Food, water not ‘extraordinary’

OCTOBER 26, 2007

My dear friends,

There was much discussion a few years ago about whether people in a “persistent vegetative state” should be given food and water by artificial means.

The catalyst for that debate, of course, was Terri Schiavo, a Florida woman who had lapsed into such a “vegetative state” and who ultimately died after her feeding tubes were removed.

Schiavo’s case made headlines for years, as her parents and husband battled in the courts over what to do. Ethicists and medical professionals also debated as to what would be the right — or moral — course of action.

Schiavo’s situation may have been high-profile, but it was not unique. As medical technology advances, end-of-life decisions become ever more complicated, and the proponents of euthanasia become ever more strident in their insistence that people’s suffering must be ended and they must be allowed to “die with dignity.”

It seemed at the time — and Florida’s bishops have long held this position — that in the face of uncertainty regarding these issues, the prudent option is to err on the side of life. That is, to continue treatment, or in this case, intravenous feeding and hydration, as long as it does not bring greater harm to the patient.

The church has long taught that Catholics are not obligated to use extraordinary means to extend a person’s life, especially if those means do not provide any benefit to the person’ s health, but merely serve to extend, by artificial means, his or her life. (Catechism Nos. 2276-2279)

But faced with the question of whether food and water, when administered by artificial means, could be considered “extraordinary” measures, the U.S. bishops asked the Vatican for a clarification in July 2005.

The Vatican’s response — approved by Pope Benedict XVI and drafted by the Congregation for the Doctrine of the Faith — arrived in September of this year. In essence, the answer is “no.” Food and water, regardless of the means used to provide them, are not “extraordinary” means of sustaining life.

Relying on past papal documents and pronouncements, the Vatican statement said, in part, that “Death by starvation and dehydration … ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission.”

The only exception to this moral imperative, according to the Vatican, is, again, a logical one: if the administration of such “minimal care” is “excessively burdensome for the patient” or in fact worsens his or her condition. Notice that the “burden” applies to the patient, not to the patient’s family or to any financial considerations.

The Vatican also notes that using terms such as “persistent vegetative state” often leads to a degrading of these persons’ “fundamental human dignity.”

Now that the Vatican has spoken, let us keep these moral imperatives in mind whenever we discuss situations that make headlines in the news media or cause great suffering in our own families.

I urge anyone facing serious, long-term illness — and their family members — to seek comfort and moral answers in institutions such as our own Catholic Hospice and the Philadelphia-based National Catholic Bioethics Center.

May their suffering be alleviated by the knowledge that it unites them with the suffering Christ, whose own passion and death brought redemption to the world.

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