The patient’s condition is terminal and she has not shown any sign of relieving symptoms. Even though feeding tube is able to prolong the patient’s life, you should not put the patient on the artificial feeding because of the involved risks of using feeding tube and benefits of allowing the patient to die a natural death. Moral and clinical factors inform this position. Ethically and as the authority over the patient who is already confused and disoriented, you need to minimize pain to the patient, to yourself, and to the children. Death of the patient is evident and the associated pain will be felt, regardless of the time at which the patient dies.
Consequently, life of the patient should not be the primary factor to the decision. Deciding not to use the feeding tube only amounts to allowing the natural death process and not contributing to the patient’s death. A legal consideration also allows for withholding of feeding tube and this also justifies the proposed decision. Even though failure to use feeding tube may induce pain to the patient, owing to the fact that she is able to respond to her environment, the level of pain can be managed.
Using the tube may prolong the patient’s life but it has many disadvantages, some of which could end the patient’s live and render the tube effort useless. The patient will likely suffer from chest congestion and fluid buildup in her throat that are threats to her life. Pressure buildup around the tumor, due to tube feeding is also likely to worsen her condition, such as increase her disorientation and confusion and reduce her sensitivity to her environment (Dunn, 2009). a natural death process, therefore, is recommended.
What to Say to the Patient when at the Bedside
Even though the patient’s condition is terminal, she needs to die a natural death and an assurance that everything will be fine is necessary. You should assure her that she is going to be fine. Because of her confusion and disorientation, she is not likely to feel the need for feeding and is likely to rely on your reassurance. Telling her that her condition is out of control may, however worsen her confusion and disorientation, and accelerate her death. Below are examples of appropriate responses.
The doctor has assured us that everything will be fine.
You have been strong and I can see you are improving.
We must remain hopeful and strong for the children.
Promotion to glory: xxxxxxxx xxxxxxx passed on at 11:45 a.m. on Tuesday 12 June 2057 at Precious Wells Life nursing home. She was married to James Wellington and left behind a son, Steve Wellington, 26, and a daughter, Jennie Wellington, 22.
She suffered from spinal and brain injuries following a fatal road accident, and received care in the facility for four months. Until the accident, she worked as a registered nurse and a director of community based organization that educates children in informal settlements and poverty-stricken areas in developing countries. She also loved organized occasional leadership forums for mentoring young and unemployed mothers. She loved soccer and attended major tournaments. Many who experienced her compassion will dearly miss her.
Dunn, H. Hard choices for loving people: CPR, artificial feeding, comfort care, and the patient with a life-threatening illness. Herndon, VA: A & A Publishers, Incorporated.