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Experts Confront Problem of Euthanasia by Omission. Underline Papal Teaching on Care for Patients in Persistent Comas
PHILADELPHIA, Pennsylvania, JUNE 11, 2009 (Zenit.org).- A group of experts are highlighting papal teaching that people in persistent comas should be nourished regardless of the cost, as an ordinary duty of persons to one another.

This was affirmed in an article published this month in the journal of the National Catholic Bioethics Center, Ethics and Medics, signed by a group of 15 scholars.

Some of the contributing scholars are: Robert George, jurisprudence professor at Princeton University; William May, retired moral theology professor at the John Paul II Institute for Studies on Marriage and Family; Christian Brugger, moral theology professor at St. John Vianney Theological Seminary; and Father Thomas Berg, executive director of Westchester Institute for Ethics and the Human Person.

They responded to a statement published in the February issue of Commonweal, written by a consortium consisting of seven directors of bioethics programs at Jesuit universities, about the "papal teaching on the moral requirement to provide food and water to patients in the so-called persistent vegetative state."

The aim of the consortium, the scholars asserted, "is to influence the American bishops against amending the 'Ethical and Religious Directives for Catholic Health Care Services.'"

The article reported that this month the bishops will consider the amendment which will "bring the directives in line with the March 2004 teaching of Pope John Paul II" on the "persistent vegetative state."

The scholars underlined a 1992 document by the pro-life committee of the U.S. bishops titled "Nutrition and Hydration: Moral and Pastoral Reflections," which "warned against any removal of food and water from persons in the vegetative state based on a 'quality of life' judgment about the value of their lives or on the cost of total care."

Although the prelates did not at that time explicitly include patients in the vegetative state, they noted that this was only because they were waiting for the official word from the magisterium, which came with Pope John Paul II.

The article reported the Pope's statement that "providing food and water to patients in a [persistent vegetative state] is morally required, even when doing so does not facilitate the patient's recovery from the comatose condition."

It explained: "Providing food and water should not be considered a medical act strictly speaking, but an ordinary and proportionate means of caring for disabled patients; the Pope calls them forms of basic health care to which every patient, no matter how disabled, has a right.

"The administration of nutrition and hydration is thus morally obligatory, provided that they remain useful for accomplishing their end, namely, to nourish the patient and preserve his or her life."

Consistent

The teaching of Pope John Paul II, the scholars asserted, "is consistent with what the Church has explicitly taught on the subject for the last 30 years."

The article also responded to the consortium's claim that the papal teaching is "out of touch with American medical and legal realities," stating that the Jesuit group missed the point of the Pope's words.

The scholars clarified: "The Pope's statement that feeding and hydrating disabled patients 'always represents a natural means of preserving life, not a medical act' is not a judgment about the complexity of health care procedures.

"It is a normative judgment about the basic duties of persons to one another based on 'the intrinsic value and personal dignity of every human being.'

"Feeding disabled people is not a medical treatment, even though a medical procedure may be required. It is a form of care owed to all persons, including patients in a [persistent vegetative state]."

The scholars noted that "the papal teaching nowhere requires a specific form of nutrition and hydration, especially if expense poses an unreasonable burden."

However, they added, "it does forbid choosing to withhold all food and water when a patient needs them to survive and they do not impose undue burdens on that patient."

The main concern of the papal teaching, the scholars stated, "is to confront the growing problem of euthanasia by omission for patients in a [persistent vegetative state]."

The article asserted, "The Holy See's teaching that assisted feeding is a part of normal care does not stop being true just because the patient's cognitive loss is due to something other than a [persistent vegetative state]."

The article affirmed that the health care guidelines should be amended if they are unclear in these principles and "lend themselves to justifying the removal of food and water from patients in a [persistent vegetative state], or any cognitively diminished patients."