Mark Vassallo, who recently obtained an MA in Bioethics from the University of Malta, examines in his dissertation ethical issues in end-of-life care in geriatrics.

The dissertation, entitled ‘Artificial nutrition and hydration in end-of-life geriatric care: medical treatment or basic care?’, was supervised by Faculty of Theology dean Emmanuel Agius. It dealt with the use of ANH in end-of-life care in geriatrics. With the increasing life expectancy and increasing co-morbidities with advancing age, the dilemma of whether naso-gastric feeding or even intravenous fluids should be considered as a medical treatment or basic care is bound to arise.

In the past decades, there have been a number of court cases dealing with such issues but mainly pertaining to young patients in a persistent vegetative state such as Tony Bland, Eluana Englaro and Terry Schiavo.

These cases mainly dealt with the issue of whether tube feeding should be stopped or not. In the case of the elderly, the issue is whether tube feeding and other modes of ANH, in end-of-life situations, should be considered as basic care, like bathing, change of position and keeping the patient warm and comfortable, or medical treatment thus one has to take into consideration the pros and cons of such treatment.

Vassallo has been a consultant geriatrician for the past eight years. He graduated as a medical doctor in 1990 and carried out his training in geriatrics in Malta. In 2011, he was accepted as a Fellow of the Royal College of Physicians of Edinburgh.

Vassallo’s three-year part-time course was sponsored by the Malta Government Scholarship Scheme (MGSS).