefits of waiving this treatment.
At the same time, Americans still have a good deal of anxiety about the prospect of discontinuing food and fluids, both for themselves and for their loved ones. This is one reason why there are approximately 1.5 million patients being tube fed in the United States today. ...Show more