Is removing a breathing tube considered euthanasia?

[rwillenborg]

Here’s the situation:
Grandma is in the hospital with an infection. She has been given the most aggressive antibiotics to fight this infection. At some point during her hospital stay, grandma stops breathing. She is resuscitated, but now has a breathing tube with the idea that, once the antibiotics do their job, the breathing tube can be removed.
However, the antibiotics fail to stop the infection from spreading throughout the rest of her body.
So we are at a crossroads with the breathing tube. Keeping it in would most certainly prolong her life in this unconscious state. However, every hour that passes that she is not breathing on her own she is getting weaker and weaker. Removing the breathing tube would MOST LIKELY result in her death, However, the removal of it is also her BEST CHANCE at a recovery, if there would be one.
Additionally, she is on heavy pain medication to make her more comfortable, but she is still squirming around like she’s in pain, so we have the pain medication increased, again, to make her more comfortable but knowing that we are risking her ability to breathe again. She is never given a lethal amount of the drug, but certainly the amount she is receiving is not helping her regain consciousness either.
The breathing tube was removed. Her breathing never quite returned to normal, though there were moments for us to hope that she would breathe on her own, and she passed away after only a few hours.
I’m not sure what role ‘will’ plays in this, but if it makes a difference, everyone wanted her to stay alive, in whatever state, but was hopeful that she could recover and breathe on her own.
Was she euthanized?

 

[Newbie2]

Absolutely not.

Euthanasia is the act of killing, and may be active or passive. In either case, the intent is to cause the death of the patient.

Unless Grandma’s ET tube was removed in order to hasten or cause her death, it was not euthanasia.

 

[Bluegoat]

No, this wouldn’t be considered euthanasia. Just a difficult situation. Something like food or water are considered just part of humane treatment, even if given by IV and feeding tube, so it is not usually ok to stop those. But a breathing tube is different, it starts to get into the territory of extreme measures, which are not always required. As well, when the treatment itself starts to be burdensome, for example causing more damage or pain than it relieves, it is ok to consider stopping the treatment. So, for example, there are times when a person might choose to stop undergoing dialysis, and that is not euthanasia or suicide.

FWIW, even if the amount of pain meds given actually caused her death, as long as they were given to control pain and not to cause death, that isn’t euthanasia either. This isn’t that uncommon with cancer patients, for example, and sometimes it isn’t clear if their body just gave up or the meds did the job.

 

[rwillenborg]

Thank you for your answers to far.
They are very comforting.
If I were to try to explain this to a person though, how would I explain that the church would not have you remove a feeding tube but it IS okay to remove a breathing tube?
It was my understanding that because food and water are necessary for EVERY person, that it is a basic right of all human beings, that we cannot deny it to anyone. But, wouldn’t that also be true of the air a patient receives through a breathing tube?
I’m trying to reconcile the difference between the two.
Thank you!

 

[Newbie2]

Thank you for your answers to far.
They are very comforting.
If I were to try to explain this to a person though, how would I explain that the church would not have you remove a feeding tube but it IS okay to remove a breathing tube?
It was my understanding that because food and water are necessary for EVERY person, that it is a basic right of all human beings, that we cannot deny it to anyone. But, wouldn’t that also be true of the air a patient receives through a breathing tube?
I’m trying to reconcile the difference between the two.
Thank you!

That’s where the tricky part is…being able to discern what is morally acceptable and what is not. For example, if a patient is in dementia and keeps pulling out the feeding tube, what then? Is it morally licit to drug them into oblivion in order to keep in the feeding tube?

The explanatory term used is “extrodinary means”. Each situation dictates what extrodinary means is. Sometimes it’s clear, sometimes not. An ET tube that’s necessary for breathing and that’s likely to be needed for the rest of a patient’s life is most likely “extrodinary” care.

 

[rwillenborg]

That’s where the tricky part is…being able to discern what is morally acceptable and what is not. For example, if a patient is in dementia and keeps pulling out the feeding tube, what then? Is it morally licit to drug them into oblivion in order to keep in the feeding tube?

The explanatory term used is “extrodinary means”. Each situation dictates what extrodinary means is. Sometimes it’s clear, sometimes not. An ET tube that’s necessary for breathing and that’s likely to be needed for the rest of a patient’s life is most likely “extrodinary” care.

Yes, exactly! (I’m referring to your first paragraph).
So, I’m guessing the church does not define extraordinary means? I’m also guessing this is probably why prayer is so important in times of crisis like this, eh?
Why would an ET tube be considered ‘extraordinary’ but not a feeding tube?

 

[Melissa]

If removing the breathing tube had been an immediate cause of death, you would not be talking about “a few hours” but rather “a few minutes”.

It is acceptable when death is very close at hand to remove even feeding tubes (as the body shuts down, a person can no longer assimilate the food provided and pumping stuff in simply results in bloating and discomfort–this happened with my grandmother and feeding via tube was discontinued approximately 6.5 hours before death). But to remove food and water from a person who is not otherwise actively dying is to take an action which will result in hastening their death, and is therefore morally unacceptable.

A person who cannot breath without assistance, unless we’re talking about a temporary situation in which recovery is expected (trauma, for example), is in the active process of dying.

When a person is actively dying, any treatment may be stopped, particularly if that treatment is causing the dying person pain and/or doing actual harm rather than benefit. It is not euthanasia, but rather allowing the process of death to continue rather than trying so hard to prevent the inevitable. When a person is not actively dying, no treatment may be given/withheld with the intent of causing that person to die.

 

[JRKH]

This is indeed a difficult subject to discuss or explain.
I know becuase we went through something similar with my father when he died.
Such decisions are heart rending for the families in any case.

You have recieved a number of good responses already so I will simply add a bit about Conscience.
The Catechism in the section on Conscience recognizes that we must take pains to properly form our conscience to the Will of God and the teachings of the Church
We then must make the best decision we can in a particular circumstance.
No matter how the Church explains her position on matters each situation is going to be just a little different and it is necessary that we make the right moral decision consistant with our conscience.

It sounds as though the decisions were well and prayerfully thought out with the best interests of your grandmother in mind. From what you have told us here I cannot see that any sin was incurred.

Peace
James

 

[rwillenborg]

James, Melissa, Newbie and Bluegoat - thank you very much for your thoughtful replies.
You have all been very helpful and I think I understand the church’s teaching on this now.
Thanks again for taking the time, I really appreciate it!

 

[Matrix_Refugee]

That’s where the tricky part is…being able to discern what is morally acceptable and what is not. For example, if a patient is in dementia and keeps pulling out the feeding tube, what then? Is it morally licit to drug them into oblivion in order to keep in the feeding tube?

The explanatory term used is “extrodinary means”. Each situation dictates what extrodinary means is. Sometimes it’s clear, sometimes not. An ET tube that’s necessary for breathing and that’s likely to be needed for the rest of a patient’s life is most likely “extrodinary” care.

In the dementia case, the person would be put in restraints to keep them from yanking the feeding tube, thus drugs would be utterly unnecessary. I want to think I read about hospital workers doing this in similar cases.

 

[JRKH]

In the dementia case, the person would be put in restraints to keep them from yanking the feeding tube, thus drugs would be utterly unnecessary. I want to think I read about hospital workers doing this in similar cases.

In any of this there is a slippery slope to be considered, and in many cases it can only be considered on a case by case basis.
The Church teaches that life is sacred from conception to “natural death”.
So we are born, we live, we get a fatal disease and we die naturally. Case closed - But wait -
The Church says that we should not withhold medical treatment if a cure is available. This delays “natural death”.
The Church says we should not withhold feeding tubes. This delays “natural death”.
So, while the Church holds that life is sacred until “Natural Death” and death should not be ended prematurely (assisted suicide), The Church does support the interference with when “natural death” occurs.

I do not post the above to denounce Church teaching, only to note that there are many areas in this field of Teaching that are not so cut and dry as we would like.

My Father died of Alzheimers dementia. At the end he was at home under the care of my dear Mother and of Hospice. Eventually he could no longer swallow. The question of a feeding tube was naturally raised but was rejected because, 1) It would not prevent his brain from continuing to shut down, and 2) It would only prolong his suffering.
My dear mother Loved and Loves my Father with all her heart. They were married for almost 57 years at the time of his death. The decision was made from Love and no other motivation (such as cost). Every one of her 5 children approved of her decision.
My father was allowed to die naturally. It was terrible to watch for, all we could do to help was place bits of ice on his lips to help hydrate a little. He died after 7 days. I was there - My Mother was there - Christ was there.
My mother said, and I agree, that whatever his sins in life, he had done his purgatory on earth.

Now, in the next year or two I may face the same decision as my Dear Wife has this same horrible disease. I am glad for the teachings of the Church on these matters. I am even more glad for the totally Christian example of my parents, especially my mother, throughout their ordeal.
Each case is unique. We must properly form our conscience on Church teaching, but then we must make the best decsions we can in accord with that conscience.

Peace
James

 

[rwillenborg]

In any of this there is a slippery slope to be considered, and in many cases it can only be considered on a case by case basis.
The Church teaches that life is sacred from conception to “natural death”.
So we are born, we live, we get a fatal disease and we die naturally. Case closed - But wait -
The Church says that we should not withhold medical treatment if a cure is available. This delays “natural death”.
The Church says we should not withhold feeding tubes. This delays “natural death”.
So, while the Church holds that life is sacred until “Natural Death” and death should not be ended prematurely (assisted suicide), The Church does support the interference with when “natural death” occurs.

I do not post the above to denounce Church teaching, only to note that there are many areas in this field of Teaching that are not so cut and dry as we would like.

My Father died of Alzheimers dementia. At the end he was at home under the care of my dear Mother and of Hospice. Eventually he could no longer swallow. The question of a feeding tube was naturally raised but was rejected because, 1) It would not prevent his brain from continuing to shut down, and 2) It would only prolong his suffering.
My dear mother Loved and Loves my Father with all her heart. They were married for almost 57 years at the time of his death. The decision was made from Love and no other motivation (such as cost). Every one of her 5 children approved of her decision.
My father was allowed to die naturally. It was terrible to watch for, all we could do to help was place bits of ice on his lips to help hydrate a little. He died after 7 days. I was there - My Mother was there - Christ was there.
My mother said, and I agree, that whatever his sins in life, he had done his purgatory on earth.

Now, in the next year or two I may face the same decision as my Dear Wife has this same horrible disease. I am glad for the teachings of the Church on these matters. I am even more glad for the totally Christian example of my parents, especially my mother, throughout their ordeal.
Each case is unique. We must properly form our conscience on Church teaching, but then we must make the best decsions we can in accord with that conscience.

Peace
James

Oh James.
My other grandmother died of that horrible disease, too.
It’s such an incredibly painful thing for not only your loved one, but your whole family.
And yes, you are right. Our decisions, if they come from a place of love, and we have a properly formed conscience surely must be in accord with God’s will.
May God bless you and your wife.
I will be praying for you.

 

[JRKH]

Oh James.
My other grandmother died of that horrible disease, too.
It’s such an incredibly painful thing for not only your loved one, but your whole family.
And yes, you are right. Our decisions, if they come from a place of love, and we have a properly formed conscience surely must be in accord with God’s will.
May God bless you and your wife.
I will be praying for you.

Thank you.

In this I am reminded of Our Dear Lord and the “Two great commandments”.
Love God - and Love your neighbor as yourself.
I know that, for myself, I try to respect others wishes and hope that they will do the same for me. I do not wish to be kept alive any longer than is reasonable and necessary in these sorts of extrodinary circumstances. This is how I “love” myself.
I also know that my Dear Wife feels the same way. Thus, when the time cmes, I hope I will have the strength to let her go in mercy, to God.