The Magazine of The Evangelical Lutheran Church in America


Artificial feeding morally required?

Pope John Paul II's stunning adjustment of Roman Catholic teaching could affect policies at U.S. Catholic hospitals on the artificial administration of nutrition.

"The administration of food and water, even when provided by artificial means, represents a natural means of preserving life, not a medical act," the pope said at March 20 Vatican conference. Consequently, hospitals are "morally obligated" to continue artificial feeding and hydration for people in a persistent vegetative state. Withdrawing such "basic care" is "euthanasia by omission," he added.

The Ethical and Religious Directives for Catholic Healthcare Services, the guiding principles for U.S. Catholic hospitals, states artificial feeding should be practiced "as long as this is of sufficient benefit to outweigh the burdens involved to the patient." While this document remains in effect, various Catholic spokespeople say it may require revision by the U.S. Catholic bishops in light of the pope's statement.

An ELCA message, End of Life Decisions, adopted by the ELCA Church Council in 1992, defines artificial feeding and hydration as "medical treatment," not "basic care." It says patients and their legal decision-makers have a right to refuse unduly burdensome treatments that are "disproportionate to expected benefits.

"When ... artificially administered nutrition and hydration will not contribute to an improvement in the patient's underlying condition or prevent death from that condition ... it may be morally responsible to withdraw them and allow death to occur."


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Embracing diversity