The most recent issue of Ethics and Medics, published by the National Catholic Bioethics Center on Health Care and the Life Sciences, wades into the whole area of the ethics of withdrawing tubing feeding and hydration of a patient who is “permanently unconscious”. Ethics and Medics contains two articles, one by Stephen Napier, a staff ethicist for The National Catholic Bioethics Center in Philadelphia, and another by William E. May, Ph.D., professor emeritus at the John Paul II Institute of Marrriage and Family and senior fellow of the Culture of Life Foundation in Washington, D.C.
This is a very thorny issue, and difficult to wade through.
Napier indicates that there are three principles endorsed by Catholic ethicists and/or orthodox moral theologians: 1) One ought to respect a patient’s wish to refuse artificial nutrition and hydration (ANH); 2) ANH is proportionate treatment; and 3) Proportionate treatment is morally obligatory. He states that these three principles are seemingly inconsistent with each other, and then goes on in the article to explain how they may not be. He cites John Paul II’s address to the International Congress on “Life Sustaining Treatments and the Vegetative State: Scientific and Ethical Dilemmas” in March, 2004. He also refers to the Congregation for the Doctrine of the Faith’s Declaration on Euthanasia. He makes some very interesting distinctions in moral decision-making.
May responds claiming Napier’s article is marred by ambiguities. He refers to Napier’s distinction between spiritual suffering and physical suffering. He suggests that John Paul II was speaking not only to medical professionals in his 2004 address but also to all of us.
The whole thing is far too dense for me to summarize well, so I would encourage all of you to read it for yourselves. This is very important stuff, especially for us who may be in a position where patients come to us for moral guidance in these areas.
You can get Ethics and Medics online at: www.ncbcenter.org and click on publications.
