Proper hospital nutrition as a human right.

ESPEN is strongly encouraging the national societies to implement the resolution on Food and Nutritional Care in Hospitals, as adopted by the Committee of Ministers of the Council of Europe in November 2003. The Committee of Ministers is the decision-making body of the Council, consisting of the foreign ministers of the member countries, or their ambassadors. The main aims of the Council are to reinforce democracy, human rights and the rule of law and to develop common responses to political, social, cultural and legal challenges, based on the Declaration of Human Rights from 1948. The Council of Europe also hosts the European Court of Human Rights in which cases concerning human rights can be raised against a state by individuals, associations or other contracting states. This particular resolution was accepted by the 18 member states of the Partial Agreement in the Social and Public Health Field, i.e. Australia, Belgium, Cyprus, Denmark, Finland, France, Germany, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden, Switzerland and the United Kingdom. The introduction to the resolution outlines the background for the initiative: (a) access to a safe and healthy variety of food is a fundamental human right, (b) proper food service and nutritional care in hospitals has beneficial effects on the recovery of patients and their quality of life, (c) the number of undernourished hospital patients in Europe is unacceptable and (d) undernutrition among hospital patients leads to extended hospital stays, prolonged rehabilitation, diminished quality of life and unnecessary costs to health care. Therefore this resolution recommends to the governments of the member states to (a) draw up and implement national recommendations on food and nutritional care in hospitals based on the principles and measures set out in the appendix to this resolution (see below), (b) promote the implementation and take steps towards the application of the principles and measures contained in the appendix, in fields where these are not the direct responsibility of governments but where public authorities have a certain power and (c) ensure the widest possible dissemination of this resolution among all parties concerned, particularly public authorities, hospital staff, primary health care sector, patients, researchers and nongovernmental organisations active in this field. The appendix to the resolution consists of some 100 specific recommendations in a number of categories: nutritional assessment and treatment, responsibility and education of staff, hospital food and food service practices and health economics. In each category, the role of the level of government/ health authority versus the level of hospital/ department/patient is specified. The recommendations were proposed by a large European expert group, based upon the information gathered from health authorities of all member states in a report which preceded the resolution. Some of the key recommendations at the level of government/health authority are: (1) Standards of practice for assessing and monitoring nutritional risk should be developed. (2) The definition of disease-related undernutrition should be universally accepted and used as a clinical diagnosis and hence treated as such. (3) Good practice to ensure the intake of ordinary food by the patients should be documented. (4) Standards of practice for initiation, monitoring and termination of all artificial nutritional support should be developed. (5) ARTICLE IN PRESS