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- W2013641230 abstract "To the Editor: — The article by Campbell-Taylor and Fisher concerning the use of tube feeding in patients with advanced and terminal neurologic diseases highlights a serious problem faced by physicians who treat nursing home residents.1 The authors make the case that tube feeding is inherently dangerous and therefore should not be used. Nevertheless, several points need to be addressed. First, the data regarding the danger of tube feeding, as the authors admit, are incomplete. The complication rate is not known and cannot adequately be compared with the risks of undernutrition (eg, skin breakdown, infection) that result if tube feeding is not done. Simply put, the risk/benefit ratio is unclear. Second, the article did not fully consider the use of jejunostomy feedings (possibly combined with H2-blockers to reduce gastric secretions) that theoretically have a lower incidence of aspiration.2 The use of jejunostomy tubes placed endoscopically, in a manner similar to percutaneous endoscopic gastrostomy, was not addressed. We are presently conducting a study to compare jejunostomy with gastrostomy. Finally, and of greatest importance, if the complications of tube feeding could be considerably reduced, would the authors recommend tube feeding for the group of patients they described? A strong ethical argument can be made for not doing so. That argument involves the patient's previously expressed desires, the family's desires, and, the New Jersey Supreme Court notwithstanding, the quality of life that is being preserved. It is this ethical question, rather than the incidence of aspiration pneumonia, that is most compelling." @default.
- W2013641230 created "2016-06-24" @default.
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- W2013641230 date "1988-06-01" @default.
- W2013641230 modified "2023-09-25" @default.
- W2013641230 title "Tube Feeding in Patients with Advanced and Terminal Neurological Disease" @default.
- W2013641230 cites W2012168253 @default.
- W2013641230 cites W2053357104 @default.
- W2013641230 doi "https://doi.org/10.1111/j.1532-5415.1988.tb04035.x" @default.
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