Understanding the Benefits and Burdens of Tube Feedings

Tube feedings for patients with severe dementia, metastatic cancer, or stroke present controversial management decisions. Artificial feedings might benefit patients by reversing malnutrition or dehySee also p 1937. dration and prolonging life in patients who are unable to take adequate nutrition by mouth. But Quill's1careful empirical study shows that feeding tubes may not accomplish these goals and may impose significant burdens on patients with severe, irreversible illness. TECHNOLOGY SHOULD BENEFIT THE PATIENT Philosophers have asserted that medicine should benefit the patient, according to the patient's definition of benefit.2Feeding tubes can benefit patients when they provide time to treat underlying medical problems or clarify prognosis or when prolongation of life is feasible and desirable. But Quill found that feeding tubes seldom gained time for underlying reversible conditions to be successfully treated. In only two cases were feeding tubes removed because patients improved. It is questionable whether feeding