Letter: `Starving' patients
Tuesday 14 December 1999
But things are never as black and white as pro-life campaigners would like. Some patients in the last stages of Alzheimer's choke on solid food, then on pureed, then cannot even swallow liquids. At this point a decision has to be made between allowing the patient to "starve" or introducing artificial feeding by tube. The patient is likely to have no coherent speech and be unable to understand explanations of clinical procedures, so the chances are that the insertion of a tube will be interpreted as an assault on the person and torn out as often as it's put in.
I may soon be in this dilemma concerning my husband's care: "To feed or not to feed? What would he want?"
Eight years ago, when he was first given his diagnosis, he wrote in his diary, "The day of the beginning of my end. No hope, it seems. All I can say is that it comes quickly to avoid any mess." So guided by that diary entry, I have recently signed a statement that in the case of a life-threatening situation, I do not want any intervention (which would include artificial feeding). Instead he should be given tender palliative care to allow nature to take its course. Others are entitled to take an opposite view. Every case is individual - that is why doctors, nurses and relatives need to talk to each other.
But if this busybody, catch-all Bill becomes law, neither doctors, patients nor relatives will have any choice. Ann Winterton will have condemned some terminally ill patients to a further period of pitiful suffering and intensified the huge burden of helplessness and anguish carried by those who love them.
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