Difference Between Artificial Nutrition And Hydration

“‘The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition’” (Thomas Edison). Artificial nutrition and hydration dates back to about 3,500 years ago. During this time, Ancient Greeks and Egyptians were performing “rectal feedings”. They injected enemas to insert nutrients into the rectum to preserve health. This was to protect inflamed bowel surfaces or treat diarrhea. It was made from liquids such as wine, milk, whey and wheat or barley broths. Later on, they added eggs and brandy to the mix. Nutrition is the process of consuming food that is necessary for life, health and growth. Hydration is drinking water that is from either fluids or foods. Artificial nutrition and hydration (N&H) is a treatment that gives someone fluids and/or nutrition for their body without them taking it in their mouths and swallowing it. There has been some disagreements whether or not to withdraw or withhold artificial nutrition and hydration for end of life care. “End of life care” is when healthcare workers take care of people who are at the end of their life. Whether it is because they are in old age, very ill or injured, or sick with a disease. The disagreements exist because of it being based on if it is necessary or required to use artificial nutrition and hydration.

Artificial nutrition and hydration should not be used for end of life patients because intravenous hydration can have a negative impact on the quality of their life, nutritional support does not reverse or cure the terminal disease and it should should be based on respecting the patient’s preference.
Artificial nutrition and hydration should not be used for end of life patients because intravenous hydration can have a negative impact on the quality of their life. According to RJ Ackermann, M.D, “There is always a risk when someone is fed through a tube. Liquid might enter the lungs. This can cause coughing and pneumonia… They can become plugged up, causing pain, nausea and vomiting” (Artificial Hydration and Nutrition, par. 19). This quote shows that it is risky to use a feeding tube because liquid can enter the lungs and cause coughing and pneumonia. Feeding tubes is one of the many methods for artificial nutrition and hydration (N&H). When a feeding tube gets “plugged up”, meaning that it gets clogged up, it causes pain, nausea, and vomiting. Since this is a way of artificial N&H, these are bad symptoms that has a negative impact on the patient’s quality of life. M. Patricia Fuhrman, RD (Registered Dietitian), observes that, “The provision of intravenous hydration can have a negative impact on quality of life by increasing … urinary output, nausea, vomiting …” (Nutrition Support at the End of Life : A Critical Decision par. 12). This shows exactly how intravenous hydration can have a negative impact on the quality of a patient’s life. It causes awful symptoms such as urinary output, nausea, and vomiting. The bad symptoms will add discomfort to the terminal disease they are already dealing with. This will cause them to suffer more, and that is not necessary because they are at the end of life. The bad symptoms will just negatively impact their quality of life even more. In Cheryl Arenella’s, M.D, article, she describes that intravenous fluids, another method for artificial N&H, requires an IV tubing. An IV tubing is inserted through a blood vessel, commonly a vein, and it is often painful. When this is inserted, there is a possibility of fluid overload, and that will cause swelling of the legs, arms and body (Artificial Nutrition and Hydration at the End of Life : Beneficial or Harmful? par. 39). In other words, besides the painful insertion of the IV tube, there are awful symptoms that may occur if something were to go wrong. Intravenous fluids is a treatment used for cases where the patient is severely dehydrated. If a fluid overload occurred during this treatment, the symptoms are swelling of the legs, arms and body. At the end of their life, it will cause the patients to suffer more, especially with an IV tube inserted in their vein. With this method of artificial nutrition and hydration, bad symptoms can occur and have a negative impact on a patient’s quality of life. All in all with intravenous hydration being a method of artificial N&H, the awful symptoms that occurs or can occur will have a negative impact on the patient’s quality of life for those who are at the end of life.
On the other hand, Cheryl Arenella, M.D, argues that in some cases artificial nutrition and hydration should be used because it provides nutrition and fluids for the patient to help them live and function longer. Arenella states “A person who has a mechanical blockage of his/her mouth, esophagus, or stomach … is likely to benefit if a tube is placed below the blockage in order to be able to receive nutrition and fluids … When a blocked bowel develops … TPN has been helpful in allowing that person to live and function longer than without the treatment” (Artificial Nutrition and Hydration at the End of Life : Beneficial or Harmful? Par. 46 and 47). This means that in cases where end of life patients can not take in foods and fluids by mouth, artificial N&H is necessary. Or in other cases when there is difficulty, it is necessary as well. Arenella describes how if there is a situation where there is a blockage of a patient’s mouth, esophagus, or stomach, the patient will benefit from a tube that can be placed below the blockage. This tube is a method of artificial nutrition and hydration to let the patient receive the nutrition and fluids they need. Situations like this would be if they suffer from head, neck or esophageal cancer. TPN is total parenteral nutrition, another way for artificial N&H. Cases where a bowel is blocked, TPN is beneficial because it helps the end of life patient live and function longer. This point of view seems persuasive at first but it explains how artificial nutrition and hydration is only necessary for certain situations. Whereas artificial nutrition and hydration simply should not be used for end of life patient because it does more harm than good. Intravenous hydration, a method of artificial N&H, has a negative impact on the quality of the patient’s life. It is most likely to cause awful symptoms and pain to occur that will negatively impact the end of life patient. Such as coughing, pneumonia, nausea, vomiting, increased urinary output, and swelling of the body. It can agonize the patient instead of aiding them. In addition, the nutritional support from artificial nutrition and hydration does not reverse or cure the terminal illness. It does not benefit the patient, instead they suffer more. Giving them artificial N&H will make them feel bloated, nauseated, develop diarrhea, increased incontinence, infections and bleeding. There is no benefits and worse of all it increases their risk of getting aspiration. Moreover, it should be based on respecting the patient’s preference. Healthcare professionals should respect decisions made by the patient, their family or surrogate. Even if it goes against their advice or opinion, and if they are trying to prevent suicide and preserve life. Healthcare workers must also act professional and do their best to ignore the guilt of “killing” a patient. Focus on how at times, withdrawing artificial nutrition and hydration stops the patient from suffering and they can be at peace. It is best to respect the patient’s preference and not use artificial nutrition and hydration even if it goes against the healthcare professional's advice. In fact, artificial nutrition and hydration should not be used for end of life patients because intravenous hydration negatively impacts their quality of life, nutritional support does not help the terminal illness, and it should be based on respecting the patient’s decision.
Artificial nutrition and hydration should not be used for end of life patients because intravenous hydration can have a negative effect on the aspect of a patient’s life, nutritional support does not aid the fatal condition or illness, and it should be based on respecting the patient’s choice and desire. Intravenous hydration can have a negative effect on the aspect of a patient’s life because it has risks of pneumonia, causes bad side effects, and it is painful. Pneumonia can occur if liquid enters the lungs, and also causes coughing. Bad side effects include increased urinary output, nausea, and vomiting. It is painful because of the IV tube that needs to be inserted for intravenous fluids. Nutritional support does not aid the fatal condition or illness because it increases suffering, makes them feel awful, and there are no benefits. It makes the patient suffers more due to an increase in incontinence, infections, nausea and vomiting. The patient will feel awful from feeling bloated, nauseated and developing diarrhea. There are no benefits, instead it increases the risk of aspiration. Artificial nutrition and hydration should be based on respecting the patient’s choice and desire because patients have the right to decide for themselves, healthcare professionals should focus on the patient’s preference, and healthcare workers should act professionally. Patients have the right to decide for themselves, even if it means that withdrawing artificial nutrition and hydration will not preserve their life. Healthcare professionals need to focus on the patient’s preference even if it goes against their advice. The healthcare workers need to be professionals and accept that withdrawing artificial N&H that a patient is already using, will stop them from suffering and let them be at peace. Certainly, artificial nutrition and hydration should not be used for end of life patients because it does more harm than good and does not benefit them a lot. Artificial nutrition and hydration is used for end of life patients because it is believed that it helps the patient live longer or helps them get through their terminal illness. In a few cases it does benefit them, but most of the time it causes them to suffer more or make them uncomfortable. It is important to know how much harm would artificial N&H cause, to decide whether or not to use it for the end of life patient. If families or healthcare professionals do not realize the harm artificial N&H could or will cause to an end of life patient, then they will not see how much more they are suffering in addition to their terminal illness. Families or healthcare professionals use artificial N&H because sometimes they feel not using it would just “kill” the patient by starving them to death. What people don’t realize is that in most cases, not using artificial nutrition and hydration allows the patient to pass away in peace and not add any more sufferings.