eCampus CancerPEN In the Division of General Medical Disciplines

Ethical Issues, PEN 302: Artificial Nutrition and Hydration

[quote] No subject provokes greater distress and uncertainty among both families and health professionals, than issues surrounding the use of artificial nutrition and hydration in the dying person.

The video talk and the PowerPoint® presentation are the intellectual property of Dr. Robert Arnold. All the material is based on Dr. Arnold's research and clinical work.

[image] Bob Arnold

Robert Arnold, M.D.

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

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.

The module is divided into two parts:

  1. A video talk representing an overview of ANH. A free pdf download of the material is included. References and article abstracts on ANH are also available.
  2. 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. Questions for discussion are posed and viewers can post there comments on the case.

click to enter the video talk click to view the case study

Dr. Arnold is a board-certified internist in the Department of Medicine's Division of General Internal Medicine. He is the Director of the Palliative Care Service at UPMC and cares for HIV-positive patients. Dr. Arnold serves on the UPMC- Presbyterian ethics committee and the UPMC medical ethics consultation service. He is the author of articles on teaching clinical ethics, the role of ethics committees, and non-heart beating organ donation.

His research interests include advance directives and decisions to forgo life-sustaining treatment, autonomy in decision-making, organ procurement, and integrating clinical ethics into internal medicine residency education. Dr. Arnold serves on the ethics committee of the Society of General Internal Medicine, and he co-authored a report for the American Society of Bioethics and Humanities.

Source: http://www.pitt.edu/~bioethic/facArnold.htm

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