Palliative Care – To Feed or Not To Feed?

Near the end of life it is common be told not to worry about feeding and even to stop feeding, suggesting it  will only  prolong their life.   Although I do not advocate feeding near the end of life in all circumstances, I propose stopping feeding because feeding will prolong life is not in keeping with a Christian world view.  Why do I say this?

Length of life, according to the Bible, is determined by God.  The Lord God gives us life, sustains life and takes away life.   In the beginning God created everything.   Psalm 139 tells us God formed us in our mother’s womb, and had our days written down even before we were formed.  Job, in one of his prayers  to God  (Job 13-14), recognized God has determined our days, even the number of them.  Hannah, the mother of Samuel in her prayer to God, in 1 Samuel 2, also saw this, saying that the Lord takes life,  makes alive, brings us to the grave and up again.  The prophet Isaiah, in chapter 42, says God created the heavens and the earth and gives breath to the people on it.  These passages indicate God has our days planned, even the day of our death.  Is this really so?  The fact that many prophesies in the Bible have historically come true, support God being in control.  As does the record that Jesus knew what people were thinking, as well as the outcome of their actions, (like His knowing Peter would deny Him three times before the rooster crowed).  God knows everything,  our days, even the day of our death.

As well as teaching about the predetermined plan of God, the Bible also teaches about about choices.  We make choices.  We make a choice to promote or not to promote life.  Reconciling the predetermined plan of God with our choices is not a simple matter.  Yet, this does not change the fact, this is what the  Bible teaches.

How do these truths tie into feeding?   Although we may act to promote life or to end life, according to scripture we do not change the day of death planned by God.   In bringing about His plan, God involves His creation, including us and our choices.  Our choices have more to do with us.  They do not change God’s plan.  If our intent is to bring about a person’s death, and the person dies, we become murderers.  (This may seem harsh-see footnote below.[1])  If our intent is to support life and the person dies we remain care givers.

I have not yet tied feeding into this.  Since feeding or not feeding does not determine the length of one’s days, the decision about feeding should be based on something else.  The day of death will come, for some when they least expect it and for others after a long period of time, hoping it will come soon.  It is important we are ready to die and that we use our remaining time well.  Both of these involve interacting with the Lord God and others.  The question becomes. “What can be done to put a person in the best position to interact with God and others until their time on earth comes to an end?”  This usually includes some form of feeding.  (as well as rest, pain control, etc.)  There can come a time when feeding can make things worse or a person simply becomes unable to take anything in.  When this happens, stopping feeding is appropriate.  It is not “feed no matter what.”

Thinking in this way can also help in deciding if a feeding tube may be of value.  If death appears very close and the body is shutting down, feeding with a tube is not likely at add to these interactions.  If a person has lost their ability to swallow, but still seems to have life in their body, a feeding tube may be useful.

So, from a Christian world view, the question of prolonging life should not be a determinate in the decision to stop feeding.  Instead, we should consider the impact of feeding on a person’s well being.
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[1] Murder is to end the life of another person.  This definition of murder is not completely accurate.  Based on God having the day of death of every person in His plan, how can we say one person ends the life of another person?  From this point of view, deciding if a death is a murder has to do with whether another person desired or intended to bring life to an end.  Most often those intent on inflicting death do it believing  they are in control of the other person’s life.  In God’s sovereign plan, if the person dies, God has allowed the choice of the murderer to bring life to an end.  Was it murder?  That depends on the intent of the person who commits the deed.

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