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CDF: CONCERNING ARTIFICIAL NUTRITION AND HYDRATION
The Congregation for the Doctrine of the Faith has issued an important statement.
It concerns artificial nutrition and hydration. Do you remember some years ago Pope John Paul II issued a forceful statement to a meeting in Rome about nutrition and hydration of patients in a persistent vegetative state (PVS). The Pope really changed Catholic teaching with that statement. I wrote a long piece on this issue for The Wanderer.
Here is another development.
The original language of the statement of the CDF is in Latin. I will get to the English when I have more time.
| RESPONSES TO CERTAIN QUESTIONS OF THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS CONCERNING ARTIFICIAL NUTRITION AND HYDRATION | RESPONSA AD QUAESTIONES AB EPISCOPALI CONFERENTIA FOEDERATORUM AMERICAE STATUUM PROPOSITAS CIRCA CIBUM ET POTUM ARTIFICIALITER PRAEBENDA
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| 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.
| 1. Quaeritur: Estne moralis obligatio subministrandi cibum et potum – sive naturali sive artificiosa ratione – aegroto qui versatur in "statu vegetativo", excepto casu quo haec alimenta a corpore aegroti recepi nequeant seu solummodo cum gravi molestia physica ministrari possunt? Respondetur affermative; quandoquidem cibi potusque subministratio, artificiali etiam methodo peracta, in linea principii, servandae vitae medium ordinarium et proportionatum evadit. Quapropter eiusdem procurandae moralis viget obligatio, quatenus consequi comprobetur finem suum proprium, nempe nutritionem et imbibitionem aegroti; qua quidem subministratione dolores et mors inanitionis et dysydrationis causa vitantur.
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| 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.
| 2. Quaeritur: Si cibus et potus methodis artificialibus aegroto in "statu vegetativo permanente" versanti procurantur, possunt cessare erogari ex idoneorum medicorum sententia, vi certitudinis moralis praedita, secundum quam aegrotus numquam conscientiam suam recuperaturum esse censetur? Respondetur negative; etenim aegrotus in "statu vegetativo permanente" versans semper persona est, dignitate humana nullatenus destituta, cui ex hac ipsa ratione curae ordinariae et proportionatae debentur; inter quas, in linea principii, subministratio cibi et potus, etiam methodo artificiali obtinenda, connumeranda est.
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| The Supreme Pontiff Benedict XVI, at the Audience granted to the undersigned Cardinal Prefect of the Congregation for the Doctrine of the Faith, approved these Responses, adopted in the Ordinary Session of the Congregation, and ordered their publication. Rome, from the Offices of the Congregation for the Doctrine of the Faith, August 1, 2007. William Cardinal Levada Angelo Amato, S.D.B.
| Summus Pontifex Benedictus XVI, in Audientia infrascripto Cardinali Praefecto concessa, haec responsa in Sessione Ordinaria huius Congregationis deliberata, adprobavit et publici iuris fieri iussit. Datum Romae, ex Aedibus Congregationis pro Doctrina Fidei, die I mensis Augusti anno MMVII. Gulielmus Cardinalis Levada
Angelus Amato, S.D.B.
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One of the important points to remember is that food and water are not medicine. A person is a vegetative state remains a human being with the need for what is basic to human life. If people see food and water as medicine, as if that person was receiving them as if they were therapy, then you can more easily argue for their denial. Of course there are situations in which adminstering food and water actually harm a person more than they help. Then hard decisions must be made.
But never forget, and keep yourselves attuned to the basic principles. If food and water are seen as therapy for a bad condition, they can be more easily denied. That is the fundamental error being made in many cases. That is why this statement, the response from the CDF, is so important.
Dear Father Z,
Comment by S — 14 September 2007 @ 11:23 amI thank you for posting this. I went back to check out your piece in the Wanderer as well. My mother is 83, and has Lewy Body Dementia. Now living in a nursing home down the street from my sister, she sees at least one of her children every single day. She had a feeding tube put in five years ago as a result of losing the ability to swallow properly. She looks just like Terri Schiavo did in the videos her family filmed of her. At the time she had this very simple procedure done, it took intense lobbying by all of her eight children, (three of whom are lawyers) to convince the doctor that it should be done. We searched for direction and my brother bought us each a copy of ‘Catholicism and Ethics’ so we could read for ourselves Catholic teaching on these issues. It is an incredibly hard road to fight the doctors, nurses, and care-givers who have no formation or guiding principals on this subject! We have all seen that our mother’s journey is charted by God’s hand and that we, as custodians of the woman who gave us each the gift of life, are now to be lights to everyone who cares for her. On my last visit, the very doctor who advised us to starve her to death five years ago told me that she has learned humility from treating my mom. She said, “She has proven me wrong every time I predict what will happen with her. Your mom is a fighter!†When JPII asked for a feeding tube shortly before his own death, we knew he stood with our mom and Terri Schiavo. This brought such consolation to all of us.
Father Z,
THANK YOU for posting this. It is absolutely critical that Catholics gain moral clarity on this issue, especially considering the absolute deriliction of duty on the part of Terri Schiavo’s bishop.
God bless,
Gordo
Comment by Gordo the Byzantine — 14 September 2007 @ 12:39 pmThis issue came before the U.S. Bishop’s National
Comment by Bill the Redactor — 14 September 2007 @ 2:02 pmAdvisory Council at which time an interesting point
made by a physician who did work in Haiti. What we may
consider to be “ordinary and proportionate” means of
providing medical treatment are in fact considered to
be “extraordinary” means in many third world nations.
This can pose critical moral issues particularly when
moral theologians from first world countries address
moral questions while exercising thier own particular
cultural bias.
Fr. Z said: The Pope really changed Catholic teaching with that statement.
Father, could you explain how his statement changed Catholic teaching? Thanks!
Comment by Jordan Potter — 14 September 2007 @ 4:57 pmFrZ
“Of course there are situations in which adminstering food and water actually harm a person more than they help. Then hard decisions must be made.”
Thanks for including this – I recently completed a Catholic Directive of Life and Death Declaration. This is addressed in it, i.e. when death is imminent and the body can no longer assimulate food or hydration.
There are several good sites on line which are in keeping with Catholic Teaching on this subject. Just do a search for Catholic Advance Directives. Most will reference the CCC and JP II’s clarification in the directive.
Comment by catholiclady — 14 September 2007 @ 5:40 pmI will not use the adjective here to describe the Florida bishops, especially Lynch, and the other bishops in the US who, by their silence, condoned the murder of Terry Schiavo.
But, as your article in the Wanderer makes clear Father, there is no excuse for what the bishops did by their negligence. The Holy Father’s declaration came almost 1 year to the day before Terry died (March 31, 2005) and every bishop in this country knew it.
I pray Our Lord has more mercy on them than they showed for Terry.
Comment by John Eakins — 15 September 2007 @ 12:28 pmI believe you have been very fair in your posts. After all we must, in the interest of clarity, call a spade a spade, and not waffle as some others do.
Comment by Allan Potts — 19 September 2007 @ 4:47 pm