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For us, it was a medical and quality of life issue. We allowed a gastrostomy tube for my husband after his stroke, hoping he would eventually be able to eat and have the tube removed. It was a life and death situation at the time. We wanted to give him a chance and hoped that, even if he continued needing the tube, he could be satisfied enough with his life. Because the feedings were keeping him alive artificially, we were assured by his doctor, the palliative care doctor, and the chaplain that my daughter and I could make the decision (ethically and legally) at any time in the future to have the tube removed if we felt that he no longer wanted to live in his condition. That was a year and a half ago. He still gets tube feedings four times a day, eats almost nothing by mouth. From time to time I have the conversation with him (he has aphasia so it's mostly just me talking), about the choice of keeping the tube, eating more, or starving. He indicates he doesn't want the tube and does want to eat. But then when given the opportunity and encouragement, he does not have the initiative or motivation to actually take in more than a spoonful or so of even his favorite foods. His life is boring, he sleeps a lot, often does not want to interact. But then there are the times when he lights up, is happy to see visitors, enjoys music, audiobooks, TV, or sitting outside, or attempts to talk. Those of us who know him well can see the same old expressions and know that he is not totally depressed and has some enjoyment in his life. He is medically stable (but does have a Do Not Resuscitate order), and he has 24-hour in-home care (partially paid for now by Medi-Cal IHSS). If his medical condition worsens or if he becomes more withdrawn (despite his anti-depressants), we will again have to make that tough decision about quality of life. For now, we just try to make each day as enjoyable as possible for him and remain grateful that we have glimpses of his former self. Hope this helps you in your process.
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I would decide based on the prognosis. Are you helping a body recover or are you keeping a body alive that should be allowed to die.

I personally have a medical directive that states specifically if I have no future beyond a bed then I refuse a feeding tube, however, if God forbid I am in an accident and it is required for my RECOVERY then by all means give me a fighting chance.

Prognosis based is the only way to make these decisions in my opinion.
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AlvaDeer Aug 2019
I agree and we have similar requests on our directives. I however have refused all artificial nutrition. I am 77, and that as much as anything accounts for that choice. I am also quite a coward, and fear many things in life much more than death. I think that each case, every person, is such an individual case.
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I think the pros and cons of feeding tubes depend somewhat on the underlying condition that prevents the person from eating normally. I'd be much more likely to agree to a feeding tube for a family member if that person had a condition that was likely to be resolved or fixed so that the person could eventually eat normally. And I'd be much less likely to agree to a feeding tube if the person was likely to be in a vegetative state until death and thus would never be able to eat normally again.
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