Hostname: page-component-7479d7b7d-m9pkr Total loading time: 0 Render date: 2024-07-13T23:02:19.633Z Has data issue: false hasContentIssue false

The Process of Dying with and without Feeding and Fluids by Tube

Published online by Cambridge University Press:  29 April 2021

Extract

The process of dying, ultimately, is an experience that will be common to us all. Considering the current trends in health care, I would guess that most of us give more than a passing thought to how that final phase of life will be played out on a personal level. Undoubtedly, that image is shaped by our attitudes and experiences. In addition each of us recognizes that we have had or are likely to have an impact on the dying in our role as family or friend, health care provider or interpreter of the legal or ethical issues. As a member of a hospice team, I have personally cared for hundreds of terminally ill patients, and based on these experiences, I present the following observations regarding the process of dying, with and without feeding and fluid by tube.

J.R. was a successful business executive until AIDS intervened; within an eight month period, he was forced to give up both his position and independence because of severe peripheral neuropathy which left him minimally functional and in constant pain.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, M.R. Levine, A.M., “Dehydration in the Terminal Patient: Perception of Hospice Nurses.” The American Journal of Hospice Care, pp 31–34, January/February, 1989.Google Scholar
Annas, G.J., “Do Feeding Tubes Have More Rights than Patients?” Hastings Center Report, pp 26–28, February, 1986.Google Scholar
Arnold, C., “Nutrition Intervention in the Terminally Ill Cancer Patient.” Journal of the American Dietetic Association, 86:522523, 1986.Google Scholar
Billings, J.A., “Comfort Measures for the Terminally Ill—Is Dehydration Painful?” Journal of the American Geriatric Society, 33: 808810, 1985.Google Scholar
Cox, S.S., “Is Dehydration Painful?” Ethics & Medics, 12: 12, 1987.Google Scholar
Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying. Hastings Center, New York, 1987.Google Scholar
Lo, B. McLeod, G.A. Saika, G., “Patient Attitudes to Discussing Life-Sustaining Treatment.” Archives of Internal Medicine, 146: 16131615, 1986.Google Scholar
Lynn, J. Childress, J.F., “Must Patients Always be Given Food and Water?” Hastings Center Report, 10: 1721, 1983.Google Scholar
Lynn, J. (ed), By No Extraordinary Means. Indiana University Press, 1989.Google Scholar
Miles, S. H., “The Terminally Ill Elderly: Dealing with the Ethics of Feeding.” Geriatrics, 40: 112120, 1985.Google Scholar
Miller, R.J. Albright, P.G.: “What is the Role of Nutritional Support and Hydration in Terminal Cancer Patients?” The American Journal of Hospice Care, pp 33–38, November/December, 1989.Google Scholar
O’Connor, E., Our Many Selves. New York, Harper and Row, 1971, p. 96.Google Scholar
Paris, J.J., “When Burdens of Feeding Outweigh Benefits.” Hasting Center Report, pp 30–32, February, 1986.Google Scholar
President's Commision for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Deciding to Forego Life-Sustaining Treatment: A Report on the Ethical, Medical and Legal Issues in Treatment Decisions. Washington, D.C.: Government Printing Office, 1983.Google Scholar
Ramsay, P., The Patient as Person. Yale University Press 1970.Google Scholar
Steinbrook, R. Lo, B., “Artificial Feeding—Solid Ground, Not a Slippery Slope.” New England Journal of Medicine, 318: 286290, 1988.Google Scholar
Watts, D.T. Cassel, C.K., “Extraordinary Nutritional Support: A Case Study and Ethical Analysis.” Journal of the American Geriatric Society, 32: 237242, 1984.Google Scholar
Zenvekh, J.V., “The Dehydration Question.” Nursing 1983, 1: 4751, 1983.Google Scholar