Аннотация:With regard to the controversy over artificial hydration and nutrition, Bernat and Beresford concisely and correctly characterized the current state of affairs.1 In doing so they had to include the longstanding debate over whether hydration and nutrition provided by feeding tube is “artificial” or “natural.”
We recently argued that the artificial vs natural distinction is irrelevant.2 Despite several decades of debate, there is still no consensus over whether tube feedings are artificial or natural—and we should not expect agreement on this in the future. More importantly, the right to refuse life-sustaining therapies derives straightforwardly from a right to self-determination and bodily integrity. From a moral standpoint, we argue that this right includes refusal of any unwanted therapies whatsoever, including oral hydration and nutrition when it is feasible—as, for example, in some patients with advanced dementia who could be fed by hand but are not for the sake of convenience and economy.3,4
Disclosure: The authors report no …
