Tube feeding

As a nurse, I've seen the order for tube feeding to be correctly utilized and well indicated and I've also seen it to be a device that supports an inevitably failing body and it becomes a device that can ultimately extend suffering. For example, research supports that if you put a sick person on a ventilator for a foreseeably self-limited problem, utilizing tube feeding will actually promote getting them well from their infection (or whatever put them on the vent) and will give them the energy to take over the work of breathing from the ventilator.

However, when the illness is not foreseeably self-limited and even more predictably relentlessly evolving and disabling, the tube feeding has no capacity to undo that underlying truth and then, all too often can all too often only serve to prolong suffering without any real hope of improvement.

Never more than when I am reading about the churches traditional stance on medical intervention at the end of life do I glimpse the kind wisdom of our preceeding church fathers. This article, dating back from the destructive Terri Schiavo event, well states what I was taught as a nursing student to be the church's stance:

http://www.msnbc.msn.com/id/7276850/site/newsweek/

Until we grasp the finiteness of our ability to provide health care will we be able to come to grips with the FACT that we are talking about the utilizaiton of a highly limited resource that really, ALL people are entitled to _in some measure_. How do we divvy that up? How do we best utilize it? It really isn't a discussion about how much of the maximum must we provide for dying people. It is much larger.

Dying people, sick people need _care_ and love and support. We've equated unlimited medical care with unlimited love but it is truly a false analogy.

People of faith should understand this.

My mother and father, who came from a more simple time would talk about people who were suffering and they would use terms like "bearing their cross". Before high tech medicine there was a much better confrontation of the idea that not all suffering can be eliminated. Some must be borne.

For a twist on the discussion of end of life issues, try this article on Perinatal Hospices, hospices created to meet the needs of families giving birth to infants with "fatal" genetic errors and anomalies:

http://www.nytimes.com/2007/03/13/health/13hospice.html

I think this was assigned by the moderators to the wrong topic. I'm reposting to get it here.

God Bless our Holy Father Pope Benedict XVI.

Vatican’s 1980 Declaration on Euthanasia. According to the declaration, euthanasia is ‘an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated. Euthanasia’s terms of reference, therefore, are to be found in the intention of the will and in the methods used.’

The obligation to provide the ‘normal care due to the sick in such cases’ (Congregation for the Doctrine of the Faith, ‘Iura et Bona,’ p. IV) includes, the use of nutrition and hydration… 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

In the Encyclical Evangelium Vitae, "by euthanasia in the true and proper sense must be understood an action or omission which by its very nature and intention brings about death, with the purpose of eliminating all pain"; such an act is always "a serious violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person" (n. 65).”

Peace and Good,
Your Brother in Christ (Franciscan Tertiary of Mary, Mother of the Most Blessed Sacrament)

I think it was John Paul II that made the point that food and water should not be considered optional as long as the person is able to gain benefit from them. Specifically, the intent should never be to cause death.

CCC# 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.”

God Bless our Holy Father Pope Benedict XVI.
Peace and Good,
Your Brother in Christ (Franciscan Tertiary of Mary, Mother of the Most Blessed Sacrament)

A young friend of mine came from a family afflicted by Huntingtons, which usually develops very slowly. She was fatherless, and her grandfather had died of the disease in his fifties. Her mother died at age 36 when C was 12. By the time C was 20 she was "unwell," and the doc suggested ME. Anyway, she couldn't continue her degree course and languished at home for some 5 years before Huntingtons was diagnosed. In the following years she watched two uncles die, one after 25 years illness, the other had the disease but had the good fortune to have a heart attack after 20 years. C herself was in the care of her grandmother - 50 years her senior!

Eventually she went into residential care where she continued to be visited by her friends. She refused medication which might have impaired her mental acuity. She gradually weakened and the time came when she could not feed by mouth. She opted for a tube in the stomach - she thought this was the right thing to do. So she eked out her days in bed, unable to do much at all once she could no longer stuff envelopes for her political party. She received a tiny morsel of the host on her tongue, and gradually she lost the power of intelligible speech. Even those who had known her since childhood and visited 5 or more times a week could not make out what she was saying. After some years of this she managed to get advice from her confessor; was she obliged to continure with the feeding tube? He said no, not if she did not wish to and realised the result of deciding to stop. She opted to stop, took three weeks to die but eventually died peacefully and gratefully aged 38. She was fully sane and entrusting herself to God to whom she'd always belonged. We, her relations and friends, could not feel sorrow. More than two hundred people of all ages attended her requiem, including her grandmother who had buried husband, daughter, two sons and a granddaughter, as well as sundry in-laws, all dying from this ghastly disease.

Luckily for C her confessor wasn't one to stick by the letter of the law.

Sorry for the length of this post, but the topic just brings her back so vividly.
Englishwoman

I'm told that 30% of medicare cost are incurred in a the last WEEK of life.
How crazy is that?

Love, John

See my website: Sacred Quest at www.torchlake.com/poetman

Bless you Poetman, Frannie and Col,

And Thank You.

I cared for my Aunt the last two years of her life. When she had a serious stroke. She refused the Tubes. She came home and had me put her bed in the living room and for ten days in the company of her extended family and many visitors, made her strong and heroic exit from our world. Always determine and very willful. She made her exit as she lived her life. With a marked determination, she taught us a wonderful lesson of will power. She lived and died behind her decisions. She was forever a woman of impeccable integrity. And she demanded the same from those around her. She would sidestep no issue and met everything head-on.

May God bless her and all of our departed until that time when we may rejoice together again. Amen.

The more we discover how much we are Loved by God, the more we want to do God's Will

Both my parents died in Catholic institutions (one hospital, one hospice) and neither had a feeding tube. Prolonging their agony would have been unconscionable.

Thanks for this thread poetman. I personally think these end of life issues deserve all the debate the beginning of life issues recieve. And it seems to me the idea of 'quality of life' has had no place in most theological or moral discussions on either end of the life spectrum, and I wonder why that is, because 'quality of life' is certainly debated in other medical situations.

I too wonder if the Church will continue this somewhat absolutist stand when technology is capable of keeping us 'alive' forever. When does intervening on the side of life cross the boundary and become prevention from eternal life with Jesus?