Updated guidance re Clinically Assisted Nutrition and Hydration

The RCP and BMA have today published updated guidance to assist decision making around Clinically Assisted Nutrition and Hydration.


This guidance covers decisions to start, re-start, continue, or stop CANH for adults in England and Wales who lack the capacity to make the decision for themselves.

It covers previously healthy patients in vegetative state (VS) and minimally conscious state (MCS) following a sudden-onset brain injury, as well as the much larger group of patients who have multiple comorbidities, frailty, or neurodegenerative conditions in whom decisions about CANH are needed.

It updates and expands on existing guidance about life-sustaining treatment from the BMA, Royal College of Physicians (RCP), and General Medical Council (GMC), and should be used in conjunction with those.

Key topics covered

  • The legal context for decision-making
  • Who is the decision-maker, and who must be consulted?
  • Conscientious objections
  • Clinical assessments
  • Best interests assessments
  • Second opinions
  • Managing disagreement and uncertainty
  • Record-keeping
  • Governance and audit

Access the guidance here ...