Food & Drink for the Least of These
The Pope Speaks Up for Those on Medical Death Row
by Kenneth D. Whitehead
In March 2004, Pope John Paul II declared at an international conference in Rome that the provision of food and water by tube to unconscious patients in the so-called vegetative state is not “extraordinary” medical care that may or may not be given to them, depending on circumstances, but is rather a part of normal and ordinary patient care. Hence, he said, such care must not be withheld from them, even though most of them have little hope of returning to consciousness, much less of actually recovering.
The pope was in no way saying that artificial means must always be used to keep people alive at all costs, as some who fear being helpless and hooked up to tubes and machines may have feared. On the contrary, he was speaking about a specific class of patients, those in what is called (wrongly) a “persistent vegetative state” (PVS), and he judged that these patients, when they are not in the process of dying, must continue to be supplied with basic food and water—assistednutrition and hydration (ANH), as the technical term has it.
Those in a “persistent vegetative state” are able to breathe and are fully alive with functioning organs. They are not conscious, but they are not comatose either, since they go through cycles of being “awake” as well as “asleep.” They are mostly unconscious, however, or at least not fully conscious, and they exhibit minimal or no reactions to stimuli or to their environment generally.
The tendency of contemporary medical practice has been to treat them not as regular patients, but as exceptional patients, in a different category from patients who are convalescing or healing. The result has been the increasing willingness to cause them to die by removing their feeding tubes. And so, not surprisingly, the pope’s statement was almost immediately met with widespread indignation and protests. But what did the pope actually say?
What He Said
John Paul II addressed a conference co-sponsored by the Pontifical Academy for Life and the World Federation of Catholic Medical Associations, with the title “Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas.” The pope’s address came at the end of the conference, after a number of his points had already been made by other speakers, and some of them contested by yet others.
Deploring the idea that a term such as “vegetative” could ever be applied to human beings, the pope was nevertheless obliged to use the term himself, since he recognized that it had come to be so “solidly established.” He insisted that there were “well-documented cases of at least partial recovery” of some of these patients, even after many years.
He criticized those “who cast doubt on the persistence of the ‘human quality’” of such patients. Given the nature and the typical permanence of their condition, many people unhappily have come to judge them not only as “hopeless cases,” but even as less than fully human. Speaking “in opposition to such trends of thought,” he insisted that
the intrinsic value and personal dignity of every human being do not change no matter what the concrete circumstances of his or her life. A man, even if seriously ill or disabled in the exercise of his highest functions, is and always will be a man, and he will never become a “vegetable” or an “animal.”
Kenneth D. Whitehead is the 2004 recipient of the Blessed Frederic Ozanam Award for Catholic Social Action of the Society of Catholic Social Scientists (SCSS). He writes frequently on Catholic social and moral issues.
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