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Questions About Medically Assisted Nutrition And Hydration

2. Is medically assisted nutrition and hydration a form of "treatment" or "care"?

Catholic teaching provides that a person in the final stages of dying need not accept "forms of treatment that would only secure a precarious and burdensome prolongation of life," but should still receive "the normal care due to the sick person in similar cases." 15 All patients deserve to receive normal care out of respect for their inherent dignity as persons. As Pope John Paul II has said, a decision to forgo "purely experimental or ineffective interventions" does not "dispense from the valid therapeutic task of sustaining life or from assistance with the normal means of sustaining life. Science, even when it is unable to heal, can and should care for and assist the sick." [16] But the teaching of the Church has not resolved the question whether medically assisted nutrition and h~dration should always be seen as a form of normal care.

Almost everyone agrees that oral feeding, when it can be accepted and assimilated by a patient, is a form of care owed to all helpless people. Christians should be especially sensitive to this obligation, because giving food and drink to those in need is an important expression of Christian love and concern (Mt 10:42 and 25:35; Mk 9:41). But our obligations become less clear when adequate nutrition and hydration require the skills of trained medical personnel and the use of technologies that may be perceived as very burdensome - that is, as intrusive, painful or repugnant. Such factors vary from one type of feeding procedure to another, and from one patient to another, making it difficult to classify all feeding procedures as either "care" or "treatment."

Perhaps this dilemma should be viewed in a broader context. Even medical "treatments" are morally obligatory when they are "ordinary" means - that is, if they provide a reasonable hope of benefit and do not involve excessive burdens. Therefore, we believe people shouid make decisions in light of a simple and fundamental insight: Out of respect for the dignity of the human person, we are obliged to preserve our own lives, and help others preserve theirs, by the use of means that have a reasonable hope of sustathing life without imposing unreasonable burdens on those we seek to help, that is, on the patient and his or her family and community.

We must therefore address the question of benefits and burdens next, recognizing that a full moral analysis is only possible when one knows the effects of a given procedure on a particular patient.