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Conclusion

In this document we reaffirm moral principles that provide a basis for responsible discussion of the morality of life support. We also offer tentative guidance on how to appiy these principles to the difficult issue ofmedically assisted nutrition and hydration.

We reject any omission of nutrition and hydration intended to cause a patient's death. We hold for a presumption in favor of providing medically assisted nutrition and hydration to patients who need it, which presumption would yield in cases where such procedures have no medically reasonable hope of sustaining life or pose excessive risks or burdens. Recognizing that judgments about the benefits and burdens of medically assisted nutrition and hydration in individual cases have a subjective element and are generally best made by the patient directly involved, we also affirm a legitimate role for families' love and guidance, health care professionals' ethical concerns, and society's interest in preserving life and protecting the heipless. In rejecting broadly permissive policies on withdrawal of nutrition and hydration from vulnerable patients, we must also help ensure that the burdens of caring for the heipless are more equitably shared throughout our society.

We recognize that this document is our first word, not our last word, on some of the compiex questions involved in this subject. We urge Catholics and others concerned about the dignity of the human person to study these reflections and participate in the continuing public discussion of how best to address the needs of the helpless in our society.