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Risks and Benefits of Artificial Hydration and Nutrition

by Viki Kind, End-of-Life Expert
February 24, 2017

Question: What is artificial hydration and nutrition?  Are there any risks to artificial hydration and nutrition?

Answer: Artificial hydration and artificial nutrition is when a patient is getting nutrients and/or fluids thru a tube; either through an IV or some type of feeding tube.  The artificial part of the word means that it is medical treatment, not eating and drinking like you might do at Thanksgiving.  And because it is a medical treatment, it comes with certain risks, benefits and burdens.

Risks:  The bad things that might happen if you choose the treatment.

Benefits:  The good things that might happen if you choose the treatment.

Burdens:  What it will feel like and be like for the patient to experience the treatment choice.  This may include pain, suffering, disability, effort, time spent, side effects, etc.

Too often, doctors don’t explain enough about the burdens of a medical treatment and only focus on the risks and benefits of the procedure itself.  They forget that the patient has to go home and live with the results of the medical treatment.  For example:  when discussing the procedure to put in a feeding tube, the doctor will focus on the risks and benefits of putting the feeding tube in.  The doctor doesn’t tell you what it will “feel like” to live with a feeding tube a week or a year from now.

    12% will have diarrhea or cramping
    10% will have nausea or vomiting
    4% will have leaking of the tube
    1% to 4% will have infections of the skin
    1% will have bleeding

After the procedure, the doctor gets to go home and have dinner.  But the person with a feeding tube, will go home and smell the food and watch others enjoy eating but not be able to eat.  This isn’t a “medical” burden, but a "life burden."  When I talk to patients about medical choices, I make sure they understand what it will be like to “live with” their decisions long term.

Viki Kind is a clinical bioethicist, professional speaker, and hospice volunteer. Her book, The Caregiver’s Path to Compassionate Decision Making: Making Choices For Those Who Can't,” guides families and professionals through the difficult process of advocating for those who can no longer speak for themselves. She has recently launched a DVD that includes a template to create a quality-of-life statement.

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