Last Updated: Friday - 09/24/2010
November 30, 2009
U.S. bishops insist non-dying patients receive food, water
Prelates clarify position in light of papal statement, misleading ethical advice
NANCY FRAZIER O'BRIEN
CATHOLIC NEWS SERVICE
BALTIMORE - The U.S. bishops are insisting that patients with chronic conditions who are not imminently dying should receive food and water by "medically assisted" means if they cannot take them normally.
The bishops overwhelmingly approved a revised text of the Ethical and Religious Directives for Catholic Health Care Services Nov. 17 to clarify the obligation to feed patients who are not in immediate danger of death.
"In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally," say the revised directives prepared by the U.S. bishops' Committee on Doctrine.
"This obligation extends to patients in chronic and presumably irreversible conditions (e.g., the 'persistent vegetative state') who can reasonably be expected to live indefinitely if given such care," the new text adds.
The vote was 219-4 in favour of the revision during the U.S. Conference of Catholic Bishops fall general assembly in Baltimore.
Bishop William Lori of Bridgeport, Conn., chairman of the bishops' Committee on Doctrine, said the changes would help bishops to be "teachers of the faith," medical practitioners to "follow the appropriate medical protocols" and "our people when they face these difficult decisions" for themselves or their loved ones.
The only substantive debate on the revised directives was about whether to use the term "permanent vegetative state" or "persistent vegetative state" in the document.
JOHN PAUL II'S STATEMENT
In presenting the revised text Nov. 16, Lori said the directives, last revised in 2001, "were written long before" Pope John Paul II's March 2004 address to an international conference on Life-Sustaining Treatments and the Vegetative State and the Vatican Congregation for the Doctrine of the Faith's August 2007 reply to questions raised by the USCCB on artificial nutrition and hydration.
The current directives based their teaching on documents by "some state Catholic conferences, individual bishops and the USCCB Committee on Pro-Life Activities," the bishop noted.
Lori said the changes were needed "particularly since the recent clarifications by the Holy See have rendered untenable certain positions that have been defended by some Catholic theologian and ethicists."
Some Catholic ethicists had argued that, because doctors consider a persistent vegetative state irreversible, artificial nutrition and hydration can be withdrawn from those patients.
Much of the ethical discussion of the nutrition and hydration question in recent years has focused on the case of Terri Schindler Schiavo, a brain-damaged Florida woman whose husband successfully fought for the right to discontinue her feeding tube.
Schiavo died March 31, 2005, 13 days after doctors withdrew nutrition and hydration.
"While medically assisted nutrition and hydration are not morally obligatory in certain cases, these forms of basic care should in principle be provided to all patients who need them," the revised directives read.
In particular, patients diagnosed as being in a "persistent vegetative state" should receive food and water, the bishops said.
"Even the most severely debilitated and helpless patient retains the full dignity of a human person and must receive ordinary and proportionate care."
WHEN LIFE CANNOT BE PROLONGED
The only times when medically assisted nutrition and hydration are not morally obligatory are "when they cannot reasonably be expected to prolong life or when they would be 'excessively burdensome for the patient or (would) cause significant physical discomfort," the directives add.
"For instance, as a patient draws close to inevitable death from an underlying progressive and fatal condition, certain measures to provide nutrition and hydration may become excessively burdensome and therefore not obligatory in light of their very limited ability to prolong life or provide comfort."
Copyright © 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009 -- Western Catholic Reporter
Our mission: To serve our readers by bringing the Gospel to bear on current issues in the Church and in secular culture through accurate news coverage and reflective commentary.