Artificial nutrition decisions for people at risk of lacking capacity


Artificial nutrition choices when someone is approaching the end of life are complex, the more so when decisions need to be made on behalf of someone who lacks the mental capacity to decide for themselves.

This project examines how decisions are made to provide, withhold or withdraw artificial nutrition for patients at risk of lacking the capacity to make healthcare decisions due to the effects of dementia, intellectual disability or Acquired Brain Injury (ABI).

The aim is to optimise care for this vulnerable group of patients by identifying opportunities for improvements in performance and making recommendations for developments in current service provision.


There are three parts to the study:

  • A systematic literature review of how decisions about artificial nutrition are made for those at risk of lacking capacity.
  • An observational study of decision-making at the Addenbrooke’s Hospital Feeding Issues Multidisciplinary Team (FIMDT). FIMDT meetings were observed over a three month period, four meetings were also audio recorded, transcribed and analysed using discourse analysis.
  • A case notes and records evaluation of the FIMDT. The aim is to evaluate the service provision and care pathway for patients referred to FIMDT.  A sample of one year of patients & records was taken and analysed.
The literature review has been accepted for publication by PLOS ONE: two further papers are in preparation.


Project partners

This study is a joint project with the Adult theme, in collaboration with members of the Addenbrooke’s Hospital Feeding Issues Multidisciplinary Team.

Other partners include Cambridge University Hospitals NHS Foundation Trust (Addenbrooke’s Hospital)

For more information contact: Dr Gemma Clarke, Department of Public Health and Primary Care, University of Cambridge,

Download a research update on this project here.