{"id":"https://openalex.org/W2885582610","doi":"https://doi.org/10.1002/hast.866","title":"When Voluntary Stopping of Eating and Drinking in Advanced Dementia Is No Longer Voluntary","display_name":"When Voluntary Stopping of Eating and Drinking in Advanced Dementia Is No Longer Voluntary","publication_year":2018,"publication_date":"2018-07-01","ids":{"openalex":"https://openalex.org/W2885582610","doi":"https://doi.org/10.1002/hast.866","mag":"2885582610","pmid":"https://pubmed.ncbi.nlm.nih.gov/35227019"},"language":"en","primary_location":{"id":"doi:10.1002/hast.866","doi":"https://doi.org/10.1002/hast.866","is_oa":false,"landing_page_url":"https://doi.org/10.1002/hast.866","pdf_url":null,"source":{"id":"https://openalex.org/S33843192","display_name":"The Hastings Center Report","issn_l":"0093-0334","issn":["0093-0334","1552-146X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","erih-plus","jufo-1","medline","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hastings Center Report","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5034068568","display_name":"Elizabeth J. Chuang","orcid":"https://orcid.org/0000-0002-2505-8159","observed_orcids":["https://orcid.org/0000-0002-2505-8159"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Elizabeth Chuang","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5086152032","display_name":"Lauren Sydney Flicker","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lauren Sydney Flicker","raw_affiliation_strings":["Epidemiology & Population Health"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Epidemiology & Population Health","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":3570,"currency":"USD","value_usd":3570},"apc_paid":null,"fwci":1.1979,"has_fulltext":false,"cited_by_count":5,"citation_normalized_percentile":{"value":0.79250947,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":97},"biblio":{"volume":"48","issue":"4","first_page":"24","last_page":"25"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.8213000297546387,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.8213000297546387,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13147","display_name":"Ethics and bioethics in healthcare","score":0.13979999721050262,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11678","display_name":"Healthcare Decision-Making and Restraints","score":0.017000000923871994,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/voluntary-stopping-of-eating-and-drinking","display_name":"voluntary stopping of eating and drinking","score":0.9649999737739563},{"id":"https://openalex.org/keywords/advanced-dementia","display_name":"advanced dementia","score":0.734000027179718},{"id":"https://openalex.org/keywords/advance-directives","display_name":"advance directives","score":0.9760000109672546},{"id":"https://openalex.org/keywords/artificial-nutrition-and-hydration","display_name":"artificial nutrition and hydration","score":0.7360000014305115},{"id":"https://openalex.org/keywords/patient-autonomy","display_name":"patient autonomy","score":0.7139999866485596},{"id":"https://openalex.org/keywords/refusal-of-life-sustaining-treatment","display_name":"refusal of life-sustaining treatment","score":0.8709999918937683},{"id":"https://openalex.org/keywords/human-dignity","display_name":"human dignity","score":0.6330000162124634},{"id":"https://openalex.org/keywords/sedation","display_name":"sedation","score":0.4490000009536743},{"id":"https://openalex.org/keywords/bioethics","display_name":"bioethics","score":0.5529999732971191}],"concepts":[{"id":"https://openalex.org/C26077564","wikidata":"https://www.wikidata.org/wiki/Q1910318","display_name":"Turnover","level":2,"score":0.8219829797744751},{"id":"https://openalex.org/C2779483572","wikidata":"https://www.wikidata.org/wiki/Q83030","display_name":"Dementia","level":3,"score":0.6030762791633606},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.48367032408714294},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.32671141624450684},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.3249197006225586},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.16041740775108337},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.10702508687973022},{"id":"https://openalex.org/C187736073","wikidata":"https://www.wikidata.org/wiki/Q2920921","display_name":"Management","level":1,"score":0.0654904842376709},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.0}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1002/hast.866","doi":"https://doi.org/10.1002/hast.866","is_oa":false,"landing_page_url":"https://doi.org/10.1002/hast.866","pdf_url":null,"source":{"id":"https://openalex.org/S33843192","display_name":"The Hastings Center Report","issn_l":"0093-0334","issn":["0093-0334","1552-146X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","erih-plus","jufo-1","medline","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Hastings Center Report","raw_type":"journal-article"},{"id":"pmid:35227019","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/35227019","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Hastings Center report","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.6240000128746033,"display_name":"Good health and well-being"}],"sustainable_development_goals_aurora":[{"id":"https://metadata.un.org/sdg/2","score":0.5199999809265137,"display_name":"Zero hunger"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":5,"referenced_works":["https://openalex.org/W2003260521","https://openalex.org/W2045881813","https://openalex.org/W2768084914","https://openalex.org/W2887349557","https://openalex.org/W4230246941"],"related_works":["https://openalex.org/W3198523940","https://openalex.org/W2886083474","https://openalex.org/W2979009734","https://openalex.org/W1693837371","https://openalex.org/W1825775149","https://openalex.org/W1189638672","https://openalex.org/W3143678519","https://openalex.org/W4392883275","https://openalex.org/W4390621082","https://openalex.org/W1977541598"],"abstract_inverted_index":{"In":[0],"\"On":[1],"Avoiding":[2],"Deep":[3],"Dementia,\"":[4],"Norman":[5],"Cantor":[6,149],"astutely":[7],"notes":[8],"that,":[9],"for":[10,54,78],"some":[11],"individuals,":[12],"the":[13,38,47,83,137,143,181,198],"concept":[14],"of":[15,40,57,66,82,87,180],"\"protracted":[16],"maintenance":[17],"during":[18],"progressive":[19],"cognitive":[20],"dysfunction":[21],"and":[22,59,89,113,141,163,225],"helplessness":[23],"is":[24,80,106,150],"an":[25,120,156,184],"intolerably":[26],"degrading":[27],"prospect.\"":[28],"This":[29],"cannot":[30,188],"be":[31,134,165,189,205,221],"argued":[32],"with.":[33],"Cantor's":[34],"solution,":[35],"however-that":[36],"in":[37,51,153,183],"wake":[39],"a":[41,64,116,168,209],"dementia":[42,140,171,215],"diagnosis,":[43],"patients":[44,95],"should":[45,61],"have":[46],"option":[48],"to":[49,98,123,147,175,191,195,197,207,220,223],"direct,":[50],"advance,":[52],"instructions":[53],"voluntary":[55],"stopping":[56],"eating":[58,224],"drinking":[60],"they":[62],"develop":[63],"state":[65],"deep":[67],"dementia-is":[68],"more":[69],"ethically":[70],"challenging":[71],"than":[72],"it":[73,90],"may":[74],"first":[75],"appear.":[76],"Respect":[77],"autonomy":[79],"one":[81],"most":[84],"fundamental":[85],"principles":[86],"bioethics,":[88],"requires":[91],"that":[92,104,131,155,161,217],"we":[93],"allow":[94],"with":[96,170,211],"capacity":[97],"refuse":[99,125],"life-sustaining":[100],"treatment,":[101],"even":[102],"when":[103],"treatment":[105,132],"something":[107],"as":[108,111],"seemingly":[109],"innocuous":[110],"nutrition":[112,127,162],"hydration.":[114],"If":[115],"capacitated":[117],"person":[118,138,210,218],"uses":[119],"advance":[121,157,185],"directive":[122,158],"prospectively":[124],"artificial":[126],"or":[128,145,177,213],"hydration,":[129],"then":[130],"must":[133],"withheld":[135,166],"if":[136],"develops":[139],"loses":[142],"ability":[144],"willingness":[146],"eat.":[148],"incorrect,":[151],"however,":[152],"suggesting":[154],"can":[159,203],"require":[160],"hydration":[164],"from":[167],"patient":[169],"who":[172],"actively":[173],"requests":[174],"eat":[176],"drink.":[178],"Regardless":[179],"language":[182],"directive,":[186],"caregivers":[187],"compelled":[190,206],"abandon":[192],"their":[193],"duty":[194],"attend":[196],"person's":[199],"human":[200],"dignity,":[201],"nor":[202],"physicians":[204],"sedate":[208],"moderate":[212],"severe":[214],"because":[216],"continues":[219],"receptive":[222],"drinking.":[226]},"counts_by_year":[{"year":2021,"cited_by_count":4},{"year":2020,"cited_by_count":1}],"updated_date":"2026-10-16T09:59:22.235173","created_date":"2018-08-22T00:00:00"}