THE practice of forced feeding has been highlighted by its use on hunger strikers in Guantánamo Bay and, more recently, in Israel, where a vigorous debate about the ethics of such a practice is taking place. But you don’t have to be in prison to have a feeding tube jammed up your nose. Millions of elderly Americans are fed through tubes despite a lack of substantial evidence pointing to any clinical benefit.

Tube feeding was developed to provide nutrition for patients — increasingly patients with dementia — who are unable to eat on their own. Most of them, especially as they approach the terminal end of the disease, develop difficulties in swallowing and frequently aspirate food or other stomach contents into their lungs, developing pneumonia.

Study after study, however, has shown that tube feeding doesn’t provide any benefit compared with feeding these patients by hand, which is more labor-intensive but much better for the patients. It doesn’t improve survival, reduce infections, reduce the incidence of aspiration pneumonia or improve patients’ nutritional status over those who are hand fed or even over patients not fed at all.

If anything, feeding tubes can be harmful. One study showed that patients with feeding tubes had a higher incidence of pressure ulcers in their backs from being immobilized and lying in bed. Feeding tubes also have frequent complications of their own like being dislodged or being clogged. (Feeding tubes are a necessary evil in some cases, such as after surgery or after a serious accident.)