Abstract

ARAYA, Adela Walter  and  TORRES, Karina Ordoñez. Is it proportionate to withhold artificial nutrition and hydration in patients with uncertain prognoses? Nutritional and bioethical perspective. rev.latinoam.bioet. [online]. 2022, vol.22, n.2, pp.85-98.  Epub Dec 31, 2022. ISSN 1657-4702.  https://doi.org/10.18359/rlbi.5711.

to carry out this research, the literature was reviewed on the case of Terri Schiavo, a patient who was in a persistent vegetative state and who died after two weeks, after her nutrition and hydration were suspended; her diagnosis was validated, and it was investigated whether she was a terminal patient, as well as the available evidence, was verified, in relation to artificial hydration and nutrition in this type of patients to determine the concordance of these measures. This information was analyzed from the nutritional and bioethical perspective; in the bibliographic search, the Scopus, Scielo, and PubMed databases were consulted with the search criteria nutrition and artificial hydration in terminal patients and patients with uncertain prognosis; these findings were analyzed with Calipari's therapeutic proportionality model. Therefore, it was determined that artificial nutrition and hydration are mandatory or optional treatments for Terri. However, there is no conclusive information on artificial nutrition and hydration in terminally ill patients, nor is the prognosis uncertain, and a case-by-case evaluation by the medical team is recommended to determine the proportionality of artificial nutrition and hydration, together with the patient and family. It should be emphasized that more studies are needed to provide better evidence to provide objective elements for better decision-making.

Keywords : persistent vegetative state; uncertain prognosis; artificial nutrition and hydration; therapeutic proportionality; clinical bioethics.

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