There has been much philosophical debate by those in the field of bioethics and in the Catholic Church on the topic of long term artificial nutrition and hydration in permanently vegetative state (PVS) patients. The issue has been even more hotly debated since the Terri Schiavo case and there is much controversy within the very influential Catholic Church. After reading the articles in the handout “Artificial Nutrition and Hydration: Catholic Controversies” I thought that the strongest perspective presented was that of James J. McCartney in his writing “Reverence for Human Life”. McCartney quotes Moses when he tells the Israelites to “Choose Life!” and to revere life in all forms. He shares the traditional Catholic opinion that biological life is not an absolute value and that it is always second to the spiritual life. When a patient is in a permanent vegetative state and there is no realistic chance that they will ever recover, then it can be in the patient’s and family’s best interest to remove the artificial nutrition and hydration.
McCartney considers artificial nutrition and hydration on PVS patients to be an “extraordinary” treatment that should not be required if it causes excessive burden to the patient, their family, and society. He uses the idea of benefits versus burdens to determine if a treatment is morally justified or not. The realistic benefits of continuing such treatment are weighed against all of the burdens that such an extreme and sometimes futile treatment can present. These excessive burdens can and should be outlined by a patient and explained to their health care proxy to determine at which point they would not want continued treatment and are unable to say it themselves. Criteria for considering if this treatment would be overly burdensome include if it jeopardizes the patient’s higher spiritual goals, if it causes great anxiety to the patient or their family, and if it significantly destroys the quality of life for the patient.
McCartney quotes the revered Pope Pius XII on this issue saying that “Life, Health, and all temporal activities are subordinated to spiritual ends”. The values of the patient should be respected during any treatment.