ABSTRACT
The withholding of nutritional support from patients is one of the most controversial issues in modem medical ethics and law. Withholding support from a consenting, terminally ill patient is the simplest case situation to defend, but patients in a persistent vegetative state or irreversible, chronic illness, require more careful deliberation. This chapter outlines some of the general legal principles that have been the foundation for decisions concerning limitation of feeding and provide historical context. The history of legal cases involving withdrawal of medical care is a short one, spanning only twenty years. Paul E. Brophy, Sr., a former fire fighter and an emergency medical technician had unsuccessfully undergone surgery in April of 1983 for a ruptured basilar artery aneurysm and never regained consciousness. The use of advance directives has been facilitated by the Patient Self Determination Act, effective December 1, 1991, requiring health care institutions to question and inform patients about these provisions.
