Monday, February 21, 2005


Why remove a feeding tube anyway

If a patient is on a ventilator and it is desired to discontinue artificial ventilation, there are reasons to physically remove the ventilator. It's bulky, useless (once its function is discontinued), and its continued presence could interfere with natural breathing.

A gastrostomic tube, however, is not a piece of external equipment to which a patient is connected. Nor does it interfere with "normal" eating. Instead, a g-tube is just a small tube that connects the stomach to the abdominal wall. A second mouth, basically. A funnel or food bag can be connected to it at feeding time, but otherwise it just sits there. Unlike a big bulky ventilator, or even an IV, a gastrosomic tube does not interfere with patient mobility nor with anything else a patient might want to do.

Even if a patient is in end-stage cancer and doesn't want to be fed, a gastrostomic tube cannot not by itself force unwanted food into the patient. If it's necessary to stop feeding a patient, a caregiver can simply decline to put any more food through the tube.

To be sure, there are sometimes good reasons to remove a g-tube:
  1. The tube becomes clogged or infected; in this case, normal protocol would be to remove the old one and install a new one.
  2. The patient regains sufficient ability to take food by mouth that there is no anticipated future need for the feeding tube and its continued presence would do naught but create a risk of future infection.
Discontinuing food and water for a terminal hydration for a terminal patient, however, is not a good reason for removing a g-tube. The tube's continued presence doesn't hurt the patient, and removing the feeding tube represents an unnecessary surgery with no therapeutic benefit.

Why, then, are feeding tubes removed from terminal or supposedly-terminal patients?

Because, to the uninitiated, "removing a feeding tube" sounds much more like letting nature take its course than does "stopping feeding the patient".

and the phrase "stop feeding the patient" sounds just like teh murder it is.....especially in this case....AAAAHHHHHHHHHHHH....I am so angry right now.
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