Shallow thinking.  Spoon feeding is not the same as tube feeding or intravenous feeding.  Spoon feeding means that the person is conscious enough to open their mouth and voluntarily swallow food.  Any person whose arms are paralyzed or even just broken would need spoon feeding, i.e. assistance of others in obtaining the food even though they may have no desire to die.  Likely a person whose arms became paralyzed and had signed a no-tube, no-intravenous feeding directive would not expect it to lead to them starving to death.  The story does not provide sufficient information to judge.  In one sense, the woman consents to continued life by accepting and swallowing the food.  A person needing tubes, etc. does not give consent, the tube is forced in and no voluntary action takes place.