Abstract
In my dual roles as a palliative care physician and philosopher-bioethicist, I am often struck by the seeming “disconnect” between largely agreed-upon moral norms—as espoused in the bioethics literature, outlined by professional guidelines, embodied in institutional and national policies, and upheld by court rulings—and the actual clinical practices that I witness on a regular basis. Perhaps nowhere is this disconnect more apparent than in decisions concerning the withdrawal or withholding of artificial nutrition and hydration (ANH). While my palliative care colleagues and I are often called upon to explain the limited benefits and medical risks of ANH to angst-ridden families grappling with the life-limiting illness of a loved one, the article “Comfort Measures for Severe Diffuse Axonal Injury: A Patient’s Last Wish” (Baek 2016) highlights the moral distress frequently experienced by health care providers, who also wrestle with such decisions, even when families’ wishes are clear in choosing to forgo ANH. […]