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A Basic Human Need

Food and fluids – a person cannot live without them. Food and water are the most basic needs we have as living beings. Yet depriving certain patients of food and water is one of the most hotly contested and agonizing questions of our times.

What happens when patients are deprived of food and fluids?

The answer is simple – they die of starvation and/or dehydration rather than the disease or illness that they have. There is no grey here – a person always dies if they are not fed or given fluids.

Who is being deprived of food and fluids?

A myriad of patients who are among the most vulnerable among us without ability to express their needs are not receiving food and fluids. The most highly publicized recent case is that of Terri Schindler Schiavo, a woman who had brain damage but was not dying. Her husband did not want her fed. Her parents wanted her at their home to care for and continue feeding her. After a lengthy court battle in the Florida courts, the federal courts and eventually the U.S. Supreme Court, the husband was given the authority to have Terri Schiavo’s feeding tube removed. Schiavo died in March 2005 of starvation and dehydration.

Click here to read an account of Terri Schiavo’s condition and death written by her brother, Bobby Schindler.

The trend to deprive patients of food and fluids began around 1983 with numerous court cases around the country. Virtually every state has a court decision which authorizes the removal of food and fluids from patients who are not dying.

Authorized by Courts:

  • Withholding or withdrawal of food and water from certain patients administered by tube.
  • Removal of food given by mouth.
  • Removal of food and fluids from unconscious patients.
  • Removal of food and fluids from semiconscious patients.
  • Removal of food and fluids from victims of disease such as Alzheimer’s.
  • Removal of food and fluids from patients who were dying.
  • Removal of food and fluids from patients who were not dying.

Is there any time when it is appropriate to remove or not provide food and fluids with a feeding tube?

  • If the patient is terminally ill and in the final dying process, a feeding tube does not help the patient and there is no moral obligation to provide one.
  • With certain illnesses, a simple feeding tube could actually harm the patient. For example, if the patient has advanced stomach cancer or excess fluid in the lungs, more liquids would cause harm. There is no moral obligation to provide a simple feeding tube in these instances.

Are feeding tubes new technology designed to keep a patient alive indefinitely?

You may believe this common misunderstanding. Feeding tubes have been used since 1822 and were perfected in the 1970s. The normal feeding tube is the size of a broom straw.

What are the most common means of providing food and fluids by tube?

Read the chart here.

What happens when a person is deprived of food and fluids?

Imagine a hot summer day. You have worked hard outside. You’re thirsty. Your tongue and lips are dry and they stick together easily. Nothing sounds better than something cold to drink.

How would you feel if you suddenly had no control and someone else decided not to give you a drink? Trapped? Frightened? Desperate? If you feel these sensations and emotions, you have taken the first steps toward realizing what it means to be deprived of food and fluids.

Depending on a person’s state of health, it takes three to ten days for a person to die from dehydration. Effects of dehydration and starvation are:

  • Dry mucous membranes (mouth, nose, throat and genital organs)
  • Constipation
  • Impaction (buildup of stool in the body), severe abdominal cramping and bloating, nausea and vomiting
  • Electrolyte imbalances (salt and water problems in the blood and tissues)
  • Arrhythmias (heart problems); myalgias and malaise (muscle pain and marked fatigue)
  • Cough and shortness of breath
  • Severe depression and confusion, severe agitation and fear, delusions
  • Dry, cracked skin
  • Urinary, vaginal and bowel infections
  • Bronchitis and pneumonia
  • Blood in the bowel, stomach, kidney and lungs; kidney failure
  • General systemic collapse and death
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