The common clinical trilemma in Alzheimer's: Reflections on tube feeding and antibiotics after a house call to Velma D.

1. Cassel CK , Jameton AL : Dementia in the elderly: An analysis of medical responsibility. Ann Int Med 1981;94:802-807

2. Callahan D : On feeding the dying. Hasting Cent Rep 1983;13:22-22

3. Beauchamp TL , Childress JF : Principles of biomedical ethics, 2nd ed. New York and Oxford: Oxford University Press; 1983

4. Schloendorff vs. Society of New York Hospital: 211 N.Y. 125, 105 N.E. 92, 95 (1914)

5. Angell M : Respecting the autonomy of competent patients. N Engl J Med 1984;310:1 115-116

6. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: Making health care decisions: The ethical and legal implications of informed consent in the patient-practitioner relationship. Vol 1, Washington, D.C.: U.S. Government Printing Office 1982:20-21

7. Lipp MR : Respectful treatment: A practical handbook of patient care. 2nd ed. New York: Elsevier, 1986:xiii-xiii.

8. Ramsey P : Ethics at the edges of life. New Haven: Yale University Press, 1978:14-14

9. Jonsen AR , Siegler M , Winslade WJ : Clinical ethics. 2nd ed., New York: Macmillan 1986:104-104

10. Tomlinson T , Brody H : Ethics and communication in do-not-resuscitate orders. N Engl J Med 1988;318:43-46

11. The Hastings Center : Guidelines on the termination of life-sustaining treatment and the care of the dying. Briarcliff Manor, NY: The Hastings Center 1987:32-32

12. Bayer R , Callahan D , Fletcher J , et al: The care of the terminally ill: morality and economics. N Engl J Med 1983;309:1490-1494

13. Callahan D : Setting limits: Medical goals in an aging society. New York: Simon and Schuster 1987:188-188

14. Ibid, 188

15. Schiedermayer DL ; The withdrawal of fluids and nutrition: A case presentation and ethical analysis. Wis Med J 1987;86:7-10

16. Paris J : When burdens of feeding outweigh benefits. Hastings Cent Rep 1986; 16:30-32

17. Annas G : Do feeding tubes have more rights than patients? Hastings Cent Rep 1986; 16:26-27

18. Derr PG : Why food and fluids can never be denied. Hastings Cent Rep 1986; 16:28-30

19. Siegler M , Weisbard JD : On killing patients with kindness: An appeal for caution. In: By no extraordinary means: The choice to forgo life-sustaining food and water. J Lynn (ed), Indiana University Press 1986;109-116

20. Siegler M. Schiedermayer DL : Should fluid and nutritional support be withheld from terminally ill patients? Am J Hospice Care 1987;4:32-35

21. Callahan D : On feeding the dying. Hastings Cent Rep 1983; 13:20-22

22. Lo B : The death of Clarence Herbert: Withdrawing care is not murder. Ann Int Med 1984;101:248-251

23. Bouvia v Superior Court: 179 Cal App. 3d 1127, 225 Cal. Rptr. 297, 300-301 (1986) and In Re Farrell. 529 A. 2d 404 (NJ 1987).

24. Meyers DW : Legal aspects of withdrawing nourishment from an incurably ill patient. Arch Int Med 1985 145:125-128

25. Dresser RS , Boisaubin EV : Ethics, law and nutritional support. Arch Int Med 1985; 145:122-124

26. Ackerman TF : Withholding nutrition and hydration: Status of the controversy. Clin Rep on Aging 1988;2:13-16

27. Dworkin R : Medicine, ethics, and law reform. Paper presented at the Center for Clinical Medical Ethics, Feb. 25

28. Nolan J : Brophy vs. New England Sinai Hospital, 398 Mass. 417-417 (1986)

29. Jonsen AR , Siegler M , Winslade WJ : Clinical ethics: A practical approach to ethical decisions in clinical medicine, 2nd ed. New York: Macmillan 1986:102-105

30. Lynn J , Childress JF : Must patients always be given food and water? Hastings Cent Rep;13:17-21

31. Steinbrook R , Lo B : Artificial feeding-solid ground, not a slippery slope. N Engl J Med 1988;318:286-290

32. Callahan D : Setting limits: Medical goals in an aging society. New York: Simon and Schuster 1987:191-191