PEG removal - is it legal?

jawuk

Registered User
Jan 29, 2014
260
0
Lutterworth, Leicestershire
My husband is in hospital and lost the ability to swallow although he still shows a wish to be given a drink and now does swallow any saliva. He has an ng and is currently nil by mouth since he had a downturn last week from which he appears to have recovered. We are smack in the middle of selling and buying houses which will mean a move to 100 miles away in the very near future.
The hospital are insistent that no other hospital would agree to accept him while he's fitted with an ng and that therefore he must be fitted with a peg. I realise that the end may be within sight, but I've always intended to care for him at home as I have so far, and even more do I want his last days to be spent at home where I can tend to him in privacy.

I understand that if a peg is fitted there is then no alternative to his dying from an infection or indeed multiple infections and that it would only mean a life extension of a few months.
Does anyone know whether in fact it is illegal to cease feeding through a peg so that come the dreaded day he might drift off in peace?
 

missmarple

Registered User
Jan 14, 2013
204
0
Hi I am a dietitian. Firstly I would say it does not sound right that a hospital would not accept your husband with an NG. Hospitals are of course well set up to deal with the care of patients with NGs. Nursing homes on the other hand will rarely accept a person with an NG and they do insist of PEGs if someone is going to be tube fed.
In practice, at end of life PEGs are not usually removed, but the feed may be tailed down or stopped, depending on patient's symptoms. For instance if there was any evidence of nausea, or vomiting indicating that nutrition is not being absorbed, then the feed rate would be turned down or even stopped.
Legally it is a grey area, the practice in the UK in geriatric medicine has been not to place PEGs in dementia although I think there is a gradual tendency to place more PEGs in elderly persons with dementia, than was the case a few years ago. Stopping feedijg towards the end of life, whether at carer's discretion or as a result of medical decision would not usually be against the law. Ideally the decision should come out of a multi disciplinary consultation also involving the carer/ next of kin/ POA for health and welfare if there is one.
HTH.
 

jawuk

Registered User
Jan 29, 2014
260
0
Lutterworth, Leicestershire
Hi I am a dietitian. Firstly I would say it does not sound right that a hospital would not accept your husband with an NG. Hospitals are of course well set up to deal with the care of patients with NGs. Nursing homes on the other hand will rarely accept a person with an NG and they do insist of PEGs if someone is going to be tube fed.
In practice, at end of life PEGs are not usually removed, but the feed may be tailed down or stopped, depending on patient's symptoms. For instance if there was any evidence of nausea, or vomiting indicating that nutrition is not being absorbed, then the feed rate would be turned down or even stopped.
Legally it is a grey area, the practice in the UK in geriatric medicine has been not to place PEGs in dementia although I think there is a gradual tendency to place more PEGs in elderly persons with dementia, than was the case a few years ago. Stopping feedijg towards the end of life, whether at carer's discretion or as a result of medical decision would not usually be against the law. Ideally the decision should come out of a multi disciplinary consultation also involving the carer/ next of kin/ POA for health and welfare if there is one.
HTH.

Thank you for this very helpful answer MissMarple, it's much appreciated.
 

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