Ethics however is a hot topic these days. Home health care providers need not be ethicists, however they do need to be 30 able to identify problems quickly, and know how to address them. This paper explores the ethical issues arising from a Nutrition narrative analysis involving an advanced cancer patient receiving Total Parenteral Nutrition (TPN) at home. It shows how complicated it is and today to make nutrition support decisions that would have been customary less than 30 years ago. For and against arguments reviewed. of TPN for advanced cancer patients are reviewed. Ethical positions adopted by the medical and nursing professions are explored and been contrasted. The importance of patient autonomy, within a holistic notion of care, including decisions incorporating quality of life, are affirmed,need providing a challenge to monitoring the status quo in approaches to decision making.