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Handbook for Mortals : Forgoing Medical Treatment

Thinking about life-sustaining treatments

As with all medical treatments, the benefits and burdens should be balanced against each other when deciding whether or not to continue tube feedings, IVs, or ventilator breathing. The burdens imposed by these artificial treatments should not be ignored just because the treatments are keeping someone alive.

Tube feedings, IVs, and breathing machines are obviously not the same thing as eating, drinking, and breathing naturally. Not only are they mechanical and not responsive to our feelings of hunger, thirst, and breathlessness, but they also are troubling, uncomfortable, and efficient -- just what human contact is not.

The way we talk of these treatments makes it easy to forget that they are, in fact, medical procedures. We talk about "feeding" patients, but the patients are not chewing, swallowing, or tasting through feeding tubes. We also discuss how patients are "breathing" on ventilators, making it easy to forget that the machine is doing most or all of the breathing for them. Some of this language is convenient, but it does make it make these machine seem almost natural.

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