A directive by American bishops that Catholic health facilities must provide food and water even to "chronic" and irreversibly vegetative patients is colliding with patients' wishes. An elderly woman taken last year to St. John Medical Center in Tulsa, Oklahoma, had suffered a massive stroke and could no longer speak, eat or drink.
Although she had an advance directive specifying no artificial hydration or nutrition if she weren't going to recover, her nephew insisted the local bishop's directive on use of feeding tubes required the Catholic hospital to install one, according to Kaiser Health News.
In November, the U.S. Conference of Catholic Bishops approved a revised ethical and religious directive that states in part that Catholic health facilities have "an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally."
"This obligation," the bishops said, "extends to patients in chronic and presumably irreversible conditions," such as persistent vegetative state, who might live for many years if given such care. A feeding tube is not required, however, if it wouldn't prolong life, would be "excessively burdensome for the patient," or would "cause significant physical discomfort."
The Kaiser Health News report said the directive raises fresh questions about the ability of patients to have their end-of-life treatment wishes honored - and whether and how a health care provider should comply with lawful requests not consistent with the provider's religious views.
Hospitals and nursing homes do not have to comply with requests that are "contrary to Catholic moral teaching," according to longstanding policy that, as in the case of the revised directive, applies to non-Catholic patients as well.
The directive could apply to patients including those with massive strokes, advanced Alzheimer's disease, traumatic brain injury and Lou Gehrig's Disease.
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