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Questions and Answers: Artificial Nutrition and Hydration and End of Life Decision Making

Are life insurance policies affected if life-staining treaAre life insurance policies affected if life-staining treatments are refused? tments are refused?

No. Because death is not the result of suicide, life insurance policies are not affected when medical treatments are stopped and the patient is allowed to die naturally.

Does the medical community agree that it is ethically permissible to stop artificial nutrition and hydration?

Professional organizations such as the American Academy of Neurology, American Medical Association, American Nurses Association, American Thoracic Society and Society of Critical Care Medicine have affirmed through policy statements that artificial nutrition and hydration are medical treatments and their use should be evaluated in the same way that any other treatment would be.

Other major organizations that have issued similar policy statements or treatment guidelines include The American Dietetic Association and the Alzheimer's Association. However, some doctors and nurses personally believe that it is never appropriate to with-hold or stop artificial nutrition and hydration. It is therefore important that individuals discuss their wishes with their physician and confirm that their wishes will be honored.

Do all nursing homes and hospitals agree that it permissible to stop artificial nutrition and hydration?

No. Some nursing homes and hospitals, for religious or other reasons, may have policies that would prevent them from honoring a patient's legal right to refuse treatment. Under the federal law known as the Patient Self-Determination Act, healthcare facilities are required to let patients know at the time of admission if they have such policies, and what those policies are.

If individuals can anticipate that they might someday receive treatment in a particular hospital or nursing home, or if a loved one is about to be admitted to a nursing home, they should find out what the institution's policy is in advance. Although facilities that have such policies generally are required to transfer a patient to a facility that will honor the patient's wishes, practically speaking, it can be extremely difficult to arrange transfer to another facility for the sole purpose of honoring a patient's refusal of treatment.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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