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מכון שלזינגר לחקר הרפואה על פי ההלכה

המשך לשאלה 446

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23 באוקטובר 2018

הרב המשיב: פרופ' א.ס. אברהם

שאלה:

Thank you for getting back to me – perhaps I can clarify the question a little. It is not an issue of completely withdrawing treatment. Right now the patient has a feeding tube inserted through her nose. The doctors have suggested that this is uncomfortable for most people and they want to switch to either a tube surgically implanted into the stomach or to IV feeding. The surgical tube may provide more nourishment, but the patient would have to be restrained so she doesn’t try and pull it out. The doctors have told the family that it is very unlikely that the patient will recover mentally, and also that the life expectancy is shorter with IV feeding, (though the patient may be more comfortable). It is not clear that she is physically suffering, she is in a vegetative state. Ultimately the family wants to do the minimum possible in the context of halacha to extend the grandmothers life in this state. My question is, what is the minimum possible they are required to do, to treat the patient? With regards to the feeding tube, are they required to surgically implant it into the stomach? Is there an option to not even connect IV nutrition, and attempt to feed the patient by hand – it seems vary unlikely that she would eat much this way?

Thank You

תשובה:

If the doctors think that the patient is uncomfortable with the feeding tube through her nose and she is attempting to to pull it out, a tube should be surgically implanted. It is more comfortable for the patient and, if securely bandaged she cannot pull it out. I do not therefore see why she has to be restrained. There is no option Halachically not to give her nutrition . IV feeding is not enough and you obviously will not – at this stage – be able to feed her by hand.

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