Nutritional Support in Clinical Care

by Simon V. Baudouin, Timothy W. Evans

Many people believe that having access to an adequate and appropriate diet is a basic human right. The provision of nutritional support to the critically ill, therefore, is an issue that is fraught with ethical implications, particularly in patients who have chronic, but stable, illnesses that necessitate intensive care, but in whom recovery is unlikely. Such circumstances, manifest particularly in patients who have severe brain injuries that led to the persistent vegetative state, clearly mitigate against the conduct of placebo-controlled trials of nutritional support. Moreover, it is an irrefutable fact that prolonged starvation will ultimately lead to death. These arguments may have led the critical care community to subject the questions surrounding the provision of feeding to less rigorous scientific evaluation than has been afforded to other interventions, and an assumption that nutritional support must, by definition, be beneficial.

6th March 2019 • comment