PRESIDENT'S COMMISSION REPORT (short title)

Organizational overview:  The President's Commission Report -- a 550-page report authored by nearly two dozen physicians, ethicists, and lawyers -- has stood for two decades as one of the most important and authoritative sources of information on end-of-life decision making in the U.S. 

Position on tube feeding at the end of life

Whether care is “ordinary” or “extraordinary” should not determine whether a patient must accept or may decline it.  The terms have come to be used in conflicting and confusing ways . . . . [T]o avoid misunderstanding, public discussion should focus on the underlying reasons for or against a therapy rather than on a simple categorization as “ordinary” or “extraordinary.” . . . . This line of reasoning suggests that extraordinary treatment is that which, in the patient's view, entails significantly greater burdens than benefits and is therefore undesirable and not obligatory, while ordinary treatment is that which, in the patient's view, produces greater benefits than burdens and is therefore reasonably desirable and undertaken.  The claim, then, that the treatment is extraordinary is more of an expression of the conclusion than a justification of it (President's Commission 1983: 88). . . .  The Commission has . . . found no particular treatments -- including such “ordinary” hospital interventions as parenteral nutrition or hydration, antibiotics, and transfusions -- to be universally warranted and thus obligatory for patients to accept (President's Commission 1983: 90).

Citations

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (President's Commission). 1983. Deciding to Forego Life-Sustaining Treatment: A Report on Ethical, Medical, and Legal Issues in Treatment Decisions.  Washington, D.C.: Government Printing Office.