This polemical note looks at the ethical issue of providing artificial nutrition and hydration (ANH) to patients with advanced dementia from the perspective of an Aristotelian and naturalist ethics. I argue that this issue may be considered in terms of the Aristotelian notion of eudaimonia, well-being. I present a number of facts about the conditions of human life that contribute to eudaimonia. In addition, I present a number of facts about advanced dementia as well as clarify the goals of medicine. From these facts, I argue that we are not ethically obligated to provide ANH to this class of patients.
This brief paper presents an Aristotelian-inspired approach to end-of-life decision making. The account focuses on the importance of teleology, in particular, the telos of eudaimonia understood as the goal of human flourishing as well as the telos of medicine when a person’s eudaimonia is threatened by serious illness and death. We argue that an Aristotelian bioethics offers a better alternative to a “fundamentalist bioethics” since the telos of eudaimonia (i) offers a more realistic conception of the self and the realities of frailty and mortality, (ii) provides a more objective basis for making decisions regarding end-of-life treatment and care, and (iii) is better able to resist the pull of the Technological Imperative. In addition, this teleological concept is flexible enough for it to be employed in multicultural and pluralistic societies.
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