Withholding and withdrawing artificial nutrition and hydration

Question 1

What does artificial nutrition and hydration refer to?

Answer 1

That provided through artificial means such as feeding tubes and IV routes

Question 2

How are decisions made for kids?

Answer 2

Two ways:

1. a child with decision making capacity - making their wishes known at that moment or prior to that moment
2. by a substitute decision maker - in the child’s best interest

Question 3

Is artificial nutrition and hydration a medical intervention?

Answer 3

The AAP recently published guidelines that support the claim that it is a medical intervention.
There is a school of thought that it is a basic right and compassion/care, and thus primarily not a medical intervention

Question 4

How do you decide if you offer artificial nutrition/hydration?

Answer 4

Whether it will provide net benefit to the patient

The primary focus of the decision should be the interest of the child

Question 5

Which children would it be morally permissible to withdraw artificial nutrition/hydration?

In these situations, is withdrawing morally required?

Answer 5

The child who permanently lacks awareness and ability to interact with the environment
The child when the NG only prolongs and add morbidity to the process of dying

No it is morally permissible, but not morally required