Factors related to providers' decisions for and against withholding or withdrawing nutrition and/or hydration in adult patient care.

Decisions that are made near the end of life include consideration of withholding or withdrawing nutrition and/or hydration. These decisions present ethical challenges to health care providers who are caring for terminally ill patients. Clinical studies published during the last twenty years provide empirical data about the many factors that influence these decisions. The purpose of this systematic literature review is to synthesize the research findings related to provider decisions about withholding or withdrawing nutrition and/or hydration in adult patient care. The clinical, educational, and ethical implications of these decisions are proposed.