The American debate about withholding artificially provided food and water is a sprawling controversy. It includes not only strictly moral but also legal questions, and is concerned with withholding food and water provided to patients in a variety of conditions by a variety of techniques. My discussion of this controversy will, therefore, involve some simplifications. The result I hope for is a presentation of the essential contours of the moral debate, along with my own evaluation, and not a summary and critique of the details of the many arguments.

My first simplification is to focus as much as possible on the moral controversy and to avoid the strictly legal matters. Thus, although I will have something to say about recent legal decisions, it will be with a view to their moral relevance.

My second simplification is to examine just two, precisely defined and closely related kinds of human action in which the treatments withheld and the patients from whom they are withheld are specified. The treatments to be withheld in the two kinds of actions I will consider are the provision of food and water by way of a nasogastric tube or by way of a gastrostomy (a surgical procedure which provides direct access to the patient's stomach).