Directives provide moral, ethical guidance for families and health care organisations
Bishop Thomas Olmsted of Phoenix, Arizona issued a document last week to help Catholics make tough decisions concerning artificially administered nutrition and hydration that are consistent with Church teaching.
The document, titled Directives for Catholics Concerning Artificially Administered Nutrition and Hydration, specifically addresses providing artificial hydration and nutrition for those facing illness who require artificial assistance.
Emphasising that “a person should die from one’s illness and not because a basic necessity of life was denied them,” Bishop Olmsted said: “Food and water are basic necessities of life and should be provided to a person even if he or she is unable to manually feed themselves.
“In fact, it would be inhumane to deprive someone who is thirsty a drink of water no matter who he or she is, or in what condition we find him or her. In short, a person should not die because of being deprived of nutrition and hydration, even if that nutrition and hydration is administered artificially.”
Bishop Olmsted adds that “Catholics are to be provided nutrition and hydration so long as that nutrition and hydration continues to be assimilated by the person’s body and does not contribute to further grave complications and burdens,” such as “in a situation where a person is actively dying, one’s death being imminent.”
Fr John Ehrich STL, an expert in bioethics who serves on the ethics committee at St Joseph’s Hospital and Medical Centre in Phoenix, told the Catholic Sun newspaper of Phoenix that the document coincides with many questions being asked in the public forum about end-of-life issues.
It also comes as the Greens are set to introduce a new euthanasia Bill into the West Australian Parliament on October 6 following the case of Perth quadriplegic Christian Rossiter, 49, being granted the right to refuse nutrition from his carer by the Perth Supreme Court.
Bishop Olmsted’s document, released to the public and health care institutions, addresses confusion about artificial hydration and nutrition that surfaced globally after the controversial death of Terri Schiavo, a brain-damaged woman whose husband won the right to discontinue her artificial nutrition and hydration. She died on March 31, 2005, 13 days after doctors withdrew nutrition and hydration.
A wide array of critics and pro-life activists decried Schiavo’s demise as murder. Bishop Olmsted describes the death as “tragic” in an introductory letter to priests, deacons and religious of the Diocese of Phoenix.
“Etched in our memories are the photos and video images of Terri Schiavo as well as the knowledge of the horrible way in which her life ended,” the Bishop wrote. “Terri was not dying and the ultimate reason her life ended was because she was not provided with food and water. She died of dehydration.”
The letter states that Catholics are not obligated to extend their lives but they are obligated to preserve them. A person is not to do anything – or omit anything – that may hasten death. Fr Ehrich said that the death of Terri Schiavo was an instance of euthanasia, condemned by the Church.
Bishop Olmsted also referred to a 1998 meeting John Paul II had with bishops in the US in which the late pontiff stated that “the omission of nutrition and hydration intended to cause a patient’s death must be rejected and that, while giving careful consideration to all the factors involved, the presumption should be in favour of providing medically assisted nutrition and hydration to all patients who need them”.
Fr Ehrich called attention to the distinction between preserving life and prolonging life. People have a duty to “avail themselves of the ordinary care which preserves their life,” he said. “Nutrition and hydration is this kind of care, even if administered artificially.”
But that doesn’t mean prolonging life when it’s clear that death is imminent.
“Most people don’t desire to either starve to death or die because of dehydration, but they also do not desire to submit to every possible medical intervention as they approach death,” Fr Ehrich said.
“A person should die because of their illness or the illnesses that are present, not because they were denied nutrition and hydration,” he said. The directives do not represent new teaching but are, rather, the application of existing Church teaching to specific circumstances.
The directives state that in cases in which a person is actively dying or death is imminent, artificial nutrition and hydration “would be unnecessary and unduly burdensome” and not obligatory.
“The faithful should seek to have a well-formed conscience which can only be attained if they know the definitive teaching of the Church. This is the starting point,” Fr Ehrich said, suggesting that people could give a copy of the Bishop’s directives to their doctor or nurse and tell them that they want to make sure that their loved one is treated according to their principles.
Fr Ehrich also said those same principles should be included in any advance directives Catholics have in order for their loved ones and medical professionals to know how they want to be treated at the end of their lives.
“The only way to be sure of doing the right thing is to follow the teachings of the Church in this area. Most people act in good faith, but often decisions of this kind are made based upon emotions or upon a desire to end a loved one’s suffering,” Fr Ehrich said.
“This reality is understandable, but it also can lead to errors of judgement.”