When nutrition becomes artificial: A bioethical issue

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Michele Karaboue
Michele Massaro
karidia karaboue


nutrition, artificial nutrition, bioethics


There is an inextricable link between nutrition in its various aspects and the general well-being of human beings. It is possible to draw up a guide for reflection as a proposal of bioethics to be applied to the reality of nutrition, starting from the analysis of human behavior. The focus is on the role of food for the human being from a bioethical point of view, highlighting the ethical value of nutrition and the psychological and socio-relational aspects associated with it. These aspects were then rejected in the context of quality of life and artificial nutrition in its various aspects.

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1. Szymański P. Discontinuation of hydration and nutrition in vegetative or minimally conscious state: No straightforward answer. Pol Arch Intern Med 2021;131(2):210-211.
2. Contaldo F, Alfonsi L, Santarpia L, Pasanisi F. Artificial nutrition at the bioethic cross-road between treatment and basic health care. Clin Nutr 2006;25(1):171-172.
3. Mazzariol B, Karaboue M, Di Luca A, Di Luca NM. Guidelines, good practices and best clinical health practices: Valuable guidance for physicians and judges?. Clin Ter 2018;169(6):E292-E296.
4. Borbón D, Borbón L. A Critical Perspective on NeuroRights: Comments Regarding Ethics and Law. Front Hum Neurosci 2021;15:703121.
5. Russo A, Reginelli A, Lacasella GV et al. Clinical Application of Ultra-High-Frequency Ultrasound J Pers Med 2022;12(10):1733.
6. Cardenas D. Ethical issues and dilemmas in artificial nutrition and hydration Clin Nutr ESPEN 2021;41:23-29.
7. Karaboue MAA, Lacasella GV, Cecannecchia C et al. End-of-Life in Italy: Critical and Bioethical Aspects of the Bill on Physician-Assisted Suicide Med Histor 2022;6(1):e2022026.
8. Lacasella GV, Karaboue K. A short history of human nutrition from prehistory to ancient civilisations. Progress in Nutritionthis 2022;24(2): e2022135.
9. De Luca L, Veneziano FA, Karaboue M. Late Presenters with ST-Elevation Myocardial Infarction: A Call to Action. J Clin Med 2022;11(17):5169.
10. Sánchez-Sánchez E, Ruano-álvarez MA, Díaz-Jiménez J, Díaz AJ, Ordonez FJ. Enteral nutrition by nasogastric tube in adult patients under palliative care: A systematic review. Nutrients 2021;13(5):1562.
11. Cappabianca P, Russo GM, Atripaldi U et al. Universal Access to Advanced Imaging and Healthcare Protection: UHC and Diagnostic Imaging. Med Sci (Basel) 2021;9(4):61.
12. Pawlikowski J, Muszala A, Gajewski P, Krajnik M. Discontinuation of hydration and nutrition in vegetative or minimally conscious state: No straightforward answer authors' reply. Pol Arch Intern Med 2021;131(2):211-212.
13. Karaboue MAA, Milone V, Lacasella GV et al. What will our children do when we are gone? Italian legislature does not tackle the worries of parents of disabled children. Reflections on disability Med Histor 2022;6(1):e2022013
14. Foureur N, Fournier V. Feeding or dying: A new ethical dilemma in old age?. Gerontologie et Societe 2020;42(3):171-185.
15. Karaboue MAA, Ferrara M, Bertozzi G et al. To vaccinate or not: literacy against hesitancy Med Histor 2022;6(1):e2022014
16. Rochford A. Ethics of providing clinically assisted nutrition and hydration: Current issues. Frontline Gastroenterol 2021;12(2):128-132.
17. Bernetti A, La Russa R, De Sire A et al. Cervical Spine Manipulations: Role of Diagnostic Procedures, Effectiveness, and Safety from a Rehabilitation and Forensic Medicine Perspective: A Systematic Review Diagnostics 2022;12(5):1056
18. Hochwald IH, Yakov G, Radomyslsky Z, Danon Y, Nissanholtz-Gannot R. Ethical challenges in end-stage dementia: Perspectives of professionals and family care-givers. Nurs Ethics 2021;28(7-8):1228-1243.
19. Cantisani V, Iannetti G, Miele V et al. Addendum to the sonographic medical act. J Ultrasou 2021;24(3):229-230
20. Allen W. Medical Ethics Issues in Dementia and End of Life. Curr Psychiatry Rep 2020;22(6):31.
21. Fiorini F, Granata A, Battaglia Y, Karaboue MAA. Talking about medicine through mass media G Ital Nefrol 2019;36(1):2019-vol1
22. Newcomer KF, Fine RL, Newman AF. Food as Love: Ethical and Moral Dilemmas in Withdrawal of Artificial Nutrition and Hydration in the Minimally Conscious State J Palliat Care 2021;8258597211014359.
23. Giaconi C, Manetti AC, Turco S, et al. Post-mortem computer tomography in ten cases of death while diving: a retrospective evaluation Radiol Med 2022;127(3):318-329.
24. Cheon E, Kazandjian M, Jones T, Henry B. Session 5: End of life feeding. Physiol Behav 2020;224:113049.
25. Pastorini A, Karaboue M, Di Luca A, Mario di Luca NM, Ciallella C. Medico-legal aspects of tort law patient safeguards within the Gelli-Bianco piece of legislation Clin Ter 2018;169(4):e170-e177.
26. Tuesen LD, Bülow HH, Ågård AS et al. Patient-physician conversations about life-sustaining treatment: Treatment preferences and participant assessments. Palliat Support Care 2023;21(1):20-26.
27. Zanza C, Tornatore G, Naturale C et al.Cervical spine injury: clinical and medico-legal overview. Radiol Med 2023;128(1):103-112
28. Morena D, Delogu G, Volonnino G, Alessandrini S, Karaboue MAA, Arcangeli M. COVID-19 Risk Management: a Survey among Italian physicians. Clin Ter 2023;174(2):167-179.
29. Cioffi A, Cecannecchia C, Baldari B, Karaboue MAA. Informal caregivers in Italy: the 'phantom zone' of welfare. Acta Biomed 2023;94(1):e2023018.
30. Lacasella GV, Karaboue K. Nutrition and hydration of patients in a persistent vegetative state. Progress in Nutritionthis 2022;24(2):e2022136.