Is force-feeding immoral?

[JesuXPIPassio]

The cult leader “Michael Travesser” (from Inside a Cult on National Geographic) was sent to prison (big surprise). He went on a hunger strike and the judge ordered that they force feed him.

While it is immoral to keep food from someone, is it moral to force them to eat? It seems to go against medical ethics (no treatment for someone who doesn’t want it). Is this compatible with theology?

 

[Newbie2]

The cult leader “Michael Travesser” (from Inside a Cult on National Geographic) was sent to prison (big surprise). He went on a hunger strike and the judge ordered that they force feed him.

While it is immoral to keep food from someone, is it moral to force them to eat? It seems to go against medical ethics (no treatment for someone who doesn’t want it). Is this compatible with theology?

That’s an excellent moral question.

In this situation, morally it’s similar to taking away someone’s shoelaces and belt to keep them from killing themself while in prison. Keeping normally healthy people from doing harm to themselves, is morally licit.

However, things get more confused when talking about end of life forced nutrition. Let’s say there is a 99 year old man in poor health in a hospice situation. He is bedridden and affected by severe dementia and needs a feeding tube to help maintain hydration and to feed him. He keeps ripping out the feeding tube.

In the first case, the person is being a (donkey) and is being stubborn and contrary. In the second, the person is unaware of his need of hydration and nutrition. However, in both cases, they need to be force-fed in order to keep them (relatively) healthy.

A third case would be a cancer patient who may have months to live but gives up and wants to end it all by starvation rather than face the inevitable end i.e. they want to have control over their death.

Different force feeding scenarios, different moral considerations.

 

[JesuXPIPassio]

That’s an excellent moral question.

In this situation, morally it’s similar to taking away someone’s shoelaces and belt to keep them from killing themself while in prison. Keeping normally healthy people from doing harm to themselves, is morally licit.

However, things get more confused when talking about end of life forced nutrition. Let’s say there is a 99 year old man in poor health in a hospice situation. He is bedridden and affected by severe dementia and needs a feeding tube to help maintain hydration and to feed him. He keeps ripping out the feeding tube.

In the first case, the person is being a (donkey) and is being stubborn and contrary. In the second, the person is unaware of his need of hydration and nutrition. However, in both cases, they need to be force-fed in order to keep them (relatively) healthy.

A third case would be a cancer patient who may have months to live but gives up and wants to end it all by starvation rather than face the inevitable end i.e. they want to have control over their death.

Different force feeding scenarios, different moral considerations.

Cases 1 and 3 seem the same to me, actually, in that the person isn’t mentally-impaired and wants to essentially commit suicide, the only difference being that the prisoner doesn’t have any choice.

The laws seem to be unequal. That is, unless if I’m misunderstanding the law, and that when someone is in prison, their liberty over even this is taken over by the government.

 

[thistle]

The cult leader “Michael Travesser” (from Inside a Cult on National Geographic) was sent to prison (big surprise). He went on a hunger strike and the judge ordered that they force feed him.

While it is immoral to keep food from someone, is it moral to force them to eat? It seems to go against medical ethics (no treatment for someone who doesn’t want it). Is this compatible with theology?

Feeding (forced or voluntary) is not medical treatment so medical ethics do not figure in this topic at all.

 

[JesuXPIPassio]

Feeding (forced or voluntary) is not medical treatment so medical ethics do not figure in this topic at all.

When they put a feeding tube into a patient who can’t eat, you don’t consider that medical treatment?

 

[LilyM]

Cases 1 and 3 seem the same to me, actually, in that the person isn’t mentally-impaired and wants to essentially commit suicide, the only difference being that the prisoner doesn’t have any choice.

The laws seem to be unequal. That is, unless if I’m misunderstanding the law, and that when someone is in prison, their liberty over even this is taken over by the government.

Is someone who is so deeply disturbed at the idea of facing death from terminal disease that they’d rather hasten their end by starving themselves really not mentally-impaired? Likewise, is someone who is so disturbed at the idea of being imprison that they’d risk severe physical impairment, if not death, in order to secure their release really not mentally-impaired?

The secular reasoning of the medical and scientific community may think so, but that’s the same reasoning that speculates that for the most part it’s perfectly OK for women to abort their unborn children. It’s not an infallible guide to the moral rightness or wrongness of the action. Neither from a secular nor a religious point of view.

 

[faithfully]

When things are done by FORCE, I would question how moral that is…

 

[LilyM]

When things are done by FORCE, I would question how moral that is…

Lots of things have to be done by force when someone is behaving irrationally, either for their own good or the good of others who may be harmed by their actions or choices. No-one lives in a vaccum, and those affected by our behaviour have some right to be protected (even by force) when there is the potential for harm.

Sometimes we have to force someone who is mentally ill to go into hospital for treatment, or force them to take their medication.

We force people to pay their debts sometimes, and can sometimes repossess and/sell the roof over their head to do so.

We force Linday Lohan to wear that alcohol-bracelet-thingy - fat lot of good it did, unfortunately.

We sometimes force sex offenders to be registered, and in so doing restrict where they can live and the jobs they can do. We force other criminals to disclose their criminal histories sometimes, which again may restrict the jobs they can do.

For that matter US troops are currently forcing a lot of more or less unwilling people in Iraq and Afghanistan to put up with their presence there. And an awful lot of people who didn’t vote for Obama to be their President are forced to put up with things they don’t like about him or his government.

 

[thistle]

When they put a feeding tube into a patient who can’t eat, you don’t consider that medical treatment?

No I do not consider that medical treatment. The patient is being fed (albeit through a tube).

 

[Zooey]

That’s an excellent moral question.

In this situation, morally it’s similar to taking away someone’s shoelaces and belt to keep them from killing themself while in prison. Keeping normally healthy people from doing harm to themselves, is morally licit.

However, things get more confused when talking about end of life forced nutrition. Let’s say there is a 99 year old man in poor health in a hospice situation. He is bedridden and affected by severe dementia and needs a feeding tube to help maintain hydration and to feed him. He keeps ripping out the feeding tube.

In the first case, the person is being a (donkey) and is being stubborn and contrary. In the second, the person is unaware of his need of hydration and nutrition. However, in both cases, they need to be force-fed in order to keep them (relatively) healthy.

A third case would be a cancer patient who may have months to live but gives up and wants to end it all by starvation rather than face the inevitable end i.e. they want to have control over their death.

Different force feeding scenarios, different moral considerations.

And in addition to your 3rd case, there are cancer patients (& other patients) whose suffering is going to be increased by force-feeding, but who are, in fact, so ill that feeding them will not keep them alive any longer; it will only cause more pain, & end in death anyway…Which is different from, the person who just decides to stop eating when s/he could be genuinely nourished by a feeding tube.

The trouble with this question (and it is a very good one), but the trouble is, that it can be very difficult to determine the difference between these cases at times. Especially when you are dealing with medical professionals who may or may not have respect for religious morality.

Yes, Zooey has been someone’s health care proxy. No, it is not an easy job. Yes, some of the people at hospital have anything but ethics on their minds.
It has been several years since I told this story, but there was one doctor who said, "[Zooey’s mother] is old; [Zooey’s mother] is sick; [Zooey’s mother] isn’t good for anything; why don’t we just let [Zooey’s mother] die?"
Zooey confesses to seriously wanting to wipe the floor with said doctor’s face.

 

[JesuXPIPassio]

No I do not consider that medical treatment. The patient is being fed (albeit through a tube).

If it makes any difference to you, though, as I understand it, the Church is okay with a patient refusing to have a feeding tube put in (though once it’s in, it won’t allow it to be removed) and it’s considered an extraordinary measure. Taking extraordinary moves to give nourishment isn’t considered mandatory. But that’s how I understand it. I could be wrong. If anyone reading this could clarify it, please post up a link to a document that we can read to understand it better.

That being said, I agree with you that feeding tubes should be put in. Unfortunately it’s hard to legislate it. Also, I don’t think we can liken it to abortion. Both pro-choicers and suicidal patients/prisoners will say that it’s their body, their business. But with the case of the pro-choicers, I think it’s a false argument because it isn’t their body, it’s their baby’s. For that reason, while I still think a feeding tube should be put in, I question the notion of doing it by force and to make it law, while I do think abortion should be outlawed.

You wrote that a person terminally ill and refusing a feeding tube is not in his or her right mind because of the illness. I can see what you mean, but you know, a lot of people who could have feeding tubes but refuse made that choice when they were still healthy and put instructions in legal papers that say not to take extraordinary measures. So, in that case, they would presumably have been totally sane when they made the decision to decline having a feeding tube put in. Do you also find a Do-Not-Resuscitate order to be immoral? Could you provide us sources to Church documents or writings from apologists that could help us understand the correct way better?

 

[LilyM]

You wrote that a person terminally ill and refusing a feeding tube is not in his or her right mind because of the illness. I can see what you mean, but you know, a lot of people who could have feeding tubes but refuse made that choice when they were still healthy and put instructions in legal papers that say not to take extraordinary measures. So, in that case, they would presumably have been totally sane when they made the decision to decline having a feeding tube put in. Do you also find a Do-Not-Resuscitate order to be immoral? Could you provide us sources to Church documents or writings from apologists that could help us understand the correct way better?

You may be thinking of me - I wrote something similar. But I didn’t say it was BECAUSE they were ill. I just said that they fear the prospect of dying more slowly.

Of course that fear can be a lifelong thing and doesn’t necessarily only develop at the time they are ill. In fact many perfectly physically sound people express a very real and strong fear of dying a slow death.

As I said, secular science/medicine can sometimes judge some pretty loopy things/people to be sane for their purposes - this may be one such case.

 

[JRKH]

That’s an excellent moral question.

In this situation, morally it’s similar to taking away someone’s shoelaces and belt to keep them from killing themself while in prison. Keeping normally healthy people from doing harm to themselves, is morally licit.

However, things get more confused when talking about end of life forced nutrition.
(Snip)
Different force feeding scenarios, different moral considerations.

I think that for the OP issue this is the best answer. Force feeding in this case is simply an effort to prevent harm (suicide) to the inmate while he is in the custody of the state.

Other situations warrant other considerations and possibly other solutions.

Peace
James

 

[Newbie2]

If it makes any difference to you, though, as I understand it, the Church is okay with a patient refusing to have a feeding tube put in (though once it’s in, it won’t allow it to be removed) and it’s considered an extraordinary measure. Taking extraordinary moves to give nourishment isn’t considered mandatory. But that’s how I understand it. I could be wrong. If anyone reading this could clarify it, please post up a link to a document that we can read to understand it better.

That being said, I agree with you that feeding tubes should be put in. Unfortunately it’s hard to legislate it. Also, I don’t think we can liken it to abortion. Both pro-choicers and suicidal patients/prisoners will say that it’s their body, their business. But with the case of the pro-choicers, I think it’s a false argument because it isn’t their body, it’s their baby’s. For that reason, while I still think a feeding tube should be put in, I question the notion of doing it by force and to make it law, while I do think abortion should be outlawed.

You wrote that a person terminally ill and refusing a feeding tube is not in his or her right mind because of the illness. I can see what you mean, but you know, a lot of people who could have feeding tubes but refuse made that choice when they were still healthy and put instructions in legal papers that say not to take extraordinary measures. So, in that case, they would presumably have been totally sane when they made the decision to decline having a feeding tube put in. Do you also find a Do-Not-Resuscitate order to be immoral? Could you provide us sources to Church documents or writings from apologists that could help us understand the correct way better?

Then there is the matter of the difficulty of placing and maintaining a feeding tube. Patients with, say, esophageal cancer may have to have a access port place surgically directly into their stomach.

IMHO, many of these “hunger strikes” are publicity stunts. Jack Kevorkian went on a hunger strike in prison, but the champion of “assisted suicide” didn’t go through with it. So much for conviction to one’s cause.

I guess we should be happy, though, that he at least saw that part of the light (no pun intended) and saw some value in his own life.