Ethically justified, clinically comprehensive guidelines for percutaneous endoscopic gastrostomy tube placement

Linda Rabeneck, Laurence B. McCullough, Nelda Wray

Research output: Contribution to journalComment/debate

170 Scopus citations

Abstract

Guidelines for the placement of percutaneous endoscopic gastrostomy (PEG) tubes are not available. We developed a decision-making algorithm by integrating the medical and ethical dimensions of the decision. According to our algorithm, physicians should not offer PEG tubes to patients with anorexia-cachexia syndromes. For patients with permanent vegetative states, physicians should-offer and recommend against the procedure. For patients who have dysphagia without other deficits in quality of life, physicians should offer and recommend the procedure. For the the remaining patients who have dysyphagia with other deficits in quality of life, the physician's role is to provide nondirective counselling regarding the short and long-term consequences of a trial of PEG tube feeding.

Original languageEnglish (US)
Pages (from-to)496-498
Number of pages3
JournalLancet
Volume349
Issue number9050
DOIs
StatePublished - Feb 15 1997

ASJC Scopus subject areas

  • Medicine(all)

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