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Clinical Ethics Terms and Concepts

Actively DyingThe hours or days preceding imminent death during which time the patient’s physiologic functions wane.”1
Advance Care PlanningInvolves discussing and preparing for future decisions about your medical care if you become seriously ill or unable to communicate your wishes. Having meaningful conversations with your loved ones is the most important part of advance care planning. Many people also choose to put their preferences in writing by completing legal documents called advance directives.2
Advance DirectivesLegal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes. The two most common advance directives for health care are the living will and the durable power of attorney for health care.
Artificial Nutrition and Hydration (ANH)Originally developed to provide short-term support for patients who were acutely ill. For patients near the end of life, ANH is unlikely to prolong life and can potentially lead to medical complications and increase suffering. Researchers have found that ANH often leads to complications in patients nearing the end of life. Patients with advanced, life-limiting illness often lose the ability to eat and drink and/or interest in food and fluids. Ethical issues may arise when patients, families, or caregivers request ANH even if there is no prospect of recovery from the underlying illness or to accrue appreciable benefit.