A document from the Congregation for the Doctrine of the Faith: giving water and food is not a therapy, which in some cases can be suspended, but a natural means by which life is preserved. The issue was raised by the US bishops.

Vatican City (AsiaNews) – People in a “permanent vegetative state” have the right to food and drink, even via artificial means: those instruments are in fact “ordinary and proportionate means of preserving life and not a therapeutic treatment”, which can however be interrupted when there is no further possibility of curing the patient whose suffering is being uselessly prolonged.  The Vatican today reiterated its no to euthanasia, recalling at the same time not only its refusal of so-called assisted suicide but also underlining the possible existence of some cases – such as when the patient is unable to assimilate either food or drink – which allow for the suspension of the administration.

 

These are the indications which – with explicit papal approval –the Congregation for the Doctrine of the Faith supply in answer to two questions posed by the United States Bishops Conference on the issue of patients in a “permanent vegetative state”.

Evidently brought to light by the case of Terry Schiavo, the women in a “permanent vegetative state” who died in the USA at the end of March 2005 as a result of the suspension of feeding.

 

 “The administration of food and water – affirms the Vatican’s Doctrinal ministry - 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”.

 

These “ordinary” means should not be suspended not even when “competent doctors judge with moral certainty that the patient will never regain consciousness”.  A patient in a “permanent vegetative state” in fact, “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”.

 

A long note accompanying the document from the Congregation retraces the indications offered by past popes on the issue – starting with Pius XII – and the self same dicastery.  In it, in particular, it reveals how “patients in a "vegetative state" breathe spontaneously, digest food naturally, carry on other metabolic functions, and are in a stable situation. But they are not able to feed themselves. 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. 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.”.

 

In affirming that the administration of food and water is a moral obligation in line with principal, the Congregation of the Doctrine of the Faith “in very remote places or in situations of extreme poverty, the artificial provision of food and water may be physically impossible, and then ad impossibilia nemo tenetur. However, the obligation to offer the minimal treatments that are available remains in place, as well as that of obtaining, if possible, the means necessary for an adequate support of life. Nor is the possibility excluded that, due to emerging complications, a patient may be unable to assimilate food and liquids, so that their provision becomes altogether useless. Finally, the possibility is not absolutely excluded that, in some rare cases, artificial nourishment and hydration may be excessively burdensome for the patient or may cause significant physical discomfort, for example resulting from complications in the use of the means employed. These exceptional cases, however, take nothing away from the general ethical criterion, according to which the provision of water and food, even by artificial means, always represents a natural means for preserving life, and is not a therapeutic treatment. Its use should therefore be considered ordinary and proportionate, even when the "vegetative state" is prolonged”.

 

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