Controverse « Peut-on ou non discuter d'un éventuel arrêt de la nutrition/hydratation médicalement assistée ou doit-on les considérer comme des soins “de base” ? »

The question of artificial nutrition and hydration and its place in situations of unreasonable therapeutic obstinacy is a question as recurrent as it is complex. Some consider that medically assisted nutrition/hydration (MANH), like eating is basic care. They conclude that these procedures cannot be considered futile and that a patient's refusal of such care is illicit. Others - in accordance with most professional recommendations as well as French law - take the opposite view, considering that within the context of a refusal of any unreasonable obstinacy, a discussion can take place over the interest of maintaining (or initiating) such a treatment. They agree with the opinion that a patient's refusal for MANH must be taken into consideration. We ranking ourselves in the second category, put forward a decision tree for discussion allowing a pragmatic approach to the question, insisting on the necessity of considering each situation as unique and the necessity for coming to a solution as wise as possible, respecting the patients' wishes and integrating the concerns of those close to him or her - in accordance with the French April 2005 law.