Artificial Nutrition and Hydration

Photo: Robert ArnoldRobert Arnold, M.D.

UPMC-Montefiore Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania.

Have you or a colleague ever been in a clinical encounter when a patient/family member has requested artificial nutrition and hydration in the face of a terminal illness?

Establishing patient/family preferences related to artificial nutrition & hydration (ANH) is a controversial and sensitive issue that needs to be handled with great skill and tact. Patients and families often have very strong feelings and fixed notions about this topic. Dr. Robert Arnold’s video module deals with common issues that arise around ANH.

A video case study

Featuring David Jones, a young man with metastatic gastric cancer s/p chemotherapy. He is married to Mary, and they have two young children. As his cancer progresses, David is not eating or drinking much and he is losing weight. His wife Mary is very concerned about this and asks Dr. Arnold about starting tube feeds.

Discussion Topics and Questions

As you watch the video, note:

  • Conflicts between information and feelings
  • How does Dr. Arnold address these conflicts?
  • Are there any nurse statements?
  • How would you have handled the same situation?
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