When Food and Water Withdrawal is Recommended to Hasten Death

This article was published on Nancy Valko's blog on October 9, 2024

Nancy Valko

By Nancy Valko

Recently, I was contacted by a man who was concerned about hospice care for his mother.

He wrote:

“I spoke to one hospice service that was recommended and asked about AHN (artificial hydration and nutrition) and I was basically told that if my mother became unconscious, they would not attempt to provide AHN. My mother has dementia and we’ve had a few scares where we were unsure she would recover. I’d like to understand what guideline I should expect the hospice to follow and whether hospice is even worth considering. Are there prescriptive standards of care that I can reference or could you tell me basically what routine care look like?”

I wrote back that I understood his concerns, especially since I recently lost a brother with dementia, diabetes and Crohn’s disease after a second fall down stairs. He had trouble eating so the doctors recommended a feeding tube.

Unfortunately, a person from palliative care told my sister-in-law that he would not improve so she decided to refuse a feeding tube.

I told her that newer feeding tubes were more comfortable, could make him feel better and were worth a try but she rejected this. She said my brother told her he would not want to live if he developed dementia - like our mother.

It took 4 long days for him to die.

I also told him that I have been writing about this problem for years, including my 2018 blog article “‘Living Wills’ to Prevent Spoon Feeding at: (Link).

I have seen the deterioration of medical ethics over 50 years as a nurse from requiring life-sustaining treatment unless it was medically futile or excessively burdensome to whatever is legal.

I would recommend to you two resources from the Healthcare Advocacy and Leadership Organization (HALO):

1. “The Food and Water Dilemma” at: (Link).

2. “Making a Difference: A Guide for Defending the Medically Vulnerable” at: (Link).

Conclusion

I have worked in hospice, critical care, etc. for decades and I was glad to be able to care for my patients, my mother and others so that they had dignity, comfort and emotional support at the end of life. I hope these resources from HALO can help bring vital information, peace and comfort to others and their families.

Nancy Valko was a hospice and critical care nurse for many years.