A gastronomy tube is NOT life support!!! Nearly 1 million "living" people in the US have gastronomy tubes, including Superman!
In drafting a living will, who would say to their spouse, "Honey, if I am ever in what doctor's describe as a vegetative state, I would prefer to die this way:
Hastening Death by Starvation and Dehydration
by Faye Girsh, Executive Director
Hemlock Society USA
The option of dying by starvation or Patient Refusal of Nutrition and Hydration (PRNH), as it is referred to, appears to be a compromise which allows terminally ill people to end their lives and still have ministrations from hospice and from a doctor. A hospice nurse was kind enough to send me eight articles from nursing and medical journals reviewing this process in an attempt to convince me that this was a painless and gentle death which would obviate the necessity of a more drastic end.
Hemlock Society is in the business of maximizing the options for a good death; for many people this means of ending their lives is acceptable while getting direct help from a doctor, using a plastic bag, or ending their lives by other more direct means is not. Having read this material I would endorse this as a legitimate alternative to which our members should give careful consideration, particularly when other means are not acceptable or available. I do have these caveats:
The length of time it took for patients to die in these studies varies considerably depending on the fragility and weight of the patient, the state of his/her heart , etc., from several days to several weeks. Most of the reports of dying patients are within one or two weeks from dehydration.
After the first day a state called detonemia develops in which there are apparently severe hunger pangs (unless feeding is restored)
Not taking fluids appears to actually reduce a person's discomfort, bloating, nausea, lung secretions, urinary frequency and pain, and is a good idea at the end of life in any case.
This method may be difficult for family members -- and some medical personnel -- who may find it difficult not to provide food and fluids. A family may need help caring for the dying person.
Excellent oral hygiene must be maintained with ice chips to moisten the mouth, careful cleaning of the mouth, and lubricants. Skin becomes dry and inelastic so a soft mattress is helpful. Dizziness and weakness also occur.
Many of the patients described, including the mother of Dr. David Eddy, whose account in the Journal of the American Medical Association has become a classic, had asked for a hastened death and had been refused by the doctors and nurses on the grounds that it would constitute an assisted suicide and thus be morally, ethically and legally wrong. This method is seen as a preferable alternative to a lethal dose of medication from a physician.
Medical care is essential; most patients required morphine for pain and many received anti-anxiety agents. It would be essential to have medical and nursing support before embarking on this route.
PRNH is a choice; it is relatively gentle and painless in most reported cases. It is certain, and loved ones can be there. Hospice workers and doctors will regard this as acceptable and treat the patient with compassion. It is not offensive to most religious groups. But it is not swift; the patient must be close to death, and medical and nursing help should be available. It may not be an option for everyone.
Since the manner of dying must be the patient's choice, this method does not obviate the search for ways which are acceptable to every person -- including direct help from a doctor -- certainly a shorter, more direct, and less torturous route.
Has Terri ever once been close to death since that first night, not counting the insulin "incidents?"