My Grandmother, who has deteriorated over the past 3-5 years with Parkinson’s, is on hospice and is on her death bed. Besides the wishes she’s made known, my Uncle is the one in charge of what care she gets. From what I gathered through others, she signed a form in advance stating she didn’t want to be kept alive by any “artificial means”, which apparently included fluids/food by tube. She has now lost the ability to swallow, and can’t really communicate, except by blinking.
Obviously, it is very difficult to see her in this state. I wonder if she has changed her mind about the feeding/fluid tube, but it’s too late to ask her what she wants regarding that. Besides that, I’m not sure if it would help at this point. From what I understand, sometimes it’s burdensome or increases discomfort to the point where it’s not helpful (or, at least, not morally obligatory). Everyone is gathering around her and trying to comfort her in her last days, and I can’t help but wonder - is she dying of natural causes, or is she starving/dehydrating to death in a way that is completely preventable?.I’m really not sure what the answer is, or what I am to do at this point (besides pray), and whether anything lies within my power to change. It’s very hard, very troubling. I’m not sure what to do.
I am sorry to hear about this, and I will be sure to keep your grandmother in my prayers.
The basic idea is simple: we are all required to use adequate, or proportionate, means to preserve our lives. However, when medical treatments become exaggeratedly onerous or burdensome–that is, disproportionate–there is no need to continue them. That is often a judgement call, and it the ultimate decision should be made by the patient (if that is possible) or (as in this case) by whoever has the faculty to make that decision.
Regarding the feeding tubes and similar things, the basic criterion should be whatever best contributes to the comfort of the patient. There is usually an obligation to give a patient nutrition and hydration, so long as the patient is in a generally stable condition. Remember that removing nutrition and hydration can cause terrible suffering: it is like starving to death or dying of thirst.
On the other hand, if there comes a point in which the patient’s body is simply unable to assimilate nutrition and hydration–if having the feeding tube there will make the patient worse off–then there is no problem in removing it, even if technically his life might be extended for a few days.
As I said, that is a judgment call, and it is something that needs to be discussed with the doctors, since they will have the know-how to know when that moment occurs.
So that is the criterion: as long as nutrition and hydration are helpful to your grandmother, they should be administered. If they are beginning to cause more harm than good, then there is no problem in removing them.
The important thing is that the goal should always remain the same: easing her suffering and making sure she is as comfortable as the situation allows.
I will keep your grandmother and your family in my prayers.