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Catholic Hospitals Consider Pope's Position On Feeding Tubes
By Dave Reynolds, Inclusion Daily Express
April 5, 2004

UNITED STATES--Catholic-run hospitals across the U.S. are deciding how to respond to a recent statement by Pope John Paul II in which he said they were "morally obligated" to provide food and water for people considered to be in a "persistent vegetative state".

In an address given March 20 to a Vatican conference on ethical dilemmas surrounding people who are considered legally incapacitated because of severe brain injuries, the pontiff said that providing food and water is ordinary and appropriate care -- not artificial medical intervention -- regardless of the person's level of disability or illness.

The pope called the act of removing feeding tubes "a true euthanasia by omission."

"We must neither forget nor underestimate that there are well-documented cases of at least partial recovery even after many years; we can thus state that medical science, up until now, is still unable to predict with certainty who among patients in this condition will recover and who will not," he explained.

"The sick person in a vegetative state, awaiting recovery or a natural end, still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention of complications related to his confinement to bed. He also has the right to appropriate rehabilitative care and to be monitored for clinical signs of eventual recovery."

The pope's opinion could affect policies at the 565 hospitals in the Catholic Health Association, which represent about 10 percent of hospitals in the United States. Up to this point, Catholic hospitals in the U.S. have considered feeding tubes to be medical care, which can be withdrawn when the "burden" of such treatment is considered to outweigh the benefits.

Association officials said that they will need to figure out how to address the abundance of "advance directives" and "do not resuscitate" orders that thousands of people have had formally drawn up, which call for no "heroic" or "artificial" measures to keep them alive in specific circumstances.

The New England Journal of Medicine estimated in 1994 that there were 10,000 to 25,000 adults and 4,000 to 10,000 children across the country in a persistent vegetative state. Many could only be fed and hydrated using feeding tubes or intravenous lines.

The pope's pronouncement comes as Florida courts consider the case of Terri Schiavo, whose family is Catholic.

Terri's husband and guardian, Michael Schiavo, believes she has been in a persistent vegetative state -- that she cannot interact with her surroundings, cannot feel pain, and will not recover from a 1990 brain injury. He petitioned the court in 1998 to have her feeding tube removed, claiming that she told him before her injury that she would not have wanted to live "by artificial means".

Terri's parents, Bob and Mary Schindler, believe she responds to her environment and is alert. They suspect that Mr. Schiavo wants his wife to die so he can marry a woman with whom he has fathered two children.

The courts ordered her feeding tube removed so she would die of starvation and dehydration on October 16, 2003. Governor Jeb Bush, responding to tens of thousands of messages from disability rights advocates and right-to-life supporters, championed "Terri's Law" through the Legislature, giving him permission to have the feeding tube reinserted six days later.

Mr. Schiavo immediately sued the governor, claiming that the law violated Terri's privacy, along with the Florida Constitution's separation of powers provisions.

On a related note, the American Center for Law and Justice filed a notice of appeal Monday, challenging a March 11 decision by the Second District Court of Appeal, which denied a motion to allow Terri's parents to become directly involved in defending "Terri's Law".

"Life-sustaining treatments and vegetative state: Scientific advances and ethical dilemmas" (Pope John Paul II)
"Hospitals face changes after Pope's comments" (The Olympian -- Washington)
"Pope: Life support mandatory" (Great Falls Tribune -- Montana)
"Concern over pope's remarks on comas" (Mercury News -- California)
"Press release: ACLJ Files Notice of Appeal of Florida Court Order" (Business Wire)
"Terri Schiavo's Right To Live" (Inclusion Daily Express Archives)


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