"The removal of a feeding tube should never be done with the intent to cause death," the CMDA leader says.
"Please someone in a principled way explain the difference between a respirator and mechanical feeding."
If you cannot breath on your own, obviously you are going to die within minutes. However, there are many people who cannot eat or drink on their own and basic nutrition, to my mind, is not medical care. Terri Schiavo was no where near death's door, in fact she seems to have had a very good consitution. She might have lived for decades more. That's why they had to kill her, you see, it was her "husband's" right to chose.
" How about a respirator? Can we ever turn that off? Please someone in a principled way explain the difference between a respirator and mechanical feeding. "
Consider a healthy newborn child. Breathing is a natural act, and interference with that breathing would also be criminal. Failure to provide nutrition and hydration (food and water) also would be criminal, even though the baby is incapable of feeding himself. After all, isn't baby formula from a bottle a form of artificial life support?
Now suppose that baby has a problem that prevents sucking on a nipple - a failure of the sucking reflex, or a physical problem like a cleft palate. But the baby breathes, cries, and responds normally otherwise. Do you withhold nutrition? Of course not. This is a temporary and correctable problem, and "artificial feeding" is simply a bridge to a full, normal life.
But what if the baby were several weeks premature, and did not breathe on its own due to underdeveloped lungs? Do you provide breathing support? Again yes, because it is once again a bridge to a full, normal life.
On the other side, a very few babies are born with a rare (and always fatal) condition called anencephaly, in which most of the brain fails to form. A baby born with anencephaly is usually blind, deaf, unconscious, and unable to feel pain. Although some individuals with anencephaly may be born with a rudimentary brain stem, the lack of a functioning cerebrum permanently rules out the possibility of ever gaining consciousness. Simple reflex actions such as breathing and responses to sound or touch may occur. But they do not possess - and will never develop - human interaction at ane perceptible level. Would you even attach such an infant to a respirator? Probably not, because this would only prolong dying. And what about nutrition? It would have the same effect, but if the infant can suckle, it provides comfort at a primitive level, and I could not refuse it. But I would not install a feeding tube.
Some couples do carry these babies to term, and love and care for them for the very few weeks or months of their lives, if they survive birth. Those who do seldom regret their decision.
Breathing is not merely a natural act - it is one that our bodies perform naturally, even in the absence of conscious control. We breathe when asleep, or even when unconscious due to trauma. And even when awake and aware, when we can control our breathing, we often withdraw our attention from this vital act, and give it no thought at all.
But eating is always an act of volition - we cannot turn eating and drinking over to a subconscious automaton that runs without our attention. Instead we are equipped with the sensations of hunger and thirst, to prod our conscious mind to seek and secure sustenance. Denying these to one who cannot act to secure them is an act of torture, and our society is the worse for having committed it.
Number one. Assess the reason for the ventilator.
If it is a brain injury severe enough to destroy the breathing center then the patient is not concious. Remove the ventilator and death in under 5-6 minutes.
Tube feeding death prolongued over 2 or more weeks. Cruel and unusual by any definition.