At their meeting this week, the bishops approved a revision to Directive 58 of the Ethical and Religious Directives for Catholic Health Care services. The Catholic Health Association has summarized the change here. The core of the change is summarized by the CHAUSA as follows:The new Directive 58 makes three points:
There is a general moral obligation to provide patients with food and water, including medically administered nutrition and hydration for those who cannot take food orally.
This general obligation extends to patients in a persistent vegetative state because of their fundamental human dignity. However, the Directive explains that this obligation ceases and the measures become "morally optional" when the measures cannot reasonably be expected to prolong the patient's life or when they become excessively burdensome. (This provision incorporates into the Directive the teaching of Pope John Paul II and the Congregation for the Doctrine of the Faith regarding medically assisted nutrition and hydration to persons in a persistent vegetative state. Catholic health care facilities have already addressed the implications of these statements).
The Directive also distinguishes between patients in a chronic state and those who are dying. This distinction has implications for the use of medically administered nutrition and hydration. For dying patients, medically administered nutrition and hydration may no longer be of benefit and may, in fact, impose significant burdens.
Traditionally, the standard for optional life-sustaining treatment was that if the treatment offered no reasonable hope of benefit and the treatment was excessively burdensome, it could be stopped. Directive 58 now interprets no reasonable hope of benefit as no reasonable hope of prolonging life. Someone in a persistent vegetative state may live 30 years irreversibly comatose and without the capacity to interact with others. I am not saying that such a life has no value, but it is hard to see how prolonging life through a surgically implanted feeding tube benefits anyone.