Bioethics in Faith and Practice, Volume 2, Number 1

14 Smith ⦁ ANH and PVS Patients 5 USCCB, ERD4. 6 USCCB, ERD5. 7 The relevant part of the Introduction to Part Five ( Issues in Care for the Dying ) of ERD 4 includes the following: “Some state Catholic conferences, individual bishops and the USCCB Committee on Pro-Life Activities have addressed the moral issues concerning medically assisted hydration and nutrition. The bishops are guided by the church's teaching forbidding euthanasia, which is "an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated." These statements agree that hydration and nutrition are not morally obligatory either when they bring no comfort to a person who is imminently dying or when they cannot be assimilated by a person's body. The USCCB Committee on Pro-Life Activities' report, in addition, points out the necessary distinctions between questions already resolved by the magisterium and those requiring further reflection, as for example the morality of withdrawing medically assisted hydration and nutrition from a person who is in the condition that is recognized by physicians as the "persistent vegetative state.” The relevant part of the Introduction to Part Five ( Issues in Care for the Seriously Ill and Dying) of ERD5 is set out below in Endnote 15. 8 See, e.g ., Christopher Tollefsen, ed., Artificial Nutrition and Hydration: The New Catholic Debate , Springer, Dordrecht, The Netherlands (2008) and Ronald P. Hamel and James J. Walter, eds., Artificial Nutrition and Hydration and the Permanently Unconscious Patient: The Catholic Debate , Georgetown University Press, Washington, D.C. (2007). 9 H. Tristam Engelhardt, Jr. and Ana Smith Iltis, “End of Life: The Traditional Christian View,” in The Lancet , volume 366, number 9490 (September 17, 2005), pp. 1045-1049. 10 John C. Harvey, “The Burdens-Benefits Ratio Consideration for Medical Administration of Nutrition and Hydration to Persons in the Persistent Vegetative State,” in Christian Bioethics , volume 12, number 1 (January 1, 2006) pp. 99- 106 at pp. 102-103. See also Alan Sanders, “The Clinical Reality of Artificial Nutrition and Hydration at the End of Life,” in The National Catholic Bioethics Quarterly , volume 9, number 2 (Summer 2009), pp. 293-304, where Sanders argues that “…the clinical reality is that ANH may cause more physical harm than good for many patients…” p. 293. 11 Harvey, “Burdens-Benefits,” pp. 102-103. 12 The Multi-Society Task Force on the Persistent Vegetative State, “Medical Aspects of the Persistent Vegetative State – First of Two Parts,” in New England Journal of Medicine , volume 330, number 21 (May 26, 1994), pp. 1499- 1508; The Multi-Society Task Force on the Persistent Vegetative State, “Medical Aspects of the Persistent Vegetative State – Second of Two Parts,” in New England Journal of Medicine , volume 330, number 22 (June 2, 1994), pp. 1572- 1579 [the foregoing sources are hereafter cited collectively for convenience as “NEJM Task Force Articles on PVS.”] 13 Myles N. Sheehan, “Feeding Tubes: Sorting out the Issues,” in Health Progress , volume 82, number 6 (November- December 2001), pp. 22-27. 14 William Shakespeare, Merchant of Venice , Act 1, Scene 2, Lines 205-207. 15 The Introduction to Part Five ( Issues in Care for the Seriously Ill and Dying ) of ERD5 provides, in pertinent part, as follows: “The Church’s teaching authority has addressed the moral issues concerning medically assisted nutrition and hydration. We are guided on this issue by Catholic teaching against euthanasia, which is ‘an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated.’ While medically assisted nutrition and hydration are not morally obligatory in certain cases, these forms of basic care should in principle be provided to all patients who need them, including patients diagnosed as being in a ‘persistent vegetative state’ (PVS), because even the most severely debilitated and helpless patient retains the full dignity of a human person and must receive ordinary and proportionate care.” The primary source cited in this Introduction is the Declaration on