Recent advances in nutrition support present new challenges to the clinician in terms of the management of ethical issues. Four ethical dilemmas are reviewed to illustrate how food and hydration can be used to control others (e.g., family members, caregivers, health care team members), accelerate death, prolong life, or prolong death. In each case, consideration is given to the patient as a unique individual with unique personal and family dynamics. Options and resources available to the health care provider are discussed.
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