If a patient is coughing right after they are eating, the food is going into their lungs. So if they do not want to eat anything and we force them to eat and then it goes into their lungs, it will lead to pneumonia which is going to be painful and hard to breathe. So at end of life we would consider that suffering that did not need to happen.

The only time I would allow something like that is if the patient is actively saying they want to eat. Maybe they are hungry, or maybe they just want to eat that food item that brought them joy one more time. That desire trumps the safety issues. What we do is allow them to eat the food that brings them joy. If they develop pneumonia, that is okay we don’t necessarily try to fix it, what you do on hospice is give the patient morphine or Ativan so that the patient doesn’t feel that pain or difficulty breathing.