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PHI 3633 St Thomas University Nutrition and Hydration Essay

  1. Cure / care: compare and contrast.
  2. Basic care: Nutrition, hydration, shelter, human interaction.
    • Are we morally obliged to this? Why? Example
  3. Swallow test, describe; when is it indicated?
  4. When is medically assisted N/H indicated?
    • Briefly describe Enteral Nutrition (EN), including:
      • NJ tube
      • NG tube
      • PEG
    • Briefly describe Parenteral Nutrition (PN), including:
      • a. Total parenteral nutrition
      • b. Partial parenteral nutrition
  5. Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.
  6. Case Study: Terry Schiavo. Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not? (it is in the documents sent)
  7. Read and summarize ERD paragraphs #: 32, 33, 34, 56, 57, 58:
  8. 32. While every person is obliged to use ordinary means to preserve his or her health, no
    person should be obliged to submit to a health care procedure that the person has judged,
    with a free and informed conscience, not to provide a reasonable hope of benefit without
    imposing excessive risks and burdens on the patient or excessive expense to family or
    community. 33. The well-being of the whole person must be taken into account in deciding about any
    therapeutic intervention or use of technology. Therapeutic procedures that are likely to
    cause harm or undesirable side-effects can be justified only by a proportionate benefit to
    the patient. 34. Health care providers are to respect each person’s privacy and confidentiality regarding
    information related to the person’s diagnosis, treatment, and care. 56. A person has a moral obligation to use ordinary or proportionate means of preserving his
    or her life. Proportionate means are those that in the judgment of the patient offer a
    reasonable hope of benefit and do not entail an excessive burden or impose excessive
    expense on the family or the community. 57. A person may forgo extraordinary or disproportionate means of preserving life.
    Disproportionate means are those that in the patient’s judgment do not offer a reasonable
    hope of benefit or entail an excessive burden, or impose excessive expense on the family
    or the community. 58. In principle, there is an obligation to provide patients with food and water, including
    medically assisted nutrition and hydration for those who cannot take food orally. This
    obligation extends to patients in chronic and presumably irreversible conditions (e.g., the
    “persistent vegetative state”) who can reasonably be expected to live indefinitely if given
    such care. Medically assisted nutrition and hydration become morally optional when
    they cannot reasonably be expected to prolong life or when they would be “excessively
    burdensome for the patient or [would] cause significant physical discomfort, for example
    resulting from complications in the use of the means employed.” For instance, as a
    patient draws close to inevitable death from an underlying progressive and fatal condition,
    certain measures to provide nutrition and hydration may become excessively burdensome
    and therefore not obligatory in light of their very limited ability to prolong life or provide
    comfort.

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