Between Choice, Necessity, and Comfort: Deciding on Tube Feeding in the Acute Phase After a Severe Stroke

Isabel Frey, Marike E. De Boer, Leonie Dronkert, A. Jeannette Pols, Marieke C. Visser, Cees M. P. M. Hertogh, Marja F. I. A. Depla

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This is an ethnographic study of decision-making concerning tube feeding in the acute phase after a severe stroke. It is based on 6 months of ethnographic research in three stroke units in the Netherlands, where the decision-making on life-sustaining treatment was studied in 16 cases of severe stroke patients. Data were collected through participant observation and interviews. For this article, the analysis was narrowed down to the decision whether or not the patient should receive tube feeding. The data on tube feeding were assembled and coded according to different modes of dealing with this decision in clinical practice, which we refer to as “repertoires.” We discerned three different repertoires: choice, necessity, and comfort. Each repertoire structures clinical practice differently: It implies distinctive ethical imperatives, central concerns, sources of information, and temporalities. We hope our findings can improve decision-making by uncovering its underlying logics in clinical practice.

Original languageEnglish
Pages (from-to)1114-1124
Number of pages11
JournalQualitative health research
Issue number7
Publication statusPublished - 1 Jun 2020


  • end-of-life decision-making
  • ethnographic research
  • palliative care
  • qualitative research; The Netherlands
  • severe stroke
  • tube feeding

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