Feeding is a moral act

Speaking of bioethics (and unethical biomedicine – below)….the Vatican has just issued some badly needed clarity on the moral obligation to provide basic nutrition and hydration to dying patients. They are answers to specific questions of the US bishops.

“First question: Is the administration of food and water (whether by natural or artificial means) to a patient in a ‘vegetative state’ morally obligatory except when they cannot be assimilated by the patient’s body or cannot be administered to the patient without causing significant physical discomfort?

“Response: Yes. The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.

“Second question: When nutrition and hydration are being supplied by artificial means to a patient in a ‘permanent vegetative state,’ may they be discontinued when competent physicians judge with moral certainty that the patient will never recover consciousness?

“Response: No. A patient in a ‘permanent vegetative state’ is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.”

That is a HUGE ‘NO’. It’s not new, but there’s a newly urgent need to clarify that answer to the public.

After those brief questions and answers, the CDF went into a full commentary, even citing Pope John Paul II’s statements on the morality of caring for dying patients and on the term “persistent vegitative state”. Some of what John Paul said:

“In response to those who doubt the “human quality” of patients in a “permanent vegetative state”, it is necessary to reaffirm that “the intrinsic value and personal dignity of every human being do not change, no matter what the concrete circumstances of his or her life. A man, even if seriously ill or disabled in the exercise of his highest functions, is and always will be a man, and he will never become a ‘vegetable’ or an ‘animal’”…

“The sick person in a vegetative state, awaiting recovery or a natural end, still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention of complications related to his confinement to bed. He also has the right to appropriate rehabilitative care and to be monitored for clinical signs of possible recovery. I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, to the extent to which, and for as long as, it is shown to accomplish its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering”.

In this commentary to the US bishops (and really, society in general), the Vatican’s CDF punctuate that teaching about dying patients.

If they are not provided artificially with food and liquids, they will die, and the cause of their death will be neither an illness nor the “vegetative state” itself, but solely starvation and dehydration.

Think Terri Schiavo. 

At the same time, the artificial administration of water and food generally does not impose a heavy burden either on the patient or on his or her relatives. It does not involve excessive expense; it is within the capacity of an average health-care system, does not of itself require hospitalization, and is proportionate to accomplishing its purpose, which is to keep the patient from dying of starvation and dehydration. It is not, nor is it meant to be, a treatment that cures the patient, but is rather ordinary care aimed at the preservation of life.