What should be done with a person who is in a persistent vegetative state and whose body only continues to live through the intervention of machines, like feeding tubes? According to Pope John Paul II, we are morally obliged to keep the machines running - a decision that conflicts with the standard practices in many Catholics hospitals. Now hospital administrations are scrambling to figure out what to do next.
Barbara Feder Ostrov writes:
In his remarks, the pope described providing food and water to such vegetative patients as "a natural means of preserving life, not a medical act." But Catholic hospitals in the United States consider feeding tubes to be medical care that can be withdrawn when the burdens of a particular treatment outweigh its benefits, a view upheld by U.S. and California Supreme Court decisions. ... His remarks could also create problems for families of patients who have requested do-not-resuscitate orders or have established living wills asking to end treatment if they enter a coma or similar vegetative state.
The remarks are considered an "allocution," which reflects the pope's opinions, but do not carry the legal weight of an encyclical, which is a formal pastoral letter by the pope addressed to the whole church. ... "We're going to take the pope's statements very seriously," Bayley said. "We're going to look at what effect this could have on our practice."
"I think the pope is completely misguided on this," said David Magnus, co-director of Stanford University's Center for Biomedical Ethics. "Putting in a gastric tube is a serious medical intervention with serious repercussions. Sometimes people don't want to be kept alive in persistent vegetative state. The importance of feeding is so culturally significant that idea of withholding it bothers some people (but) if there's no prospect of getting better, what is the value of continuing medical intervention?"
The key point here seems to be the level of intervention created by a feeding tube. The pope considers it a "natural act" rather than an invasive procedure - and if he were correct, I would be inclined to say that he has a point. I can certainly understand a general bias that treats the provision of nutrition as a "natural act" rather than a "medical act," but in this case I think that Magnus has the better argument: feeding tubes are invasive procedures that have serious repercussions.
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