Forgoing Artificial Nutrition and Hydration: What to Make of Parents’ Views

Abstract

* Abbreviations: FANH — : forgoing artificial nutrition and hydration In this issue of Pediatrics , Rapoport et al1 report qualitative findings of a study of parents whose children died after forgoing artificial nutrition and hydration (FANH). The authors explored the experiences of bereaved parents who chose FANH and describe the parents’ perceived quality of death in these children.1 Rapoport et al1 conclude the parents were satisfied with their experiences and believed the deaths of their children were peaceful. The authors emphasize the parents’ readiness to discuss FANH when they perceived their child’s quality of life as poor. Patients’ difficulties with feeding played a key role in parental views of quality of life as intolerable. Further, while they relied on input from the health care team, the parents felt they must take personal responsibility for deciding if FANH was the right approach for their dying child. Finally, the study participants experienced persistent fears of being judged negatively for their decisions to FANH and those worries required sustained support from the health care team after initiating the FANH. Given the complex medical, ethical, religious, … Address correspondence to Joel Frader, MD, MA, A Todd Davis Professor of Academic General Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Box 16, Chicago, IL 60611-2605. E-mail: jefrader{at}luriechildrens.org