Allocation of feeding pumps: an ethical question.

Situations arise in clinical practice that force the dietitian to make a moral/ethical decision. Traditional undergraduate dietetic programs have not routinely included learning activities on ethical decision making. Therefore, a dietitian confronted with such an issue may defer to someone else the responsibility for finding a viable ethical solution. If the dietitian does accept the challenge, she/he must develop a systemic way to solve the problem. This case study demonstrates how a nutrition support dietitian solves a complex ethical problem involving the allocation of two enteral feeding pumps to seven critically ill patients. The three tools used to aid in the decision making were the Standards of Professional Responsibility of The American Dietetic Association, the Four-Step Process of Moral Judgment and Action of Purtilo and Cassel, and the Nutrition Support Team. It is hoped that this case example will provide some insight to other dietitians faced with similar ethical dilemmas.