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The Japan Geriatrics Society has come up with the view that medical facilities should consider as an option the suspension or infrequent use of a medical procedure in which a surgical incision is made in the stomach of aged terminally ill patients and a feeding tube inserted.

Health care professionals and patients' families are facing the difficult decision over how terminally ill patients can die with dignity.

"I don't know whether it was right to give him this kind of treatment," a 74-year-old woman from Saitama Prefecture said, describing her feelings whenever she visits her husband in the hospital.

Her 78-year-old husband, who was diagnosed with dementia about four years ago, gradually stopped eating. He was hospitalized two years ago.

When the doctor offered to use the procedure, known as percutaneous endoscopic gastrostomy, she agreed after being told he would wither away and die without it.

She said her husband was a sociable man who was active in community matters.

As he is bedridden, unable to express an opinion and kept alive through the nutrition supplied by a feeding tube, she wonders whether he is happy now or really wants to go on living.

Whether the procedure should be used after a patient is unable to eat anything is a major challenge doctors and patients' families face in providing terminal care for aged patients.

Late last month, for the first time in 10 years, the geriatrics society revised its position on medical and other treatment for aged patients at the end of life.

The society now says, "The suspension or lesser use of such methods as percutaneous endoscopic gastrostomy and artificial respirators need to be reconsidered as options when such treatments could undermine the dignity or increase the pain of patients."

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