Feeding Tubes: Techniques, Problems and Solutions
The problem of maintaining the life of severely ill patients has been a highly controversial topic for a long time. However, decisions related to this issue always depend on circumstances. In this case, an elderly woman is in a coma. Although there are good chances that she will regain consciousness and restore health, it might take years. Her son has to decide whether to keep feeding tubes in or not. The issue related to the insertion of feeding tubes is very complicated. Many clinicians insist on using feeding tubes, disregarding possible drawbacks of this procedure. On the other hand, various specialists argue against the necessity of this measure. Nonetheless, not only an application of this method is consistent with the principles of morality but feeding tubes are also necessary for severely ill patients (Korcz). In my opinion, the son should insist on keeping feeding tubes because these medical devices allow life to be prolonged, this method does not cause severe permanent effects as it is a very convenient feeding option, and the rejection of this method, in this case, is considered to be euthanasia, thus it is morally wrong and illegal in most societies.
Reasons against Keeping the Feeding Tubes
There are several objective reasons why the son should stop enteral nutrition (EN). Many clinicians emphasize the drawbacks of inserting feeding tubes. The first reason is that this approach causes physical discomfort and pain. Also, the body needs to adapt to liquid food. The second reason is that regarding the weak and vulnerable condition of the patient, the insertion of a feeding tube increases the risk of serious inflammation and infestation. Finally, it might lead to overflow as the stomach sends signals to the brain when the body requires food or water, and there is not such a connection between the stomach and a feeding tube (Imperato and Danowski). Some clinicians state that patients in a coma might feel pain. Therefore, these arguments support the opinion that the son should refuse the application of feeding tubes as his mother might experience pointless sufferings caused by this procedure. However, most studies prove that comatose patients do not react on any external interventions. Also, feeding tubes are the only option that can keep this patient alive. In addition, this approach offers good chances for a full recovery. Therefore, the son should agree to EN for his mother, taking into account the possible drawbacks of this method.
Reasons for Keeping the Feeding Tubes
In order to make the right decision, the son should consider two major aspects of this issue. The first aspect is the effectiveness of feeding tubes, and the second is the moral side of the problem. There are several arguments that prove the efficacy of this method. These medical devices allow life to be prolonged. The doctor explained that without such assistance the mother does not have any chance to recover. Feeding tubes are special medical devices that are necessary for patients who cannot obtain nutrition without help. These tubes are used to feed such patients or provide them with nutritional supplements. Feeding Tubes: Techniques, Problems and Solutions
To keep the mother alive, it is necessary to place these devices permanently until she awakens from a coma. It is possible to note that approximately 500,000 people in the United States depend on feeding tubes (“Feeding Tube Awareness Week”). People who suffer neurological or mechanical disorders throughout the world require the application of this method as these medical devices are essential for them. The mother is in a coma, thus she does not respond to any types of stimulation like pain, light, and sound because comatose patients cannot initiate any voluntary actions. Hence, there is no other option for her. The mentioned above statistics show that enteral nutrition is a widely applied technique. Therefore, the son should choose it as this method saves the lives of thousands of people throughout the world.
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Another advantage of this method is that it does not cause severe permanent effects. If used correctly, feeding tubes do not lead to any serious medical conditions. According to Blumenstein et al., “the success rate of endoscopic transnasal and transoral NET feeding tube placement has been described to range from 86% to 97%” (8506). Although this procedure demands a high level of professional competence from medical personnel, there are various training programs that aim at increasing required skills. In addition, other negative factors might be controlled. For example, stomach overfilling might cause serious complications that include infections and backups of fluid in the lungs (“Life Sustaining Treatment”).
However, abiding by the principles of patient-centered care allows reducing the risk of such complications. In addition, feeding tubes are one of the easiest ways for enteral nutrition. Nearly 247,000 out of 39,541,948 patients received EN during their hospital stay in the United States in 2007 (“Feeding Tube Awareness Week”). This method is much more effective than hand-feeding. Compared to parenteral nutrition (PN), it is also a much cheaper way to feed comatose patients. Finally, EN reduces septic disorders in comparison with PN. These statistics demonstrate that feeding tubes are a highly effective approach that might be applied in this case. In addition, these facts serve as evidence that supports the doctor’s opinion that the mother has high chances for a full recovery. Therefore, the son should pay particular attention to personnel that deliver medical care to his mother because, in spite of the fact that this procedure is well-known, professional competence still plays the crucial role in ensuring patient safety.
Finally, except for objective sides of this issue, there is a moral dimension. In spite of serious drawbacks of this medical intervention, the son should not let his mother die as it would be the violation of the main moral principles. The rejection of feeding tubes should be considered euthanasia as it inevitably will lead to the death of the patient in this case, and this practice is banned in most countries as morally unacceptable and illegal. First of all, the act of killing an individual is homicide regardless the intentions of a murderer. Even if a person has a terminal illness or suffers severe symptoms, it is still illegal and morally wrong to take their life away. Also, euthanasia should not be confused with palliative care that is provided by professional clinicians in order to help patients and their families to go through a physically and emotionally difficult period. For example, approximately 20 percent of patients in Canada receive this type of care (“Arguments Against Euthanasia”). This approach does not intend to accelerate or postpone death. However, in this case, leaving the mother without feeding tubes will be certainly fatal.
Other statistics show that “90% of doctors working in palliative care in Canada oppose euthanasia” (“Arguments Against Euthanasia”). In addition, there are no special guidelines that can limit the application of this method. It is very difficult to interpret official norms related to euthanasia, thus the use of this method might result in numerous medical errors. In this case, the doctor admitted that no one could be sure whether the patient would recover or not. Hence, if the son refuses the application of feeding tubes, it might be a fatal mistake. Another important aspect of euthanasia is that personnel that commit it often endure negative emotional consequences. Many of them have to undergo psychotherapy because they cannot overcome such mental traumas without assistance. Therefore, if the son decides to choose this option, he will have to bear a heavy emotional burden for the rest of his life. In addition, there are other statistics that demonstrate the impact of euthanasia on different communities. For example, suicide rates in the Netherlands have increased by 6 percent since this practice was permitted in this country (“Arguments Against Euthanasia”). Therefore, the son should understand that even a single case of euthanasia might eventually affect the society in which he lives. This factor is very important and should not be neglected.
In conclusion, the son has to agree to keep feeding tubes because this method offers his mother very good chances to come out of a coma and restore her health. Various drawbacks of this approach cannot outweigh its advantages. The patient is in a coma, thus she will not feel any discomfort. Also, this procedure is relatively safe if personnel have adequate competence and experience. Therefore, the mother is less likely to suffer serious permanent complications. Moreover, feeding tubes are the only opportunity to keep this patient alive. Hence, the rejection of this method amount to euthanasia. Therefore, the moral and legal side of the issue takes place. If the son decides to let his mother die, he will violate fundamental principles of humanity and federal laws as well. Such a decision might negatively affect his emotional condition in the short term and society as a whole in the long run. The mentioned above statistics reveal that many clinicians are against euthanasia but support palliative care. All these facts prove that if the son agrees to stop eternal nutrition, this decision will result in highly unfavorable outcomes. Feeding Tubes: Techniques, Problems and Solutions