Breaking News
July 18, 2018 - Smoking May Boost Atrial Fibrillation Risk
July 18, 2018 - Genome editing method targets AIDS virus
July 18, 2018 - These things matter: Medical complications are not inevitable, a physician writes
July 18, 2018 - Cognitive functions often wilt as water departs the body, shows study
July 18, 2018 - Low-dose ketamine found to be as effective as opioids for treating acute pain
July 18, 2018 - Novel bioengineering technique could help repair bone defects
July 18, 2018 - Researchers identify new potential target protein for colon cancer
July 18, 2018 - Air pollution contributes significantly to diabetes globally
July 18, 2018 - Cell membrane’s importance offers new strategy to fight infections
July 18, 2018 - Researchers identify key protein involved in irregular brain cell activity
July 18, 2018 - 3D modeling of drug resistance could lead to more effective cancer treatment
July 18, 2018 - Hunger hormones could be key to new treatments for drug, alcohol addiction
July 18, 2018 - Nitrate-cured meats may contribute to mania, study finds
July 18, 2018 - Why men may recover more quickly from influenza infections than women
July 18, 2018 - KemPharm Announces Top Line Results from KP415.E01 Efficacy and Safety Trial in Children With ADHD
July 18, 2018 - Self-control and obesity: Gender matters in children
July 18, 2018 - Bioengineers, diabetes researchers convene to discuss future concepts for precision medicine
July 18, 2018 - Practicing yoga benefits pregnant women, study suggests
July 18, 2018 - New strategy may lead to more accurate breast cancer diagnoses
July 18, 2018 - FDA Approves Symtuza (D/C/F/TAF), the First and Only Complete Darunavir-Based Single-Tablet Regimen for the Treatment of HIV-1 Infection
July 18, 2018 - New guide helps hospitals pick right partner to handle hospitalist services
July 18, 2018 - Deep data dive helps predict cerebral palsy
July 18, 2018 - Stricter firearm legislation associated with reduced murder and suicide rates
July 18, 2018 - Physical and sexual abuse in childhood associated with endometriosis risk
July 18, 2018 - Omega 3 supplements do not reduce risk of heart disease, stroke or death
July 18, 2018 - GSA’s new publication provides support for safe use of OTC analgesics by older adults
July 18, 2018 - Researchers receive grant from U.S. Department of Education to study children with HFASD
July 18, 2018 - Early childhood adversity increases sensitivity of the body’s immune response to cocaine
July 18, 2018 - Parental incarceration affects health behaviors of children in adulthood
July 18, 2018 - Researchers find that yellow fever and Asian tiger mosquitoes can carry new virus
July 18, 2018 - Two Regimens Fail to Stop Declines in β-Cell Function
July 18, 2018 - Researchers apply computing power to track the spread of cancer
July 18, 2018 - Olfactory receptors play pathophysiological role in all organs than merely smell perception
July 18, 2018 - Fish consumption associated with lower risk of early death
July 18, 2018 - MR Solutions’ 7T MRI imaging system installed at University of Hawaii
July 18, 2018 - Humorous ads screened around World Cup game achieve higher biometric response than sporty ads
July 18, 2018 - New study demonstrates little effect of hormone therapy on artery thickness
July 18, 2018 - A 3-Pronged Plan to Cut Type 2 Diabetes Risk
July 18, 2018 - New clues to sepsis may speed diagnosis
July 18, 2018 - Stars of Stanford Medicine: Improving cardiovascular health in Africa and beyond
July 18, 2018 - Heart attack risk continues to increase among pregnant women, study finds
July 18, 2018 - Few tips to help avoid sunburns in summer
July 18, 2018 - High-fat diet and systemic inflammation contribute to progression of prostate cancer
July 18, 2018 - Researchers develop 3D map of gene interactions that play key role in heart disease
July 18, 2018 - Conservative management of lung subsolid nodules reduces overtreatment and unnecessary surgery
July 18, 2018 - Report warns of dog illness that can spread to owners
July 18, 2018 - A winning essayist’s tips for keeping track of scientific facts
July 18, 2018 - Researchers seek to understand role of APOE mutation in Alzheimer’s disease
July 18, 2018 - Animal studies reveal brain changes responsible for appetite effects of cannabis
July 18, 2018 - New ZEISS ZEN Intellesis machine allows segmentation of correlative microscopy
July 18, 2018 - Study findings highlight importance of early detection of SMA through newborn screening
July 18, 2018 - Results of Phase III (PIX306) Trial Evaluating Progression-Free Survival of Pixuvri (pixantrone) Combined with Rituximab in Patients with Aggressive B-cell Non-Hodgkin Lymphoma
July 18, 2018 - Diabetes researchers find switch for fatty liver disease
July 18, 2018 - The future of the microbiome: A conversation
July 18, 2018 - States attacking ACA would hurt most if shield on preexisting conditions were axed
July 18, 2018 - Novel delivery system for bacteriophages could offer new way to battle lung infections
July 18, 2018 - PTSD may increase risk of stroke, heart attack in World Trade Center response crews
July 18, 2018 - Finding the right protective eyewear for young athletes
July 18, 2018 - Routine screening, treatment could help stem nationwide opioid epidemic
July 17, 2018 - AI and radar technologies could help diabetics manage their disease
July 17, 2018 - New Stanford algorithm could improve diagnosis of many rare genetic diseases
July 17, 2018 - Burdensome symptoms of eczema can lead to impaired quality of life, shows study
July 17, 2018 - Sartorius Stedim Biotech and Penn State partner to advance teaching, research in biotechnology
July 17, 2018 - Researchers map family trees of cancer cells to understand how AML responds to new drug
July 17, 2018 - Mortality from heart failure remains higher in women than men
July 17, 2018 - Can-Fite BioPharma receives Australian and Chinese patents for new drug to treat erectile dysfunction
July 17, 2018 - AAP: Lawnmowers Pose Serious Injury Risk to Children
July 17, 2018 - Fewer U.S. kids are getting cavities
July 17, 2018 - Differences in brain’s reward circuit may explain social deficits in autism
July 17, 2018 - YCC researchers suggest promising treatment for two rare inherited cancer syndromes
July 17, 2018 - FAU and partners receive NIH research grant to shed light on sleep loss and metabolic disorders
July 17, 2018 - Advanced MRI technique predicts risk of disease progression in MS
July 17, 2018 - Health Tip: Microwave Safely – Drugs.com MedNews
July 17, 2018 - New target for treating heart failure identified
July 17, 2018 - Biodesign fellows simplify heart rhythm monitoring
July 17, 2018 - Study reveals new risk genes for allergic rhinitis
July 17, 2018 - Community college education can increase physician diversity and access to primary care
July 17, 2018 - Inflection Biosciences’ dual mechanism inhibitor shows promise as treatment for CLL
July 17, 2018 - Researchers uncover how cells invite corrupted proteins inside
July 17, 2018 - Large international study finds new risk genes for hay fever
Dementia patient at center of spoon-feeding controversy dies

Dementia patient at center of spoon-feeding controversy dies

image_pdfDownload PDFimage_print

An Oregon woman with Alzheimer’s disease, whose husband claimed she was kept alive with spoon-feeding against her written wishes, has died.

Nora Harris, 64, died early Wednesday at the Fern Gardens senior care center in Medford, Ore. Her husband, Bill Harris, said the death marks the end of an eight-year battle with the progressive, debilitating disease, which included an unsuccessful court fight to withdraw all food and liquid.

“It is a blessing and a relief,” he said.

Nora Harris, a librarian and scholar who was diagnosed with early-onset Alzheimer’s disease at age 56, had drafted an advance directive that called for no measures to prolong her life, including artificial nutrition and hydration.

Her husband contended that the document covered oral assisted feeding, too. He went to court last year to force staff at the center to stop spoon-feeding Nora, saying the practice violated his wife’s wishes and her advance directive.

“Nora never wanted to live like this,” said Bill, 76, a retired tech worker.

However, a local judge denied his request, siding with the state’s long-term care ombudsman who said state rules to prevent abuse required the center to offer residents three meals each day and provide help eating, if needed. That practice continued in recent weeks, even as Nora’s kidneys failed and she became bed-bound.

“I had to struggle with everybody all the way through to the end to try and respect her wishes,” Bill said.

The controversy turned Nora Harris into a central character in an ongoing debate over advance directives and dementia. At issue is whether patients with Alzheimer’s and other progressive diseases can stipulate in advance that they want oral food and liquid stopped at a certain point, hastening death through dehydration.

It’s a controversial form of what’s known as VSED — voluntarily stopping eating and drinking — a small but growing practice among some terminally ill patients who want to end their lives. In those cases, people who still have mental capacity can refuse food and water, usually resulting in death within two weeks.

“The right to VSED is reasonably well-established, but it’s when a person isn’t competent that’s the issue,” said Paul T. Menzel, a retired bioethicist at Pacific Lutheran University in Tacoma, Wash., who has written extensively on the topic.

Unlike medical aid-in-dying, VSED doesn’t require a law or a doctor’s approval. But the question of whether it’s possible for people who can no longer actively consent to the procedure remains ethically and legally unclear. That’s especially true for patients who open their mouths to accept food and fluids, as Nora Harris did until her last days.

“VSED is a unique exit option,” said Thaddeus Mason Pope, director of the Health Law Institute at Hamline University in St. Paul, Minn., and an expert on end-of-life law. “This is probably the least discussed option. We don’t have statutes, we don’t have regulations, we don’t have a court case.”

Advocates for VSED contend that, with proper medical support, it can result in a peaceful death that allows patients control over their own fate. Critics say the practice amounts to torture and that it will lead to starvation of elderly, disabled and mentally ill people.

Advance directives that tell caregivers to continue or withdraw artificial nutrition and hydration provided through feeding tubes or IV lines are common. Most don’t mention assisted oral feeding, however.

Nearly two dozen states have laws that address assisted feeding, including many that specifically prohibit withdrawing oral food and fluids. Other states address only artificial feeding or are unclear or silent on the issue.

Just one state — Idaho — appears to sanction withdrawal of assisted feeding by a health care proxy “in accordance with a valid directive,” according to a July analysis compiled by Charles Sabatino of the American Bar Association.

But Idaho state law also prohibits any form of assisted suicide and requires “comfort care” for patients if artificial nutrition and hydration is withdrawn. It’s not clear whether a request to halt assisted feeding would be honored, said Robert Aldridge, a Boise lawyer who has worked for years to shape Idaho’s Medical Consent and Natural Death Act.

“Assisted feeding is a somewhat limited situation if the patient is not competent,” Aldridge said in an email.

With more than 5.5 million people living with dementia in the U.S., questions about stopping assisted feeding are becoming more common, said Judith Schwarz, clinical director for End of Life Choices New York, which advocates for medical aid-in-dying.

“Increasingly, this is going to be an issue,” she said. “The people I talk to are much more afraid of Alzheimer’s than they are of cancer. They are afraid of being stuck for years in a nursing home in a diaper.”

The doctor overseeing Nora Harris’ case, Dr. Karen Kahn, called the situation “one gigantic gray zone.”

On one hand, research shows that “feeding somebody with end-stage dementia will not prolong their life,” said Kahn. On the other hand, if a patient accepts food and swallows it, “it should be incumbent on them to feed her,” she added.

Bill Harris said he sat for three hours on Tuesday afternoon watching as Nora took tortured breaths. She died at 1:32 a.m., he said.

“What the court case did a year ago in July was they condemned her to the full gamut of the disease,” he said.

He said he’ll continue to push for changes to state law to allow people with dementia to stipulate in advance if they don’t want assisted feeding.

“From my perspective, the way the laws are written now, they do not respect people with dementia,” he said.

When Nora Harris was diagnosed with Alzheimer’s in 2009, she made arrangements to donate her brain and spinal cord tissue to the University of California-San Francisco, medical school for research.

“She didn’t want anyone else to go through what she did,” Bill Harris said.

KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation and its coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles