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B
bekalc
Guest
I think they know this because of how patients with cancer who refuse feeding tubes respond to dehydration. Honestly, I really don’t know and I’m glad its not my call to make…This seems questionable.
M
mosher
Guest
This is of course silly. Experience does not change what is true. Rather experience can in many ways cloud our judgment because of our emotional involvement in the situation and if we find that we made the wrong choices then we will try to justify our actions by emphasizing that same decision to others. Experience does not give anyone a moral high-ground.I think that its a hard situation but until people have been through it they shouldn’t judge.
The question that would need to be asked in this case would be if the use of the feeding tube or the other procedures would have caused her to maintain the same level of medical health. If that would have been the case it was unethical for nutrition to be removed. Just as some cancers are terminal illnesses it does not mean that one can choose to not take nutrition because they will eventually die anyway. For basic nutrition to be removed ethically death must be immanent.Her nine children decided not to give her a feeding tube… Yes, there are surgeries that could be done to pro long Grandma’s life, but we don’t see the reason why it should be done. It’s merely prolonging the inevitable and its not something Grandma wants either.
Yes but as medical science develops the means to keep a person alive change. We cannot ignore legitimate medical advancement when factoring the morality of a bio-ethics situation.It use to be that in many ways this is how it would happen anyways. A patient would get very old and sick, and than the would refuse to eat/drink…
This has nothing to do with life itself. We do not define quality of life as a function of activity, worth, or comfort. Rather, quality of life is intrinsic to possession of life and is not modified by any other factor. Thus, the immoral termination of the life of another can not be justified on these points.Death by dehedraytion as actually pretty painless…It feels like this way is more natural than forcing Grandma to go through procedures to pro long her life, when she’s really unable to live her life anymore… Until her new illness she did talk a bit but would be catatonic for hours, now she’s at the point where she is no longer talking whatsover…
Most doctors do not know ethics. While clinically it may seem that this decision is correct it is not correct ethically which is superior to clinical judgment.I have done a lot of research on this subject in the last hour, and the more doctors study the issue of end stage dementia, more and more are recommending NOT giving these patients feeding tubes.
Comfort is not a factor in end of life issues. Comfort is not a factor in any kind of life issue. Celebrating the comfort (lack of physical suffering) of an individual is a subtle method of the Culture of Death as it plays on our emotions but it does not speak to our intellect.I think they know this because of how patients with cancer who refuse feeding tubes respond to dehydration. Honestly, I really don’t know and I’m glad its not my call to make…
M
Mommyof02green
Guest
I didn’t read all the posts. However, I wanted to give my 2 cents.
In 2001 my Dad, at the age of 49, had a heart attack and stroke that left him in comma-like state, until he passed away in 2004, at the age of 52.
First, if my Mom knew of my Dad “last will and testament”. She never would of agreed to the feeding tube and breathing machines. My Mom didn’t find Dad’s WILL until 2002 when she started to clean his office and back his clothing, it was clear by late 2002 that Dad was not coming home. It was when she read his Will in 2002 did she know that he did NOT want to be kept alive by extraordinary means. She would of let him go in 2001 if she knew that, she would of told the Drs. No that day. However she didn’t know, and she had hope that in a few days he would be healthier and would “wake-up” after all he was only 49.
You don’t have to have the stuff done! You don’t have to have feeding tubes put in and you don’t have to have breathing machines. You can say “NO” to the treatments. If you don’t want to be kept a live like that then you need to let your family members know. You need to make it clear to them that is your wish not to use extraordinary means. You also need to let them know what you mean by that. This is so they can tell the Drs “NO, I don’t want you to put a feeding to in him/her or hook them up to a breathing machine.”
However, if you say, “YES” to the treatments you cannot pull the plug later. Once you say “yes” then you have to keep on with the treatments.
My Dad did get healthy enough where he was taken off the breathing machines. (Meaning the machine no longer breathed for him) However he still had oxygen “blown”. This is because for the breathing machine, they had to go in trachea. So he need the oxygen “blown” to get air to breathed. The Drs tried closing the whole in is neck, but the years of cigarette smoking made it impossible. He had too much mucus drainage to close the wound (the hole in the neck).
Therefore he needed a machine to “blow” oxygen. It really was no different then people that you may see in the store that have oxygen tanks that ‘blow” oxygen in their nose. Those people are breathing on their own the “blown” oxygen just gives them better oxygen to breathe. That is what it was like for Dad, it just blown on his neck.
Seeing my Dad was in a coma-like state, he was put on a feed tube. The tube gave him food, seeing he could not feed himself. My Mom kept him on the feeding tube.
Now I mention, how she found his last will and testament in late 2002. Well, that was hard because she knew then this was not what he wanted. However, she could not stop the feedings. So she left it in God’s hands. A few months later she found out that the Dr’s and Nurses were changing the feeding tubes.
They change them regularly and put knew one in for hygiene reasons. She didn’t know this. She always thought it was the same tube. She also in 2002 had learned that my Dad’s body had also rejected the feeding tube twice, and the Dr’s had to put new one in.
Over time the body sometimes rejects the feeding tube and “blows it out”. My Mom learned that stuff in 2002. So my Mom took that information along with my Dad’s Will to her priest and had a talk with him.
The priest told her, that if the Drs/nurses were changing the tubes for hygiene reasons, that she had to let them change it and put a new one. He said it was like eating with a clean plate: you would want a clean plate to eat with.
However, if my Dad’s body NATURALLY rejected the feeding tube and “blows it out” then she does not have to let a new one be put back in. This is because my Mom had my Dad’s last will and testament: with the aid of the last will testament, my Mom could assume that my Dad was rejecting treatments when the body Naturally rejected the feed tube: My Dad still had the right to refuse treatment.
So in 2004 my Dad’s body once again naturally rejected the feeding tube and “blown it out”. So in 2004, my Mom did not have new tube put in and we let my Dad pass on. That’s just my 2 cents.
In 2001 my Dad, at the age of 49, had a heart attack and stroke that left him in comma-like state, until he passed away in 2004, at the age of 52.
First, if my Mom knew of my Dad “last will and testament”. She never would of agreed to the feeding tube and breathing machines. My Mom didn’t find Dad’s WILL until 2002 when she started to clean his office and back his clothing, it was clear by late 2002 that Dad was not coming home. It was when she read his Will in 2002 did she know that he did NOT want to be kept alive by extraordinary means. She would of let him go in 2001 if she knew that, she would of told the Drs. No that day. However she didn’t know, and she had hope that in a few days he would be healthier and would “wake-up” after all he was only 49.
You don’t have to have the stuff done! You don’t have to have feeding tubes put in and you don’t have to have breathing machines. You can say “NO” to the treatments. If you don’t want to be kept a live like that then you need to let your family members know. You need to make it clear to them that is your wish not to use extraordinary means. You also need to let them know what you mean by that. This is so they can tell the Drs “NO, I don’t want you to put a feeding to in him/her or hook them up to a breathing machine.”
However, if you say, “YES” to the treatments you cannot pull the plug later. Once you say “yes” then you have to keep on with the treatments.
My Dad did get healthy enough where he was taken off the breathing machines. (Meaning the machine no longer breathed for him) However he still had oxygen “blown”. This is because for the breathing machine, they had to go in trachea. So he need the oxygen “blown” to get air to breathed. The Drs tried closing the whole in is neck, but the years of cigarette smoking made it impossible. He had too much mucus drainage to close the wound (the hole in the neck).
Therefore he needed a machine to “blow” oxygen. It really was no different then people that you may see in the store that have oxygen tanks that ‘blow” oxygen in their nose. Those people are breathing on their own the “blown” oxygen just gives them better oxygen to breathe. That is what it was like for Dad, it just blown on his neck.
Seeing my Dad was in a coma-like state, he was put on a feed tube. The tube gave him food, seeing he could not feed himself. My Mom kept him on the feeding tube.
Now I mention, how she found his last will and testament in late 2002. Well, that was hard because she knew then this was not what he wanted. However, she could not stop the feedings. So she left it in God’s hands. A few months later she found out that the Dr’s and Nurses were changing the feeding tubes.
They change them regularly and put knew one in for hygiene reasons. She didn’t know this. She always thought it was the same tube. She also in 2002 had learned that my Dad’s body had also rejected the feeding tube twice, and the Dr’s had to put new one in.
Over time the body sometimes rejects the feeding tube and “blows it out”. My Mom learned that stuff in 2002. So my Mom took that information along with my Dad’s Will to her priest and had a talk with him.
The priest told her, that if the Drs/nurses were changing the tubes for hygiene reasons, that she had to let them change it and put a new one. He said it was like eating with a clean plate: you would want a clean plate to eat with.
However, if my Dad’s body NATURALLY rejected the feeding tube and “blows it out” then she does not have to let a new one be put back in. This is because my Mom had my Dad’s last will and testament: with the aid of the last will testament, my Mom could assume that my Dad was rejecting treatments when the body Naturally rejected the feed tube: My Dad still had the right to refuse treatment.
So in 2004 my Dad’s body once again naturally rejected the feeding tube and “blown it out”. So in 2004, my Mom did not have new tube put in and we let my Dad pass on. That’s just my 2 cents.
B
bekalc
Guest
Mosher the reason I said until your in that situation you don’t understand is because a lot of people don’t understand things like Alzheimers, they think its just “people forget things.”
I actually had a hard time when my family announced the situation. The only reason I’m getting okay with the situation is because of a talk with my Aunt from the different side of my family (not related)
My Aunt’s a nurse who works in xrays near the Er in the hospital, and she works with patients like my Grandmother all the time. Now, while my Aunt is a lapsed Catholic, she is very pro life was upset over Terri Schiavo is no for embroynic stem cells etc…
But what she told me about my Grandmother’s case is that eventually it gets to the point where the situation deterioates to a great deal…Because they aren’t eating right, not moving, and their brain isn’t working. Plus, they can’t control their bladder they get terrible, terrible infections, infections that eventually do kill them. (not to mention their inability to move, talk etc) She said to me 100 years ago there was no feeding tube, and what happened was these people in those situations eventually died. She said that’s the natural course in those types of diseases, and just because we have the means of stopping that natural course doesn’t mean that we should stop it. Especially when the only thing we know for sure is there will be more infections etc… She said that of course you always err on the side of giving people feeding tubes, but in some cases its only right to let nature take its course.
In my Grandma’s situation this isn’t about Grandma can’t remember us so let’s get rid of her. My Grandma couldn’t remember most of us for years now…And has had a 24/7 caretaker for years…Who hand fed her took care of her etc… While Grandma didn’t remember us she could still smile, and I knew she was praying 24/7 so her life had meaning.
The issue is that two weeks ago my Grandmother had a terrible urinary tract infection, and the doctors told my Aunt that there was nothing more really they could do. They could give my Grandma all these surgeries that would pro long her life (possibly) but well her condition would still deteriate. Then, my Grandma refused to be handfed…And my family just felt like it was a sign that she no longer has the will to fight this infection…She’s 93 years old and we know four years ago she had talked about how all she wants now is to be with Jesus…
We just don’t want to fight my Grandmother, if she would take food by hand, we would give it to her. But to say that we are morally obligated in this situation to have her force fed isn’t right. Medicine was made for man, not man for medicine. We don’t want her surrounded by tubes and things…
I actually had a hard time when my family announced the situation. The only reason I’m getting okay with the situation is because of a talk with my Aunt from the different side of my family (not related)
My Aunt’s a nurse who works in xrays near the Er in the hospital, and she works with patients like my Grandmother all the time. Now, while my Aunt is a lapsed Catholic, she is very pro life was upset over Terri Schiavo is no for embroynic stem cells etc…
But what she told me about my Grandmother’s case is that eventually it gets to the point where the situation deterioates to a great deal…Because they aren’t eating right, not moving, and their brain isn’t working. Plus, they can’t control their bladder they get terrible, terrible infections, infections that eventually do kill them. (not to mention their inability to move, talk etc) She said to me 100 years ago there was no feeding tube, and what happened was these people in those situations eventually died. She said that’s the natural course in those types of diseases, and just because we have the means of stopping that natural course doesn’t mean that we should stop it. Especially when the only thing we know for sure is there will be more infections etc… She said that of course you always err on the side of giving people feeding tubes, but in some cases its only right to let nature take its course.
In my Grandma’s situation this isn’t about Grandma can’t remember us so let’s get rid of her. My Grandma couldn’t remember most of us for years now…And has had a 24/7 caretaker for years…Who hand fed her took care of her etc… While Grandma didn’t remember us she could still smile, and I knew she was praying 24/7 so her life had meaning.
The issue is that two weeks ago my Grandmother had a terrible urinary tract infection, and the doctors told my Aunt that there was nothing more really they could do. They could give my Grandma all these surgeries that would pro long her life (possibly) but well her condition would still deteriate. Then, my Grandma refused to be handfed…And my family just felt like it was a sign that she no longer has the will to fight this infection…She’s 93 years old and we know four years ago she had talked about how all she wants now is to be with Jesus…
We just don’t want to fight my Grandmother, if she would take food by hand, we would give it to her. But to say that we are morally obligated in this situation to have her force fed isn’t right. Medicine was made for man, not man for medicine. We don’t want her surrounded by tubes and things…
G
gardenswithkids
Guest
I agree that experience doesn’t change truth, but some may experience situations where two things we think “true” appear to conflict. Take the example of an elderly woman offered food who refuses it. Must the next step be a feeding tube, or is it acceptable to have the food available and allow her to refuse eating? We can “fast” if we want to, so can she?Experience does not change what is true. Rather experience can in many ways cloud our judgment because of our emotional involvement in the situation …
The question that would need to be asked in this case would be if the use of the feeding tube or the other procedures would have caused her to maintain the same level of medical health.
Now, if she’s just not eating because she chokes on her food, then a feeding tube seems appropriate. But sometimes confused people pull out their feeding tube. If she pulls out the feeding tube, should we replace it? Does she have the “right” to refuse nutrition or do we have the obligation to feed her regardless? Sometimes patients are sedated or restrained to prevent them from pulling out their own tubes. This might be appropriate in some situations, but is it required?
If anyone has a link to the actual Vatican document, I’d appreciate it. Does it say that? And back to our elderly lady, how close would she have to be to death? I believe we should provide nutrition, but I am left wondering how that applies if they refuse the nutrition and hydration that is offered.For basic nutrition to be removed ethically death must be immanent.
Z
Zooey
Guest
Been there, done that…This is the way it is.Anyone been on a respirator? I’ll volunteer my experience.
You have a tube down yr throat. You feel like you are choking to death. Every fiber of your being wants to pull that damn thing out. Your hands are tied to the bed. You can’t talk. You’re panicking. And you think you are dying. And it doesn’t stop. Not as long as you have a respirator in you.
Now, I am very grateful that the respirator was there for me, until I was better. But it was hellishly uncomfortable, & there is no way around that…
Not in my experience…(See above). And I was on **all kinds **of medication. (I was recovering from open heart surgey).As one who has inserted endotracheal tubes and managed ventilators for a living, I can tell you that your case was not handled very well if you were in that much discomfort over a period of time.
Being on a ventilator is very unpleasant but with proper medication and setting management it can be made semi-tolerable.
I still tell people, that once I decided that it was better to live than to die, I knew I was getting better. But I never felt that way until after I improved enough for the tube/ventilater stuff to be taken away.
I really did think I was dying. Not from the surgery, not even from the heart failure that put me in hospital. I felt I was dying from that bloody respirator.
A
a_priori
Guest
I understand what you are saying. Being on a vent is not a fun thing under any circumstances. My point is that there is a wide range of patient experiences that are based on how well the staff does their job. A properly managed patient, all things being equal, will have a better experience. There is no way to make it a happy experience.Been there, done that…This is the way it is.
Now, I am very grateful that the respirator was there for me, until I was better. But it was hellishly uncomfortable, & there is no way around that…
Not in my experience…(See above). And I was on **all kinds **of medication. (I was recovering from open heart surgey).
I still tell people, that once I decided that it was better to live than to die, I knew I was getting better. But I never felt that way until after I improved enough for the tube/ventilater stuff to be taken away.
I really did think I was dying. Not from the surgery, not even from the heart failure that put me in hospital. I felt I was dying from that bloody respirator.
Some people with COPD actually WANT to go on a ventilator. Anyway, I’m glad you are here to talk about it. Hopefully there are no vents in your future.
B
bekalc
Guest
It’s funny because today I actually did express some of my concerns about my Grandma’s situation to my father…Seeing my Grandmother today nearly broke my heart. And I’m concerned about how long she’s been going without food and water… So I mentioned to my Dad if this was really the right thing, feeding tube etc…
Dad sounded pretty sure and convinced in himself that it was right, and its his mom…But at least I let my Father know I was conflicted about this…One of the things Dad told me that I didn’t like was the whole vegative state thing.
But one of the things he told me that did make sense, was the fact that a feeding tube could get infected, is uncomfortable, etc… About the burdens that could come with it for my Grandmother. And there is the fact of my Aunt who talked about how these types of patients get so many infections and are clearly in so much pain…My Dad said just because you can intervene in a situation doesn’t mean you always should…
I still hate this situation though.
Dad sounded pretty sure and convinced in himself that it was right, and its his mom…But at least I let my Father know I was conflicted about this…One of the things Dad told me that I didn’t like was the whole vegative state thing.
But one of the things he told me that did make sense, was the fact that a feeding tube could get infected, is uncomfortable, etc… About the burdens that could come with it for my Grandmother. And there is the fact of my Aunt who talked about how these types of patients get so many infections and are clearly in so much pain…My Dad said just because you can intervene in a situation doesn’t mean you always should…
I still hate this situation though.
M
mosher
Guest
When we perceive two apparent goods we must take great care to discern what is the greater good. In such a situation there is always an option that is more correct. At times it is hard to see but if we take the time to educate ourselves on these issues they do become clearer.I agree that experience doesn’t change truth, but some may experience situations where two things we think “true” appear to conflict. Take the example of an elderly woman offered food who refuses it. Must the next step be a feeding tube, or is it acceptable to have the food available and allow her to refuse eating? We can “fast” if we want to, so can she?
Now, if she’s just not eating because she chokes on her food, then a feeding tube seems appropriate. But sometimes confused people pull out their feeding tube. If she pulls out the feeding tube, should we replace it? Does she have the “right” to refuse nutrition or do we have the obligation to feed her regardless? Sometimes patients are sedated or restrained to prevent them from pulling out their own tubes. This might be appropriate in some situations, but is it required?
If anyone has a link to the actual Vatican document, I’d appreciate it. Does it say that? And back to our elderly lady, how close would she have to be to death? I believe we should provide nutrition, but I am left wondering how that applies if they refuse the nutrition and hydration that is offered.
Concerning your example one would have to determine why she would not be taking the food. If it is out of some form of despair or desire to die then that is not a good. Also, in a medically grave situation fasting is not a virtue. So, there could be a case when force feeding is a licit practice. Many will not like this response because it seems to smack in the face of our over-emphasized sense of personal freedom in the western world but just as a parent must at times force their child to do things it is also necessary to force a person who is under our care to do things that are correct over that which they may desire.
As far as a church document I don’t think that you can find something that is specific. However, the best source that I am aware of on all bio-ethic issues is the book that I have often cited here called “Catholic Bioethics and the gift of human life” by William May.
G
gardenswithkids
Guest
Bekalc, our prayers are with you and your grandmother.
While trying to find the specific comments John Paul II made about tube feedings, I found an old USA Today article from 2005 which said:
Thank you for your response. We are in times when what was once considered extraoridinary care may now be fairly routine, such a feeding tubes. It was only about two years ago that Pope John Paul II made a comment about feeding tubes not being extraordinary. His comments cause some Catholics educated on bio-ethics to re-think their previous position. Prior to his comments a couple years ago, many regarded feeding tubes as aggressive care.When we perceive two apparent goods we must take great care to discern what is the greater good. In such a situation there is always an option that is more correct. At times it is hard to see but if we take the time to educate ourselves on these issues they do become clearer.
…As far as a church document I don’t think that you can find something that is specific. …
While trying to find the specific comments John Paul II made about tube feedings, I found an old USA Today article from 2005 which said:
A 1980 Vatican document makes the distinction between “proportionate” and “disproportionate” means of prolonging life. While it gives room for refusal of some forms of aggressive medical intervention for terminally ill patients, it insists that “normal care” must not be interrupted.
John Paul set down exactly what that meant in a speech last year to an international conference on treatments for patients in a so-called persistent vegetative state.
“I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory.”
From: http://www.usatoday.com/news/world/2005-03-31-pope_x.htm
B
bekalc
Guest
Yes, but the vatican document DOES mention how at times the burdens of using the feeding tube can outweigh the benefits.
For example, after hearing more about this situation with my family. I found out that one reason my Grandmother doesn’t have a feeding tube is because my Aunt was against it. Her husband recently died (three months ago) of cancer, and he had a feeding tube inserted into his stomach. The feeding tube gave him a bunch of infections, and my Aunt didn’t want my Grandmother going through that, especially since my Grandmother’s condition is prone to infections.
For example, after hearing more about this situation with my family. I found out that one reason my Grandmother doesn’t have a feeding tube is because my Aunt was against it. Her husband recently died (three months ago) of cancer, and he had a feeding tube inserted into his stomach. The feeding tube gave him a bunch of infections, and my Aunt didn’t want my Grandmother going through that, especially since my Grandmother’s condition is prone to infections.
B
bekalc
Guest
In fact while the Late Pope JPII did have a feeding tube, he did not have a permanent feeding tube…
M
mosher
Guest
You are correct. In such circumstances we leave the judgment up to the doctor. What I mean by this is that the doctor is the competent authority concerning what are viable options that will provide success in treating a patient. However, we must guard against any suggestion that the doctor provides that is immoral. So, in a sense it has to be a dialog between the medical expert and the well formed Catholic.Yes, but the vatican document DOES mention how at times the burdens of using the feeding tube can outweigh the benefits.
For example, after hearing more about this situation with my family. I found out that one reason my Grandmother doesn’t have a feeding tube is because my Aunt was against it. Her husband recently died (three months ago) of cancer, and he had a feeding tube inserted into his stomach. The feeding tube gave him a bunch of infections, and my Aunt didn’t want my Grandmother going through that, especially since my Grandmother’s condition is prone to infections.
F
fix
Guest
In the case where one reasons a feeding tube is burdensome, as in may cause chronic infections, is it just to withhold the tube even if the proximate cause of death would be starvation?You are correct. In such circumstances we leave the judgment up to the doctor. What I mean by this is that the doctor is the competent authority concerning what are viable options that will provide success in treating a patient. However, we must guard against any suggestion that the doctor provides that is immoral. So, in a sense it has to be a dialog between the medical expert and the well formed Catholic.
Or, what of demented patients who chronically pull out tubes and they cannot be managed with sedation? Can the cause of death ever be from direct starvation and dehydration and be licit?
G
gardenswithkids
Guest
Here are two links that some of you might be interested in.
One is to the Church Document, Evangelium Vitae. The other is the address of John Paul II On Life Sustaining Treatments given at a conference on Persistent Vegetative States.
http://www.vatican.va/edocs/ENG0141/__PR.HTM
One is to the Church Document, Evangelium Vitae. The other is the address of John Paul II On Life Sustaining Treatments given at a conference on Persistent Vegetative States.
http://www.vatican.va/edocs/ENG0141/__PR.HTM
http://www.priestsforlife.org/magisterium/papal/04-03-20vegetativestate.htmFrom Evangelium Vitae (a magesterial document from the Church)
- …Euthanasia in the strict sense is understood to be an action or omission which of itself and by intention causes death…Euthanasia must be distinguished from the decision to forego so-called “aggressive medical treatment”, in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience “refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted”.77 Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death.
From a speech John Paul II gave March 20, 2004 at a conference on persistent vegetative states.
I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.
…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….6. However, it is not enough to reaffirm the general principle according to which the value of a man’s life cannot be made subordinate to any judgment of its quality expressed by other men; it is necessary to promote the taking of positive actions as a stand against pressures to withdraw hydration and nutrition as a way to put an end to the lives of these patients.
M
mosher
Guest
No, it cannot be the intended cause of death. We can never directly intend an evil. If death results unexpectedly from dehydration or starvation then the person who ordered the removal of nutrition is not morally culpable for the persons death under the principle of double effect. This is even if it is known that there will be a high probability of the person dying from a lack of nutrition. However the probability cannot be proportionately higher than death from another terminal cause.In the case where one reasons a feeding tube is burdensome, as in may cause chronic infections, is it just to withhold the tube even if the proximate cause of death would be starvation?
Or, what of demented patients who chronically pull out tubes and they cannot be managed with sedation? Can the cause of death ever be from direct starvation and dehydration and be licit?
What we must keep in mind when doing bioethics is that the distinction between ordinary and extraordinary means is a sliding scale that changes as medical science progresses. The easier and less troubling and more effective a treatment is the closer it moves to being considered ordinary means. A perfect example of this would be chemotherapy. Some forms of this are considered ordinary means while others are extraordinary. As such treatments are perfected then it becomes ordinary. Even so recent as 20 years ago one would have been able to make the case that all forms of “chemo” were extraordinary means where that cannot be the claim today. This is why it is so important to get the principles down so that the principles can be applied to the treatment and situation.
F
fix
Guest
So, practically speaking many such cases would be where the illness is likely to cause death rather soon? It would seem this is similiar to increasing narcotic dose knowing respiration will eventually stop when trying to decrease pain?No, it cannot be the intended cause of death. We can never directly intend an evil. If death results unexpectedly from dehydration or starvation then the person who ordered the removal of nutrition is not morally culpable for the persons death under the principle of double effect. This is even if it is known that there will be a high probability of the person dying from a lack of nutrition. However the probability cannot be proportionately higher than death from another terminal cause.
M
mosher
Guest
Yes, except in the case you cite death cannot take place as a result of the increase of narcotic medication. If it gets to a point where a person will either die from the medication or die naturally but with pain then we must allow them to die with pain because we cannot directly intend their death.So, practically speaking many such cases would be where the illness is likely to cause death rather soon? It would seem this is similiar to increasing narcotic dose knowing respiration will eventually stop when trying to decrease pain?
F
fix
Guest
OK, so when I read that folks say if they get in a situation when they are very ill and they have an advanced directive that declares they want to refuse feeding tubes we can conclude such a sweeping statement is morally wrong unless they carefully qualify it?Yes, except in the case you cite death cannot take place as a result of the increase of narcotic medication. If it gets to a point where a person will either die from the medication or die naturally but with pain then we must allow them to die with pain because we cannot directly intend their death.
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