Argumentation for the Withdrawing or Withholding of Artificial Nutrition by the Mobile Palliative Care Team

Abstract

Introduction: Palliative care practice confronts us with the dilemma of «equitable care», namely: when to treat, by what means and, above all, when to stop. The issue of artificial nutrition is the perfect example. The present study was conducted to identify the arguments used by the Mobile Palliative Care Team to discuss the introduction or withdrawal of artificial nutrition and compare these arguments according to the advice given. Methods: A descriptive, historical cohort-type epidemiological study was carried out on all medical files of patients followed by the mobile team of the Metz-Thionville Regional Hospital in 2013 and for whom a discussion had taken place regarding artificial nutrition. Results: The most commonly mentioned arguments were general patient condition (68.4% of cases), estimated life expectancy (67.3%) and the palliative nature of care management (55.1%). Advice for the withdrawal or withholding of artificial nutrition formulated by the mobile team was followed in 75.9% of cases while the advice for the introduction or continuation of artificial nutrition was followed in 93.3%. Conclusion: The decision to withdraw or pursue artificial nutrition is based on a body of arguments and a multidisciplinary evaluation with discussion encompassing an ethical dimension involving the patient and his/her relatives. DOI: 10.29011/APCM-107.000007