Feature

‘Aggressive’ new advance directive would let dementia patients refuse food


 


Whether the new directive will be honored in New York – or anywhere else – is unclear. Legal scholars and ethicists say directives withdrawing oral assisted feeding are prohibited in several states. Many care facilities are unlikely to cooperate, said Thaddeus Pope, director of the Health Law Institute at Hamline University, St. Paul, Minn., and an expert on end-of-life law. Doctors have a duty to honor patient wishes, but they can refuse if they have medical or moral qualms.

“Even solidly legal advance directives do not and cannot ENSURE that wishes are respected,” Pope said in an email. “They can only ‘help assure’ that.”

Directors at End of Life Choices New York consider the document “legally sturdy,” Schwarz said, adding, “Of course it’s going to end up in court.”

Whether assisted feeding can be withdrawn was at the center of recent high-profile cases in which patients with dementia were spoon-fed against their documented wishes because they continued to open their mouths. In a case in Canada, a court ruled that such feeding is basic care that can’t be withdrawn.

Pages

Recommended Reading

Idalopirdine falls short in three phase 3 Alzheimer’s trials
MDedge Internal Medicine
High levels of neuroinflammatory markers may drive increased Alzheimer’s prevalence among blacks
MDedge Internal Medicine
Full report confirms solanezumab’s failure to rescue cognition in mild Alzheimer’s
MDedge Internal Medicine
APOE4 may drive tau deposition in Alzheimer’s
MDedge Internal Medicine
Aspirin may protect against dementia in T2DM
MDedge Internal Medicine
Haloperidol does not prevent delirium in ICU patients
MDedge Internal Medicine
Excessive daytime sleepiness linked to increase in Alzheimer’s biomarker
MDedge Internal Medicine
Alcohol dependence may accelerate aging, frontal cortical deficits
MDedge Internal Medicine
Early diagnosis of Alzheimer’s could save U.S. trillions over time
MDedge Internal Medicine
Office-based screen predicts dementia in Parkinson’s disease
MDedge Internal Medicine