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Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

Overview of attention for article published in BMC Medical Ethics, June 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (83rd percentile)

Mentioned by

14 tweeters
1 Facebook page


8 Dimensions

Readers on

79 Mendeley
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Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?
Published in
BMC Medical Ethics, June 2015
DOI 10.1186/s12910-015-0034-8
Pubmed ID

Gemma Clarke, Sarah Galbraith, Jeremy Woodward, Anthony Holland, Stephen Barclay


Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 79 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Spain 1 1%
United States 1 1%
Unknown 76 96%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 14 18%
Student > Master 13 16%
Student > Bachelor 13 16%
Other 10 13%
Student > Doctoral Student 4 5%
Other 15 19%
Unknown 10 13%
Readers by discipline Count As %
Medicine and Dentistry 25 32%
Nursing and Health Professions 21 27%
Social Sciences 5 6%
Psychology 5 6%
Agricultural and Biological Sciences 3 4%
Other 6 8%
Unknown 14 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 March 2017.
All research outputs
of 12,961,406 outputs
Outputs from BMC Medical Ethics
of 553 outputs
Outputs of similar age
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Outputs of similar age from BMC Medical Ethics
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Altmetric has tracked 12,961,406 research outputs across all sources so far. Compared to these this one has done well and is in the 86th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 553 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.3. This one has gotten more attention than average, scoring higher than 66% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 233,879 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 83% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them