Life Support Question

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Marc_Anthony

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Here’s a morals question:

My grandfather died earlier this year. He choked on a carrot. He was alive when he got to the ER but had no brain activity. Three days later my family decided to take him off of life support. He was dead within hours, having stopped breathing soon after the respirator was removed, and happily after receiving Annointing of the Sick.

So, my question: If my grandfather had kept breathing after the respirator had been removed, would we have been obligated to keep him nourished? A feeding tube would have had to been placed in his throat, and we would have had to pay for him to live in a home. I have no idea how we would have gotten the money.

More background: We had no discussions specifically, but my family was universally sure that he would not have wanted to live in a home, nor would he want to live in an extreme vegetative state with no hope of recovery.

So if he had kept breathing with the ventilator removed, would we have been morally obligated to do our absolute utmost to keep him provided with hydration and nutrition? What is Church teaching on this issue? I know food and water generally falls under normative care, but I’ve also heard there’s a tiny bit of wriggle room there too.

I’m not sure.

I’m not sure.
 
There is no perfect yes or no answer to that senario. There are other issues involved with in making those decisions. It’s impossible to answer you because (my condolences) your grandfather passed away after he was removed from life support.
 
In short, yes, there is an obligation to provide basic hydration and nutrition.

Here is a quote that, although not an official Church document, states the issue quite clearly:

“The sick person in a vegetative state, awaiting recovery or a natural end, still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention of complications related to his confinement to bed . . . Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission.” – Pope John Paul II, 2004

Catholic bioethics has established the principle that we do not need to pursue extraordinary measures in the care and treatment of terminal illnesses, but basic hydration and nutrition are never considered extraordinary. By contrast, turning off a ventilator for a vegetative patient is generally considered OK.
 
Thank you for the condolences Rence. 🙂

underacloud, are there any stipulations depending on circumstance? And to what extent would we be obliged to weaken ourselves financially?

I’m assuming here he’d be completely “brain dead” except for the fact that he’d be on a feeding tube.
 
Having wrote multiple essays and done a presentation on this I forget the latin phrase but the ideas is to do what is ordinary (as oppose to extra-ordinary) and humane. The idea is to apply these two things, and yes I do believe financial aspects do come into consideration under what is ordinary and also is what you are doing humane and respectful of the human person.
 
Marc_Anthony said:
underacloud, are there any stipulations depending on circumstance? And to what extent would we be obliged to weaken ourselves financially?

I’m assuming here he’d be completely “brain dead” except for the fact that he’d be on a feeding tube.
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I’m certainly no expert on bioethics, but I don’t know of any stipulations. Moreover, keep in mind that the Church considers suffering to have real spiritual value and that even the elderly who suffer while awaiting death should not be deprived of this portion of their life.

Also, one cannot be completely brain dead yet breathing of their own accord, since the brain controls breathing and heartbeat. The upper cortex…responsible for concious thought…may be no longer functioning, if that’s what you mean by brain dead. Of course, this is perhaps a matter of semantics only. Or perhaps not…? The Church deals with matters or morality and faith, not science, so some of these issues are not fully resolved.
 
Marc_Anthony said:
Thank you for the condolences Rence. 🙂

underacloud, are there any stipulations depending on circumstance? And to what extent would we be obliged to weaken ourselves financially?

I’m assuming here he’d be completely “brain dead” except for the fact that he’d be on a feeding tube.
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I’m sorry about your grandfather, that’s a tragic way to die. 😦

If he was really “brain dead”, hydration and feeding tubes wouldn’t do much good. Even on full life support a truly brain dead person doesn’t last very long, and its usually not very pleasant.

A ventalator or other mechanical means of keeping life ticking over when there is significant brain damage or death I think comes under the extraodinary means, and they’re not required.

A feeding tube and hydration aren’t extra-ordarinary methods and should be imployed if there is some hope of recovery, and even if there isn’t, its not right to have someone die of dehyrdation. In the final stages of death the body can’t really take food or fluids, and it actually causes more problems due to parts of the body shutting down and being unable to process it.
 
vera_dicere said:
A feeding tube and hydration aren’t extra-ordarinary methods and should be imployed if there is some hope of recovery, and even if there isn’t, its not right to have someone die of dehyrdation. In the final stages of death the body can’t really take food or fluids, and it actually causes more problems due to parts of the body shutting down and being unable to process it.
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Thank you very much for the condolences vera, I really appreciate them. :o

So I’m half making up this case and half going by what the Doctors said, but say he went off the ventilator, could breathe, but had zero hope of recovery, no reaction to the world whatsoever, and could only be kept alive through feeding tubes. Do you think that at one point relatively soon after putting in the feeding tubes it would be worse to give him food and water?

The problem here is that if not we would be making a huge financial sacrifice, like a really life-effecting one.
 
Those who have stated that feeding and hydration are not necessary are mistaken. The Church’s position on this is firm. Feeding and hydration are ordinary means and therefore must always be employed.

Have we so quickly forgotten Terri Schiavo, starved to death by her “husband”?
 
Marc_Anthony said:
Thank you very much for the condolences vera, I really appreciate them. :o

So I’m half making up this case and half going by what the Doctors said, but say he went off the ventilator, could breathe, but had zero hope of recovery, no reaction to the world whatsoever, and could only be kept alive through feeding tubes. **Do you think that at one point relatively soon after putting in the feeding tubes it would be worse to give him food and water?
**
The problem here is that if not we would be making a huge financial sacrifice, like a really life-effecting one.
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What happened with my mother was that her feeding tube draw was never empty. 🤷

Basically, when you use a feeding tube, before you start a feeding, you make sure their stomach is empty (or only has gastric juices). Otherwise you can feed a person to beyond full. You do this by drawing up on the feeding tube. As my mother was closer to death, her stomach wasn’t as empty. She stopped saying she was hungry/thirsty. The same thing happened with my father, although he didn’t have a tube, he just wasn’t interested in food or drink. As you die, your body shuts down.

For us, the signs of death were pretty obvious.
 
1ke said:
Those who have stated that feeding and hydration are not necessary are mistaken. The Church’s position on this is firm. Feeding and hydration are ordinary means and therefore must always be employed.

Have we so quickly forgotten Terri Schiavo, starved to death by her “husband”?
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Well to be fair there were two other HUGE problems with her case.
  1. The excuse for removing the feeding tubes was her husband’s hearsay, which was CONTRADICTED by the parents!
  2. She wasn’t COMPLETELY unresponsive.
IMO these were at least as important. 🤷
 
1ke said:
Those who have stated that feeding and hydration are not necessary are mistaken. The Church’s position on this is firm. Feeding and
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I accept this, but it’s unfortunate that I would have had to oppose my entire family on the issue, including my Mother and Grandmother. 😦

That would have caused some rift…

In a way I guess we got lucky.
 
Marc_Anthony said:
…The problem here is that if not we would be making a huge financial sacrifice, like a really life-effecting one.
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Is a human life more important that financial stability? If you were a parent would you kill your child if the cost of living were to imply bankruptcy? Are we justified to do evil (killing someone) to achieve some good (financial stability)? Circumstances (e.g. financial convenience) does not take away the immorality from behaviors when the act is intrinsically evil.
 
The medical/financial situation in America is NOT yet so screwed up that you or your parents would be on the hook to pay for your grandfather’s care. Yes, he’d be required to spend basically all his OWN money before Medicare would take over. But after that, it’s Medicare unless your family opts for more care than Medicare provides.

You may have had to take Grandma in, yes. Spend any inheritance, yes. Go broke yourself, no.

Feeding tubes are NOT that expensive until/unless there are complications. If there are complications that would require extraordinary actions to alleviate and there appears to be no real chance of recovery for him then it may not be immoral to simply allow the impending death to proceed without any heroic attempts to correct it.

Feeding CAN be witheld when the tube itself causes the patient more suffering than benefit and death is imminent and likely to occur from a cause that is NOT starvation/dehydration.

I’m sorry for your loss. Please be assured that catholic teaching never intends to unnecessarily prolong suffering. We just can’t commit evil for supposedly good intentions. Starving/dehydrating ANYone to death simply can’t ever be a good thing.
 
To all of you: I am trying to follow the teachings of the Church here. Please don’t make comparisons about how I’d let my child die for financial reasons, I find it insulting. I’m not making an argument here, I’m trying to understand and it’s hard for me to distance myself emotionally.

Of course I’ve pointed out several times myself that you need to separate emotions from logic and I AM trying to do that but can you please be considerate? Thank you.
 
maryjk said:
What happened with my mother was that her feeding tube draw was never empty. 🤷

Basically, when you use a feeding tube, before you start a feeding, you make sure their stomach is empty (or only has gastric juices). Otherwise you can feed a person to beyond full. You do this by drawing up on the feeding tube. As my mother was closer to death, her stomach wasn’t as empty. She stopped saying she was hungry/thirsty. The same thing happened with my father, although he didn’t have a tube, he just wasn’t interested in food or drink. As you die, your body shuts down.

For us, the signs of death were pretty obvious.
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People get very emotional over these issues and don’t always understand the medicine behind all this. I’ve already seen a few families insist on feeding tubes for people who have (predictably) had to had their feedings turned off from third spacing with horrible edema and /or their lungs filling up with fluids. The latest one happened this week where this poor old lady, whose family kept ignoring her protests, had a nasogastric tube put in…we had to turn it off because she bloated so bad and got such bad diarrhea that it escorated her poor little bottom and perineal area, then as soon as the bloating went down and the diarrhea stopped, the family insisted we turn it back on again. So the lady pulled it out. So the family insisted on a peg placement…so here she goes to surgery to have this hole in her stomach…which the lady pulled out. I mean, come on, what more are they going to do to that poor lady? Today, she is tube feeding free and resting peacfully. I wish they would stop messing with her. 😦
 
Rence said:
People get very emotional over these issues and don’t always understand the medicine behind all this. I’ve already seen a few families insist on feeding tubes for people who have (predictably) had to had their feedings turned off from third spacing with horrible edema and /or their lungs filling up with fluids. The latest one happened this week where this poor old lady, whose family kept ignoring her protests, had a nasogastric tube put in…we had to turn it off because she bloated so bad and got such bad diarrhea that it escorated her poor little bottom and perineal area, then as soon as the bloating went down and the diarrhea stopped, the family insisted we turn it back on again. So the lady pulled it out. So the family insisted on a peg placement…so here she goes to surgery to have this hole in her stomach…which the lady pulled out. I mean, come on, what more are they going to do to that poor lady? Today, she is tube feeding free and resting peacefully. I wish they would stop messing with her. 😦
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I went through it twice last year. First my mom then my dad. Family members need to take a step back and try to look at the situation calmly. Its hard. 😦

Mom had a feeding tube for a while. It worked. Until the cancer took over and shut down her systems. When that happened, we stopped the feedings. That happened about 24 hours before she died.

Dad went downhill while still able to swallow, which Mom couldn’t do. But he stopped eating because his body no longer needed nourishment. That happened about 12 hours before he died.
 
My (87 yo) mom has been bleeding for two months. They just keep watching her hemoglobin level, to see when they have to give her some blood.

But, the doctors refuse to do anything like a colonoscopy on her to find the bleeding, which they consider too risky for her. Also, they argue that if they find the bleeding, the surgery is too risky, so what’s the point of scoping her?

I haven’t read the documents, but this seems much like when John Paul II went to the hospital the last time, and then left because the doctors said there wasn’t anything more they could do. so, he left to die in the papal apartments.

That’s the equivalent of “where” my mother is now: declining, bleeding now in the third month.

With a hemoglobin level of 8.4, NATURALLY she doesn’t want to go to physical therapy, eat a lot, etc. She has some dementia (forgetting) but “she” is still there.

If I find a doctor to do the testing, there are still the risks ahead with treating the bleeding.

I don’t know how hard to push this.
 
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