confused...legal to not feed patients?

Nurses General Nursing

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Okay so I am confused. A family friend has a parent in the hospital. The patient is in a coma and was on a ventilator. They pulled the ventilator out and the patient was able to breathe on his/her own.

I was under the impression that the "DNR" status means that if the patient arrests/codes, heroic measures won't be taken and they won't put him back on a ventilator even if he needs it....hence the "Do not resiscuate"

What I don't understand? There is no stomach tube and he's not getting any food or water! Won't this kill him anyway? Is that even legal? Or is there something about the situation that I don't understand?

This is a very, very old person who has lived his/her life. I am not anti the person dying but I am trying to understand, from a legal standpoint...isn't this killing him?

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Specializes in LTC,Hospice/palliative care,acute care.

The family member may have made his wishes known regarding artificial feeding and his loved ones are honoring them. You can keep the empty shell of a person "alive" through artifical feeding for 20 years or more.To some that is a fate worse then death. Also a "dry" death is much more comfortable then a well hydrated "wet" death. Nature will take it's course,he'll dehydrate-there will be a minimum of oral secretions to handle,little or no abdominal distension or vomiting.He'll bve kept comfortable with meds and good hygiene and die a dignified death.

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If he can no longer swallow he must be kept alive with a feeding tube or IVs. Horrible way to live if there's nothing left.

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Specializes in LTC,Hospice/palliative care,acute care.

If he has advance directives and specifically does not want either? In what states? In Pa if no advance directives we must support life but when directives are clear we don't over ride them..

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If he can no longer swallow he must be kept alive with a feeding tube or IVs. Horrible way to live if there's nothing left.

That's what I thought? I thought that the only way his life could "stop" was if he/she stopped it on their own...I didn't think anyone could do anything to "speed" the process up...which isn't starving someone doing that?

I'm just confused about what is legally okay?

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That's what I thought? I thought that the only way his life could "stop" was if he/she stopped it on their own...I didn't think anyone could do anything to "speed" the process up...which isn't starving someone doing that?

I'm just confused about what is legally okay?

if the patient made this decision, made his/her wishes known, and his HCP is honoring his/her wishes. no legal issue....unless other family members get in the way, and actually that shouldnt happen with a strong HCP

If the HCP makes this decision, should again be ok, they presumably have a knowledge of what the patient would have decided if presented with the issue...

so, i am not really understanding your distress/ambivalence.....?

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I just didn't know that was legal and I don't really understand how it is. there is a difference between "not saving a person" (DNR) and speeding up the process of death. By not feeding someone, aren't you essentially killing them?

On a related note, what does this indicate for organ donation? Won't the organs become unviable if this occurs?

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Specializes in home health, dialysis, others.

It's not considered starving. When we can no longer swallow because we are near the end of life, that is part of the normal dying process. Putting in a tube can be considered cruel because it only prolongs the process, frequently leading to infection, aspiration, pneumonia, fluid overload, constant diarrhea, etc. Dry, they die. Wet, they fret.

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so is this what the whole terri shavo case was about? or was that about taking her off the ventilator?

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I just didn't know that was legal and I don't really understand how it is. there is a difference between "not saving a person" (DNR) and speeding up the process of death. By not feeding someone, aren't you essentially killing them?

On a related note, what does this indicate for organ donation? Won't the organs become unviable if this occurs?

If you are feeding someone who can't or won't swallow you will kill them more quickly by choking them.

It is very unlikely that someone at this stage of life has donatable organs left. And you can't artifically prolong his life for spare parts.

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Specializes in LTC.

You're correct - DNR means we will not intervene if this patient arrests / codes. That is one type of advance directive. There are others, that include non-treatment.

Not putting a tube in this man is absolutely legal. He has a right to exercise his autonomy in receiving medical care, and his family has a right to exercise such autonomy on his behalf since he is incapacitated. Karen Ann Quinlan was a patient who prompted the discussion which resulted in the laws that govern such decisions today.

He is at the end of his life. We are not prolonging his death. This is an entirely different situation from killing someone - like administering a lethal dose of morphine.

We aren't killing someone, we are allowing him to die. Different thing entirely.

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so is this what the whole terri shavo case was about? or was that about taking her off the ventilator?

no, Terri was not on a vent.

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