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Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper
Schwartz DB, Barrocas A, Annetta MG, Stratton K, McGinnis C, Hardy G, Wong T, Arenas D et al.. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2021-02-22
Topic: Risk, prevention and care in population studies
The American Society for Parenteral and Enteral Nutrition (ASPEN) Position Paper focus is on applying the 4 ethical principles for clinician's decision-making in the use of artificially administered nutrition and hydration (AANH) for adult and pediatric patients. These basic principles are (1) autonomy, respect the patient's healthcare preferences; (2) beneficence, provide healthcare in the best interest of the patient; (3) nonmaleficence, do no harm; and (4) justice, provide all individuals a fair and appropriate distribution of healthcare resources. Preventing and resolving ethical dilemmas is addressed, with an emphasis on a collaborative, interdisciplinary approach. Optimizing early communication and promoting advance care planning, involving completion of an advance directive, including designation of a surrogate decision-maker, are encouraged. Clinicians achieve respect for autonomy when they incorporate the patient, family, community, country, geographical, and presumed cultural values and religious belief considerations into ethical decision-making for adults and children with a shared decision-making process. These discussions should be guided by the 4 ethical principles. Hospital committees and teams, limited-time trials, clinician obligation with conflicts, and forgoing of AANH are addressed. Specific patient conditions are addressed because of the concern for potential ethical issues: coma, decreased consciousness, and dementia; advanced dementia; cancer; eating disorders; and end-stage disease/terminal illness. Incorporated in the Position Paper are ethical decisions during a pandemic and a legal summary involving ethical issues. International authors presented the similarities and differences within their own country or region and compared them with the US perspective.
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APA 7th
Schwartz, D. B., Barrocas, A., Annetta, M. G., Stratton, K., McGinnis, C., Hardy, G., et al. (2021). Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. https://doi.org/10.1002/ncp.10633
Vancouver
Schwartz DB, Barrocas A, Annetta MG, Stratton K, McGinnis C, Hardy G, et al. Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2021. doi:10.1002/ncp.10633. PMID: 33616284.
BibTeX
@article{schwartz2021-33616284,
author = {Schwartz, D. B. and Barrocas, A. and Annetta, M. G. and Stratton, K. and McGinnis, C. and Hardy, G. and Wong, T. and Arenas, D. and others},
title = {{Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper}},
journal = {Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition},
year = {2021},
doi = {10.1002/ncp.10633},
pmid = {33616284},
url = {https://doi.org/10.1002/ncp.10633}
}
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Key findings
- These discussions should be guided by the 4 ethical principles.
- Hospital committees and teams, limited-time trials, clinician obligation with conflicts, and forgoing of AANH are addressed.
- Specific patient conditions are addressed because of the concern for potential ethical issues: coma, decreased consciousness, and dementia; advanced dementia; cancer; eating disorders; and end-stage disease/terminal illness.
- Incorporated in the Position Paper are ethical decisions during a pandemic and a legal summary involving ethical issues.
- International authors presented the similarities and differences within their own country or region and compared them with the US perspective.
Study details
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 23 of the 58 points we could judge it on, which is 40 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33616284) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 23 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 23 of the 58 points we could judge it on is 40 out of 100. |
| Total | 40 / 100 | — |
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