By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    photo of hands with blue veins
    8 Proven Tips on Finding Difficult Veins
    November 12, 2021
    tips for getting over the pandemic blues
    4 Proven Ways to Get Over the Pandemic Blues
    February 22, 2022
    medical industry innovations
    How is CNC Machining Transforming the Medical Industry?
    June 2, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Doctors on Google: Manhattan Research Survey 2012
    July 23, 2012
    HealthCare’s Need for Transparency Goes Far Beyond Pricing
    December 10, 2012
    Medicare Payments to Providers Are Carved, Sliced and Chopped by Sequestration
    March 25, 2013
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: End of Life Care: The Feeding Tube Frenzy
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Medical Ethics > End of Life Care: The Feeding Tube Frenzy
Medical Ethics

End of Life Care: The Feeding Tube Frenzy

Michael Kirsch
Last updated: March 18, 2012 1:26 pm
Michael Kirsch
Share
6 Min Read
SHARE

Okay, readers, how many of you desire to have a feeding tube inserted into your belly one day? Some of you? A few of you? All of you? Not me, that’s for sure.

Okay, readers, how many of you desire to have a feeding tube inserted into your belly one day? Some of you? A few of you? All of you? Not me, that’s for sure. So, if there comes a time when I cannot speak for myself, let this blog post serve as a statement of my philosophy that I do not wish to be subjected to everything that medicine may have to offer. If I am enjoying no meaningful life, and if I am not giving pleasure to others…
I placed yet another feeding tube (PEG) in a patient this week. This is often an unsatisfying experience for me as I am not always serving the patient’s interest. Usually, the patient is not capable to express his own views and the decision is properly delegated to the family or to a designated medical power of attorney (POA). In this instance the tube was medically indicated and I reviewed the procedure and the alternatives with the 3 daughters in a conference room.

The daughters were uncertain how to proceed. The ladies were clearly vexed. One of them was the POA. I counseled them to take more time to weigh the options. While the decision was difficult, the situation was not emergent and they had the luxury of time to deliberate. I reminded the POA that her charge was not to make a decision based on what she felt was in her mother’s best interest, but to make the decision that her mom would make if she were able to do so. This distinction is critical if the patient’s autonomy and medical ethics are to be respected.

Hours later, the daughters all agree to proceed with the PEG, and I did so.

More Read

Money, Medicine and Ethics
BioPharma Beat: Imagination Is More Important Than Innovation
Force-Feeding Guantanamo Prisoners Tortures Medical Profession
Feds Bust Doctor for Medicare Fraud– Biggest MD Fraud Case in History
The Ethics of Waste Avoidance

Luckily, there was a consensus, as it would be very problematic to proceed if there was a split decision, even if the POA has the legal right to decide. Indeed, if this occurred, I would make every effort to facilitate a unanimous decision, and might recruit other professionals to assist in this effort. It is easy to forecast the family tensions that might ensue when there is discord on how to proceed. There are times, however, when a consensus is impossible, and the POAs directive must be followed. In such cases, at least there is a POA to make the difficult decision. When there is no POA, and the family members are torn, then the situation is delicate and difficult.

Most of the PEG tubes I place are in demented elderly individuals who reside in nursing homes. For many of them, these tubes are a rite of passage and provide a convenient portal to administer nutrition and medication. Are they truly necessary? Certainly not. Indeed, there have been numerous medical studies in recent years that conclude that individuals with advanced dementia do not benefit from feeding tubes. Moreover, the notion that feeding through PEG tubes provides comfort to patients has been challenged.

Resources are limited. If every nursing home patient had a dedicated aide who could devote the time necessary to help patients eat, then they wouldn’t a gastroenterologist like me to violate them. In addition, eating food in the conventional manner provides gustatory and social pleasures. Do we want to deprive a patient of any of life’s remaining pleasures, when so few of them are remaining?

There is an aspect of the PEG procedure that does give me pleasure, and I experienced it this past week. I had placed a PEG in a rugged and vigorous man 2 months ago who had a temporary impairment in his swallowing function. This week, he came to my office for me to remove the tube. This is a rare event as most PEGs are placed for indefinite use.

Many hospitalized patients are advised to undergo PEGs when a swallowing study demonstrates dysfunction. My suspicion is that many of these folks have had this ‘dysfunction’ for years, and yet have managed to get through thousands of meals over the years without loss of life. In these cases, the PEG tube can be justified, but may not be truly needed.

Obviously, many PEG tubes are absolutely necessary and should be placed. It’s the rest of the PEGs that I’m lamenting over. Ask your gastroenterologist if he has ever placed an unnecessary PEG tube. If he says no, then whip out the polygraph equipment.

My advice? Make sure you have a living will with a designated medical power of attorney who will reliably act on your behalf, should the need arise. Otherwise, you might end up going down the tubes.

TAGGED:feeding tube
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

Medical Ethics

It’s All the Doctors’ Fault

September 14, 2011
Medical EthicsWellness

Using the D Word: Discussing Death and End of Life Care With Patients

October 17, 2017

The Three Cs of Physician Reputation Management

May 19, 2016
Global HealthcareHospital AdministrationMedical Ethics

Corporate Social Responsibility in Healthcare

August 13, 2012
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?