End of life care: Patients who have capacity

Please see footnote³³

1. 116. If you consider that a patient is not receiving adequate nutrition or hydration by mouth, you should follow the decision model in paragraph 14. You must assess the patient’s nutrition and hydration needs separately and offer the patient those treatments you consider to be clinically appropriate because, for example, they would provide symptom relief or would be likely to prolong the patient’s life. You must explain to the patient the benefits, burdens and risks associated with the treatments, so that the patient can make a decision about whether to accept them.

2. 117. If you assess that clinically assisted nutrition or hydration would not be clinically appropriate, you must monitor the patient’s condition and reassess the benefits, burdens and risks of providing clinically assisted nutrition or hydration as the patient’s condition changes. If a patient asks you to provide nutrition or hydration by tube or drip, you should discuss the issues with the patient and explore the reasons for their request. You must reassess the benefits, burdens and risks of providing the treatment requested, giving weight to the patient’s wishes and values. When the benefits, burdens and risks are finely balanced, the patient’s request will usually be the deciding factor. However, if after discussion you still consider that the treatment would not be clinically appropriate, you do not have to provide it. But you should explain your reasons to the patient and explain any other options that are available, including the option to seek a second opinion.