Medico-legal issues related to the withholding and withdrawing of artificial nutrition and hydration at the end of life

Abstract

The 21st Century has been testament to the ever changing façade of medicine and technology, which has in turn also manipulated society’s perception of medicine and how it is to be utilised. Death is the unwanted result. Conversely society at large, seems to be under the impression that since medicine is making remarkable steps forward, and is capable of controlling to a certain extent the lives of patients, the same can be said for death. It is as if the natural course of life is no longer distinguishable from human action, but instead, human action is altering the natural course of life and death. We have a right to life that is fundamental, but do we have a right to die? The choice of withholding and withdrawing Artificial Nutrition and Hydration (ANH) from a patient is influenced by many factors and comes with great responsibility and attention to legal implications where applicable. Patients may have different reasons for which they choose to have ANH withdrawn or withheld, that will be discussed in further detail in this project. This withholding or withdrawal depends also on where care is being provided, namely, in hospitals, also more specifically in palliative care units, in residential homes, or in hospices, whether patients have transitioned from receiving treatment for cure to treatment for care, and more importantly whether the patient has been given a diagnosis of death.