Reflection on Nutrition and Hydration
All of the notoriety given to Mrs. Terri Schiavo, the Florida
woman with serious brain damage, and the feeding tube that
provides her nutrition and hydration highlights for us once
again the need for moral reflection when we deal with human
life and particularly the termination of any human life.
Our Holy Father, Pope John Paul II, in his encyclical
letter Evangelium Vitae, The Gospel of Life, provides an
up-to-date frame of reference for these moral reflections.
In 1991 the bishops of Pennsylvania provided guidance on
this important issue in their statement, Nutrition and Hydration:
Moral Considerations.
The media reports, both electronic and print, on the condition
of Terri Schiavo indicate that she is seriously impaired
but aware of her surroundings and capable of responding
to some stimuli particularly pain. On the one hand are those
who would like to see her feeding tube removed thus terminating
her nutrition and hydration and bringing about, since she
is still aware, an excruciatingly painful death. On the
other hand are those who argue that she must be allowed
to continue to receive basic human care – a care that
is obligatory to every human being.
At the core of this discussion is the distinction between
medical treatment and basic human care. No one is obliged
to extraordinary medical treatment but every one is entitled
to ordinary human care. It is important to note in the Terri
Schiavo case we are not dealing with extraordinary treatment
such as a ventilator or dialysis but rather with a feeding
tube that supplies basic nutrition and hydration –
food and water.
The provision of nutrition and hydration is a normal part
of human care. The United States Bishops’ pro-life
committee provides us direction in this area when it writes:
“We reject any omission of nutrition and hydration
intended to cause a patient’s death. We hold for a
presumption in favor of providing medically assisted nutrition
and hydration to patients who need it, which presumption
would yield in cases where such procedures have no medically
reasonable hope of sustaining life or pose excessive risks
or burdens” (NCCB, Pro Life Committee, Nutrition and
Hydration: Moral and Pastoral Reflections, 1992).
The Catholic Church teaches that when medical treatment
becomes futile and it is no longer possible to prevent a
patient’s death, or when the only result of intensive
medical treatment would be to add suffering or prolong dying,
we must accept the inevitability of death. At this point,
respect for the dying indicates that it is no longer necessary
to offer medical treatment. Yet normal comfort care must
be provided.
While it is true that the means of supplying nutrition
and hydration can in themselves become morally extraordinary
in some circumstances, the presumption should always be
in favor of sustaining human life through the provision
of nutrition and hydration (see proceedings of Pontifical
Academy for Life, February 1999).
The call for uninterrupted respect for all human life
requires that people of faith act responsibly in end-of-life
situations. When we deal with the last stages of human life,
we need to be particularly sensitive to both our capabilities
and our limitations. Eventually all physical remedies fail.
All life begins, grows, matures, declines, and ends in death.
As responsible Christians, we are called to provide medical
treatment for the body while there is still hope of healing
and restoration of health. But even when healing is no longer
possible, treatment is futile, and death is inevitable,
we are still obliged to care for the dying.
As he concludes his encyclical on human life, Pope John
Paul II calls us to reflect on the Gospel of Life in our
actions, culturally, socially and politically. “Walk
as children of light . . and try to learn what is pleasing
to the Lord. Take no part in the unfruitful works of darkness’
(Eph. 5.8, 10-11). In our present social context, marked
by a dramatic struggle between the ‘culture of life’
and the ‘culture of death,’ there is need to
develop a deep critical sense capable of discerning true
values and authentic needs.
“What is urgently called for is a general mobilization
of consciences and a united ethical effort to activate a
great campaign in support of life. All together, we must
build a new culture of life; new because it will be able
to confront and solve today’s unprecedented problems
affecting human life” (95).
The Catholic Church brings a living ethical tradition
to this and so many current issues. It does so with confidence
because the Church’s moral reflection is guided by
a wisdom rooted in God’s word and directed by God’s
Spirit.
May God continue to enlighten and strengthen all of us
as we face the critical issues of our day with an attitude
and perspective rooted in the Gospel and the Church’s
teaching. May we be guided by the Holy Spirit so that we
truly pass on to our children and their children a civilization
of love.
Holy Week, 2005
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