Death by Starvation

[philip01]

My 91 year old grandmother died this evening. She was in an assisted living facility unresponsive and was not breathing well. Hospice stated they would only make her as comfortable as possible and would not provide nourishment intravenously. Family friends and family members with medical backgrounds were unanimous that it would be a “bad idea” to move her elsewhere so that she could be fed, and stated that she could not feel hunger as justification for allowing her to starve. My aunt, being power of attorney had an ambulance called to transport her to a local hospital so that she can be fed, as she believed that this was a moral imperative to not allow her to die by starvation. My grandmother died on her way to the hospital.

Any thoughts on this?

 

[Trishie]

My sympathy, and a prayer, regarding your grandmother and your loss.
You aunt had to do what she thought was right.

Excerpts from the Catechism of the Catholic Church

2277 …Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator…

NB 2278 **Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment.
Here one does not will to cause death; one’s inability to impede it is merely accepted.
The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.
**

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged.

2299 The dying should be given attention and care to help them live their last moments in dignity and peace. They will be helped by the prayer of their relatives, who must see to it that the sick receive at the proper time the sacraments that prepare them to meet the living God.

 

[davesmith]

Hello,

Starvation is nothing but the reduction of vitamins and protein from the body. Many death occur due to Starvation.

Thanks,
Dave Smith

 

[RosaryFan]

My 91 year old grandmother died this evening. She was in an assisted living facility unresponsive and was not breathing well. Hospice stated they would only make her as comfortable as possible and would not provide nourishment intravenously. Family friends and family members with medical backgrounds were unanimous that it would be a “bad idea” to move her elsewhere so that she could be fed, and stated that she could not feel hunger as justification for allowing her to starve. My aunt, being power of attorney had an ambulance called to transport her to a local hospital so that she can be fed, as she believed that this was a moral imperative to not allow her to die by starvation. My grandmother died on her way to the hospital.

Any thoughts on this?

Sorry about your grandmother. If I was your aunt I would have done the same. It’s a shame that this backwards world we live in has everyone so confused about end-of-life issues. It’s amazing how the devil works. He gets in there and causes so much confusion that good appears to be evil and evil appears to be good.

 

[Rence]

I’m very sorry for your loss Phillip. My prayers are with you and your family.

 

[wabrams]

Without all the medical facts and taking into account she died enroute to the hospital, I would say that giving her intravenous nutrition would not have been necesaary.

I am terribly sorry about your loss.

 

[1ke]

Hospice stated they would only make her as comfortable as possible and would not provide nourishment intravenously. Family friends and family members with medical backgrounds were unanimous that it would be a “bad idea” to move her elsewhere so that she could be fed, and stated that she could not feel hunger as justification for allowing her to starve.

Withholding nutrition and hydration is gravely immoral.

vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20070801_risposte-usa_en.html

My aunt, being power of attorney had an ambulance called to transport her to a local hospital so that she can be fed, as she believed that this was a moral imperative to not allow her to die by starvation. My grandmother died on her way to the hospital.

Your aunt did the right thing. Nutrition and hydration are ordinary care and cannot morally be withdrawn.

 

[Palomas]

My 91 year old grandmother died this evening. She was in an assisted living facility unresponsive and was not breathing well. Hospice stated they would only make her as comfortable as possible and would not provide nourishment intravenously. Family friends and family members with medical backgrounds were unanimous that it would be a “bad idea” to move her elsewhere so that she could be fed, and stated that she could not feel hunger as justification for allowing her to starve. My aunt, being power of attorney had an ambulance called to transport her to a local hospital so that she can be fed, as she believed that this was a moral imperative to not allow her to die by starvation. My grandmother died on her way to the hospital.

Any thoughts on this?

I am so sorry for your loss. I went through a very similar situation recently… I was so incredibly distraught, upset, and angered that the medical staff – who were so bent (it seemed to me) on causing her to die and making it sound oh so dignified – succeeded in convincing my family and the power of attorney (my Mom) that it was the best thing to take away nourishment from my dying grandmother. I just said a Hail Mary for you, your grandmother, and your family.

Your aunt did the right thing. Food and water are necessities, NOT medical treatments, as Trishie has quoted: “the ordinary care owed to a sick person cannot be legitimately interrupted.”

 

[solemnwarrior]

I am so sorry for your loss. I went through a very similar situation recently… I was so incredibly distraught, upset, and angered that the medical staff – who were so bent (it seemed to me) on causing her to die and making it sound oh so dignified – succeeded in convincing my family and the power of attorney (my Mom) that it was the best thing to take away nourishment from my dying grandmother. I just said a Hail Mary for you, your grandmother, and your family.

Your aunt did the right thing. Food and water are necessities, NOT medical treatments, as Trishie has quoted: “the ordinary care owed to a sick person cannot be legitimately interrupted.”

The giving of fluids intravenously is a medical treatment. Without a medical intervention, via intravenous fluids, no nourishment / energy could be given to the body.

My grandmother died the same way. It simply sped up the inevitable and released her from her coma sooner than later.

 

[philip01]

I thank all of you for your thoughtful responses. Your thoughts and prayers are much appreciated. I will keep all of you and your loved ones in my prayers as well.

 

[1ke]

The giving of fluids intravenously is a medical treatment. Without a medical intervention, via intravenous fluids, no nourishment / energy could be given to the body.

This is contrary to Catholic Church teaching.

Nutrition and hydration are not mendical treatments.

My grandmother died the same way. It simply sped up the inevitable and released her from her coma sooner than later.

According to the Church, it is gravely sinful to “speed up” someone’s death by starving or dehydrating them. It is murder.

 

[solemnwarrior]

This is contrary to Catholic Church teaching.

Nutrition and hydration are not mendical treatments.

According to the Church, it is gravely sinful to “speed up” someone’s death by starving or dehydrating them. It is murder.

Actually no, medical intervention ceased in that intravenous nourishment was discontinued. Making the choice to discontinue medical intervention isn’t murder.

She died as God wanted her to die…with an agonizing inoperable broken pelvis, she died tragically, naturally, slowly and in a coma, without medical interventions delaying her death.

If you want to call that murder, although your wrong, your free to do so.

 

[solemnwarrior]

Nutrition and hydration are not mendical treatments.

If I eat a an apple by way of my mouth, that’s not a medical intervention.

If someone inserts and IV into one of my veins and forces fluids / electrolytes into my body to help my body sustain itself, that is a medical intervention and a medical treatment.

 

[rpp]

Withholding nutrition and hydration is gravely immoral.

vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20070801_risposte-usa_en.html

Your aunt did the right thing. Nutrition and hydration are ordinary care and cannot morally be withdrawn.

First, my prayers are with you and your family. As is usual, 1ke is correct. Food and water (nutrition and hydration) is never considered medical care but normal human needs. It it immoral to withhold them. Your aunt’s instinct and her resulting actions were morally correct. The actions of other were morally reprehensible. The other posts on this thread which said anything other than that they agree with what your aunt did are also morally reprehensible and utterly opposed to the constant teachings of the Catholic Church.

Euthanasia is inherently evil, just like abortion.

 

[UbiCaritas]

First of all, I’m very sorry for your loss.

Was your grandmother in the process of dying anyway from cancer or some such? The reason I ask this is that at a certain point in the dying process (and I’m talking 36 hours or so before death may occur) the body simply rejects food and nutrition. Because the body is shutting down, the consumption of food just makes the person really uncomfortable because it’ll just, well, sit there. It won’t prolong life at all; it will just make the person uncomfortable. There is no similar reason to stop hydration; fluids are often given by mouth (in very small amounts) or by IV (depending on the situation) until very close to the end. People who are dying often complain of thirst, which is why fluids are offered.

If your grandmother was going to die from “not breathing well” (lung cancer? emphysema? severe pneumonia?) in the next few hours, food might have been justifiably considered excessive. (I don’t know how the body reacts to IV nutrition, though it does require, if I remember correctly, a very large and quite uncomfortable IV). On the other hand, if she could have recovered with good care or if she could be expected to live for weeks, withholding food (did they withhold hydration?) was nothing short of inexcusable. Whether or not she could feel it wouldn’t mitigate that.

I do not envy your aunt’s position. My father and I have talked about what sort of care he wants and doesn’t want, and I’m not looking forward to dealing with that. (Hopefully, I won’t have to for a long time.)

 

[RazzsMom]

First of all, I’m very sorry for your loss.

Was your grandmother in the process of dying anyway from cancer or some such? The reason I ask this is that at a certain point in the dying process (and I’m talking 36 hours or so before death may occur) the body simply rejects food and nutrition. Because the body is shutting down, the consumption of food just makes the person really uncomfortable because it’ll just, well, sit there. It won’t prolong life at all; it will just make the person uncomfortable. There is no similar reason to stop hydration; fluids are often given by mouth (in very small amounts) or by IV (depending on the situation) until very close to the end. People who are dying often complain of thirst, which is why fluids are offered.

If your grandmother was going to die from “not breathing well” (lung cancer? emphysema? severe pneumonia?) in the next few hours, food might have been justifiably considered excessive. (I don’t know how the body reacts to IV nutrition, though it does require, if I remember correctly, a very large and quite uncomfortable IV). On the other hand, if she could have recovered with good care or if she could be expected to live for weeks, withholding food (did they withhold hydration?) was nothing short of inexcusable. Whether or not she could feel it wouldn’t mitigate that.

I do not envy your aunt’s position. My father and I have talked about what sort of care he wants and doesn’t want, and I’m not looking forward to dealing with that. (Hopefully, I won’t have to for a long time.)

First of all, I want to extend my deepest condolences on the loss of your grandmother.

Now - if I may - I would explain this a bit more and I quotes Ubicaritas as she is very close to important medical facts.

I am an RN and I have worked for Hospice. If your grandmother was in the active dying process (certain physical signs will point to the fact that death will happen in a matter of a few hours), the withholding of food is not a source of discomfort to her. Attempting to feed her would cause her more discomfort because the body is trying to shunt all of its blood supply and oxygen to her vital organs - brain, lungs and heart - and will take away from her digestive organs (stomach and intestines) to try to preserve life. Therefore, putting food or excessive amounts of liquids into her system will cause discomfort due to the inability of it to digest. (Think of how uncomfortable you have been in your life after you ate more food than you should have. Now multiply that…) The continuation of forcing “food” will eventually cause a bowel obstruction due to the inability to digest and eliminate waste. This is an extremely painful event.

You said the aunt did not want the grandmother to “die by starvation”. To “feed intravenously” is possible in two ways. One is to provide certain vitamins, fats and minerals by IV. It does indeed need a large-bore IV needle to be able to pump this nourishment. That is often very difficult to insert in a frail elderly person who may also be already somewhat dehydrated. Then the medical staff would need to insert the needle into a larger vein - in the subclavian vessel (below your collarbone) or into the jugular vein. This is pretty painful in of itself. This type of “feeding” can only last a short amount of time. A person who needs to live without eating orally for extended periods of time needs a “feeding tube” placed. This would be a tube inserted into her stomach or intestine and is a surgical procedure. Again - this is not feasible nor desirable in a person who is in the active dying process for the reasons I have described above.

(Continued in the next post.)

 

[RazzsMom]

However, a dying person does indeed often request liquids. As long as she can take liquids by mouth, and wants them, they should be offered. Small, frequent amounts can alleviate thirst adequately. If the person is unable to drink, the IV can give hydration fluids. Careful monitoring is needed because as the body begins to shut down (as I described above), a fluid overload can cause (among other things) heart failure. This can be detected by frequent monitoring of lung sounds basically. The fluid overload can be heard in the lungs by stethoscope. I am sure you have heard of a “death rattle”… that is the fluids building up at the back of the throat when the person is no longer able to swallow the secretions. That is not a painful thing to the person, even though to our ears, it sounds like the person is stangling or suffocating. It is similar to when you gargle. But if the person cannot spit out the fluids nor swallow them, and the fluids can then go into the lungs - it can cause aspiration pneumonia. So over-hydratng or forcing the person to drink unwanted fluids carries its own risks.

Paying close attention to **all **the person’s signs and monitoring for signs the person is in active dying stages, is what is caring, loving and Christian. I would **never **advocate withholding of nutrition or fluids from a person who is not in the dying process. There are other ways to give comfort to the actively dying person than to “force” fluids — there is artificial saliva which can keep the mouth moist. Frequent lip balms and mouth care will also be comforting. (Wiping the mouth out with special swabs that provide moisture and also clean the teeth and gums as well as the roof of the mouth and tongue. NOT using swabs that contain mouthwash as they usually have alcohol in them and will dry the mucous membranes further.)

I now the Hospice I worked for paid very close attention to determine th time when it was no longer beneficial and was even painful for the person to eat or drink. Spiritual support was as much a part of our care as the elimination of pain. I would even say it was more important. Spiritual pain can cause more discomfort than bodily pain. We always had a minister/priest/sister on call if the family did not have a priest or minister of their own. And all of the RNs were praying and offering support to the families we cared for.

In your message, you said your grandmother died on the way to the hospital. That tells me the Hospice staff you were dealing with were assessing her correctly. I am certain they had her best comfort in mind, as well as what was best for the family.

Again - my condolences. :console:

 

[dontknow]

Razz(name removed by moderator) - Thank you for the insightful and easy to comprehend post on the nature of the topic.

It’s personally hard for me believe the statement about withholding food and water until the entire situation is known.

Condolences are certainly in order.

Life challenges such as this can be very difficult to navigate as things, though sometimes seem so slow, at the same time seem so fast.

There is no value in second guessing, the only benefit now is through prayer.

I’ve buried 2 parents who were on Hospice.

 

[RazzsMom]

Razz(name removed by moderator) - Thank you for the insightful and easy to comprehend post on the nature of the topic.

It’s personally hard for me believe the statement about withholding food and water until the entire situation is known.

Condolences are certainly in order.

Life challenges such as this can be very difficult to navigate as things, though sometimes seem so slow, at the same time seem so fast.

There is no value in second guessing, the only benefit now is through prayer.

I’ve buried 2 parents who were on Hospice.

You are welcome. I was hoping I had stated it well enough for it to be helpful.

I myself buried a dear FIL and also my brother who were in Hospice.

The idea that Hospice advocates “starvation” is so totally untrue that it can really upset me. If we were to assess a person who wants to commit what we called “Suicide by Hospice”, we would not even accept that person into the program.

 

[dontknow]

The idea that Hospice advocates “starvation” is so totally untrue that it can really upset me. If we were to assess a person who wants to commit what we called “Suicide by Hospice”, we would not even accept that person into the program.

I’ve never heard of such a claim myself. To me you are all much stronger people than I could ever be.

In addition, I’m sure you’ve experienced some amazing end of life events at the time of the patient’s death which (in my opinion) could only strengthen the Spiritual Self.

Thank you for all you do.