Artificial nutrition and hydration is a medical treatment for people who are seriously ill, recovering from surgery or receiving end-of-life care. It contains a mix of nutrients and fluids that is fed through a tube inserted into the stomach, intestine or vein. Artificial nutrition and hydration is given to someone who cannot eat or drink enough to stay healthy. Like all medical treatments, it can cause help or harm depending on the situation. It requires careful thought and discussion before its implementation.
Understanding Life-Sustaining Treatments
In order to make a decision about this life-sustaining medical treatment, it is important to understand how the body processes nutrients and fluids. The following information explains artificial nutrition and hydration in the context of end-of-life care. It can help you make an informed decision for yourself or a loved one.
What is Artificial Nutrition and Hydration?
Artificial nutrition and hydration is a life-sustaining medical treatment. It allows patients to receive food (nutrition) and fluids (hydration) when they can no longer eat or drink through the mouth. The nutrients and fluids used for treatment are chemically balanced and “fed” to patients by intravenous (IV) administration or feeding tubes.
How Does Treatment Differ From Eating and Drinking?
Artificial nutrition and hydration differs from eating and drinking in that it is a medical treatment. It requires technical skills to administer, and it has many serious risks. Professional training is needed to insert the tube or IV, and health care providers decide what type (and how much) of nutrition to give patients. They must also monitor these patients for complications and side effects.
Artificial nutrition and hydration does not provide the sensory comforts — such as taste and texture — that come from food and drinks. Unlike eating and drinking, tube feedings are controlled by health care providers rather than the patients they are treating.
How Does Treatment Affect End-of-Life Patients?
When end-of-life patients can no longer eat or drink, it usually means their organs are shutting down. Their bodies cannot function the way they did when the patients were healthy, and artificial nutrition and hydration cannot return them to a healthy state.
While artificial nutrition and hydration can help people recovering from illness or surgery, it can increase suffering for dying patients. Most doctors agree on this. Dying people no longer have the desire to eat or drink, and tube feeding adds discomfort to their other symptoms such as bloating, cramps, diarrhea and shallow breath.
When the body starts to shut down, it is due to the dying process rather than the absence of nutrition. There are ways to improve the comfort of dying patients such as treating dry mouth and cracked lips. Hospice and palliative professionals are experts at providing end-of-life comfort care.
Is Refusing Treatment Considered Suicide?
Everyone has the right to refuse medical treatment — or discontinue treatment after it starts. People at the end of life are dying from disease, not by choice. It is not suicide to refuse artificial nutrition and hydration, a treatment that cannot restore health.
What Are the Legal Consequences of Refusing Treatment?
Artificial nutrition and hydration is a medical treatment. Legally, people can refuse it at the end of life. Patients who are able to make end-of-life decisions can tell their doctors about their decisions. For those who can no longer speak for themselves, strong evidence is required in some states to show a patients’ wishes.
When it is unclear whether someone wants end-of-life medical treatment, doctors usually continue the treatment. This is why advance care planning, a medical power off attorney and a living will are so important. These legal documents spell out exactly what kind of medical treatments people want, or do not want, at the end of their lives.
