Food and water are not extraordinary care

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Second in a series of reflections on Catholic teaching regarding health and end-of-life decisions

As I mentioned last week, the “Ethical and Religious Directives for Catholic Health Care Services” indicate that “the task of medicine is to care even when it cannot cure.” It also notes that “there should always be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient.”
The case of Terry Schiavo highlighted a crucial question regarding patients in a very specific situation: Are food and water (nutrition and hydration) to be considered “extraordinary” or “ordinary” means of sustaining life, when patients are in what is sometimes called a “persistent vegetative state” (PVS)? Such persons are unable to feed themselves or take adequate nourishment by mouth and must be fed artificially (e.g., through a tube inserted directly into the stomach or indirectly through the nose). They have sleep/wake cycles and thus are not comatose, but they give no sign of awareness of themselves or their surroundings.
On March 20, 2004, Pope John Paul II gave a clear answer to this question: food and water, even when supplied to a patient in a so-called persistent vegetative state by artificial means, are to be considered “ordinary” means of sustaining life and are morally obligatory. They are “care,” not “treatment.” Removal of artificial nutrition and hydration is morally permissible only when they no longer attain the ends for which they are provided (i.e., when the body is no longer able to benefit even from such means). The Holy Father wrote:
“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 eventual 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, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.” He added that to withhold food and fluids from persons in PVS is a kind of euthanasia by omission.
In framing his remarks, the Holy Father also commented on the term “persistent vegetative state.” He wrote that no human being ever descends to the status of a vegetable or animal. “Even our brothers and sisters who find themselves in the clinical condition of a ’vegetative state’ retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as his sons and daughters, especially in need of help.”
It is a striking and crucial point that a human person, no matter his or her age or state of health, will never be a vegetable or simply “vegetate.” Human life is always human life, even if physically impaired by serious disease or advanced years. A human person at every age and in any illness bears God-given dignity as a child made in his image and likeness.
Thus in the case of Mrs. Schiavo, it is important to remember that even though she was in a so-called vegetative state, she still maintained her full human dignity and deserved to be treated in a way consistent with that dignity: she deserved proper medical care, comfort, cleanliness, the love of her family — and food and water. Furthermore — and this point is absolutely crucial — she was not dying until she was deprived food and water. The withdrawal of food and water caused her death.
I would like to continue these reflections next week by addressing the meaning of the term “quality of life,” the Christian understanding of suffering, and what all of us can do to ensure insofar as possible that good decisions will be made in our regard should we ever be faced with serious or terminal illness.
Do you have an intention for Bishop Sartain’s prayer? If so, send it to him at Bishop Sartain’s Prayer List, Diocese of Little Rock, 2500 North Tyler St., P.O. Box 7239, Little Rock, AR 72217.

Special to Arkansas Catholic

Latest from From the Bishop

Food and water are not extraordinary care

Latest News

Second in a series of reflections on Catholic teaching regarding health and end-of-life decisions

As I mentioned last week, the “Ethical and Religious Directives for Catholic Health Care Services” indicate that “the task of medicine is to care even when it cannot cure.” It also notes that “there should always be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient.”
The case of Terry Schiavo highlighted a crucial question regarding patients in a very specific situation: Are food and water (nutrition and hydration) to be considered “extraordinary” or “ordinary” means of sustaining life, when patients are in what is sometimes called a “persistent vegetative state” (PVS)? Such persons are unable to feed themselves or take adequate nourishment by mouth and must be fed artificially (e.g., through a tube inserted directly into the stomach or indirectly through the nose). They have sleep/wake cycles and thus are not comatose, but they give no sign of awareness of themselves or their surroundings.
On March 20, 2004, Pope John Paul II gave a clear answer to this question: food and water, even when supplied to a patient in a so-called persistent vegetative state by artificial means, are to be considered “ordinary” means of sustaining life and are morally obligatory. They are “care,” not “treatment.” Removal of artificial nutrition and hydration is morally permissible only when they no longer attain the ends for which they are provided (i.e., when the body is no longer able to benefit even from such means). The Holy Father wrote:
“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 eventual 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, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.” He added that to withhold food and fluids from persons in PVS is a kind of euthanasia by omission.
In framing his remarks, the Holy Father also commented on the term “persistent vegetative state.” He wrote that no human being ever descends to the status of a vegetable or animal. “Even our brothers and sisters who find themselves in the clinical condition of a ’vegetative state’ retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as his sons and daughters, especially in need of help.”
It is a striking and crucial point that a human person, no matter his or her age or state of health, will never be a vegetable or simply “vegetate.” Human life is always human life, even if physically impaired by serious disease or advanced years. A human person at every age and in any illness bears God-given dignity as a child made in his image and likeness.
Thus in the case of Mrs. Schiavo, it is important to remember that even though she was in a so-called vegetative state, she still maintained her full human dignity and deserved to be treated in a way consistent with that dignity: she deserved proper medical care, comfort, cleanliness, the love of her family — and food and water. Furthermore — and this point is absolutely crucial — she was not dying until she was deprived food and water. The withdrawal of food and water caused her death.
I would like to continue these reflections next week by addressing the meaning of the term “quality of life,” the Christian understanding of suffering, and what all of us can do to ensure insofar as possible that good decisions will be made in our regard should we ever be faced with serious or terminal illness.
Do you have an intention for Bishop Sartain’s prayer? If so, send it to him at Bishop Sartain’s Prayer List, Diocese of Little Rock, 2500 North Tyler St., P.O. Box 7239, Little Rock, AR 72217.

Special to Arkansas Catholic

Latest from From the Bishop

Food and water are not extraordinary care

Latest News

Second in a series of reflections on Catholic teaching regarding health and end-of-life decisions

As I mentioned last week, the “Ethical and Religious Directives for Catholic Health Care Services” indicate that “the task of medicine is to care even when it cannot cure.” It also notes that “there should always be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient.”
The case of Terry Schiavo highlighted a crucial question regarding patients in a very specific situation: Are food and water (nutrition and hydration) to be considered “extraordinary” or “ordinary” means of sustaining life, when patients are in what is sometimes called a “persistent vegetative state” (PVS)? Such persons are unable to feed themselves or take adequate nourishment by mouth and must be fed artificially (e.g., through a tube inserted directly into the stomach or indirectly through the nose). They have sleep/wake cycles and thus are not comatose, but they give no sign of awareness of themselves or their surroundings.
On March 20, 2004, Pope John Paul II gave a clear answer to this question: food and water, even when supplied to a patient in a so-called persistent vegetative state by artificial means, are to be considered “ordinary” means of sustaining life and are morally obligatory. They are “care,” not “treatment.” Removal of artificial nutrition and hydration is morally permissible only when they no longer attain the ends for which they are provided (i.e., when the body is no longer able to benefit even from such means). The Holy Father wrote:
“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 eventual 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, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.” He added that to withhold food and fluids from persons in PVS is a kind of euthanasia by omission.
In framing his remarks, the Holy Father also commented on the term “persistent vegetative state.” He wrote that no human being ever descends to the status of a vegetable or animal. “Even our brothers and sisters who find themselves in the clinical condition of a ’vegetative state’ retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as his sons and daughters, especially in need of help.”
It is a striking and crucial point that a human person, no matter his or her age or state of health, will never be a vegetable or simply “vegetate.” Human life is always human life, even if physically impaired by serious disease or advanced years. A human person at every age and in any illness bears God-given dignity as a child made in his image and likeness.
Thus in the case of Mrs. Schiavo, it is important to remember that even though she was in a so-called vegetative state, she still maintained her full human dignity and deserved to be treated in a way consistent with that dignity: she deserved proper medical care, comfort, cleanliness, the love of her family — and food and water. Furthermore — and this point is absolutely crucial — she was not dying until she was deprived food and water. The withdrawal of food and water caused her death.
I would like to continue these reflections next week by addressing the meaning of the term “quality of life,” the Christian understanding of suffering, and what all of us can do to ensure insofar as possible that good decisions will be made in our regard should we ever be faced with serious or terminal illness.
Do you have an intention for Bishop Sartain’s prayer? If so, send it to him at Bishop Sartain’s Prayer List, Diocese of Little Rock, 2500 North Tyler St., P.O. Box 7239, Little Rock, AR 72217.

Special to Arkansas Catholic

Latest from From the Bishop