Clinically-assisted nutrition and hydration

Clinically-assisted nutrition and hydration and the decision-making process

Location: England Wales
Audience: All doctors
Updated: Wednesday 26 April 2023
Topics: Ethics

All decisions about CANH for a patient who lacks capacity must be made in line with the Mental Capacity Act 2005. This protects patients by ensuring that decisions are made about treatment and care that are right for each individual, in the widest sense.

It also protects doctors by providing protection from liability in relation to the decisions they make, but only when the correct decision-making process has been followed. It is important to remember that it is not just the decision reached which determines liability, but also the process through which those decisions were made.

Decision-making process flowchart

Our flowchart will take you through each step of the decision-making process. You should use this in conjunction with the full guidance document, but you can also download the flowchart to display around your workplace.

Model proforma

You can also download the model proforma to be used in practice to assist in the decision-making process. This includes both a checklist of evidence for best interests decision-making, and a separate form for patients in vegetative state (VS) or minimally conscious state (MCS), which has been developed as part of this guidance.