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Utilization of Percutaneous Endoscopic Gastrostomy in Chronically III Elderly Patients-Reply

Arch Intern Med. 1990;150(10):2206. doi:10.1001/archinte.1990.00390210150035.
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(Continued from p 2204.)

In Reply. — I would agree in full with the suggestion by Drs Lee and Harford that the principles used to decide about nasogastric feeding are fully applicable to percutaneous endoscopic gastrostomy feeding. In specific, assessment of the patient's wishes and their quality of life is fundamental to the decision-making process for individuals with severe chronic or terminal diseases where recovery of nutritional independence is unlikely. The indications reported by the requesting physicians (patient pulled out tube, swallowing disorder, and refusal to eat) do not give adequate information in themselves to make a decision about using feeding tubes for an individual patient. What is the purpose of the tube for this unique person? How will it make this person's life better? If they cannot speak for themselves, how sure are we that they would (or would not) want their life prolonged by a feeding tube? It


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