The issues of ethical considerations with regards to the conditions of grandmother Ann as the physician ask the family’s permission to insert a feeding tube for Ann as she starts to cough and have fever as she has been diagnosed by the doctor for having pneumonia and because Ann stops talking and refuses to eat does not justifies a valid reason for using a feeding tube as in taking care of patients well being and quality of life implies moral and ethical standards of actions to be taken to the patient as in the case, feeding tubes can’t be good to patients with pneumonia as it can only give further health complications and there are still other ways to handle Ann’s situation aside from feeding tubes like for instance, it is still possible to acquire mouth feeding as there was no indication that Ann has difficulty in swallowing food, maybe she was just feeling lonely and alone because she misses her husband Frank and daughter Sarah what the patient truly needs is her family’s care and attention not allowing the nursing home to decide everything with regards to the situation. Moreover, the feeding tube is not right for the case of Ann as there could be any unethical speculations that can justify moral rules and principles within the consequences of doing the act.
Accordingly, placement of a feeding tube does not always mean that eating by mouth is over but supplementation is necessary for proper nutrition and health. (2002; 2000; 2000; 2000; 1996). Furthermore, progression must be considered when making the decision. If the patient is at the end of their struggle and cannot utilize nutrients a feeding tube may not be helpful. (2003; 2000; 1999) A physician will not place a feeding tube if all attempts at feeding by mouth have been exhausted. Tube feeding is a method of providing nutrition to people who cannot sufficiently obtain calories by eating or to those who cannot eat because they have difficulty swallowing. (2003; 2000; 1999) Thus, oral intake can be continued for more pleasurable sensations, such as small bites of a favorite food. It is a very important decision to be made and will be easier if the person wishes are understood and if family members can agree upon the decision long before tube feeding is considered. (2003; 2000; 2000)
The family members will find it difficult to decide against alternative feeding because death may be hastened by their decision as there is no easy answer and it can be very hard to gauge a personís quality of life and tube feedings can cause discomfort the need for physical restraints to prevent the tube from being pulled out, risk infection and discomfort. (2003; Finucane and Christmas, 2000) In addition, there are laws about tube feeding and the use of do not resuscitate orders differ from state to state. The Patient and her family should be provided with a realistic picture of the probable outcome of patients who are tube-fed, without providing undue expectations of favorable outcomes ( 2003; 2000; 2000). Aside, tube feeding will not help prevent or heal pressure sores, nor has it decreased the incidence of pneumonia (1999; 2001). On the contrary, pneumonia remains a significant contributor to mortality in tube-fed patients and neither has the quality of life, including patient comfort and improved substantially ( 1999; 2002; 2000).
In nursing homes, assessments by speech therapists, staffing patterns, and fiscal constraints appear to influence the practice of tube feeding in cognitively impaired patients (2003). Tube feeding is considered a medical intervention, not obligatory care (2001). The physicians need to provide information to the patient about the benefits and burdens associated with long-term tube feeding and not encourage undue expectations ( 2002; 2000; 2000; 2000; 1996). Therefore, the ethics committees can help physicians reach a consensus on how to proceed as tube feeding is an art and a science that is used in the aging society as more people become physically incapacitated as properly used, the tube feeding can be helpful. However, the patient should be monitored for tolerance and complications and assessed for a possible return to oral feeding. (1998) The procedure can be burdensome through tube-related complications and the use of restraints. The non-clinical factors may influence the ultimate decision of placing a feeding tube as the clinicians may fear that they are vulnerable to legal action if they do not place a feeding tube in the patient.
Aside, the physician may fear that not having a feeding tube in a cachectic patient with progressive weight loss and bedsores will insinuate neglect and have negative legal consequences. (1998) Nursing homes may not be willing to devote more time to each patient, especially without financial compensation. This may explain why residence in a nursing home is associated with an increased risk of receiving a new feeding tube.It is important to be sensitive to certain assumptions because they will influence the decision of whether or not a feeding tube is inserted. ( 1998)
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