Joseph Torchia, Artificial Hydration and Nutrition for the PVS Patient: Ordinary Care or Extraordinary Intervention?

Joseph Torchia, Artificial Hydration and Nutrition for the PVS Patient: Ordinary Care or Extraordinary Intervention? 3 NAT'L CATH. BIOETHICS Q. 719 (2003).

Does artificial hydration and nutrition (AHN) constitute ordinary care or extraordinary medical intervention in the case of persistent vegetative state (PVS) patients? The problematic nature of this issue proceeds from the fact that the PVS patient provides the paradigmatic example of human life reduced to its most basic constituents. The phenomenon of PVS (and related neurologic conditions whereby the individual is deprived of consciousness or cognitive capacity prompts us to assess the clinical situation of the basis of the patient's very humanity, rather than upon considerations of what he or she is capable of doing or expressing. In such scenarios, the compelling question is whether a loss of conscious awareness of oneself and others results in a corresponding loss of one's status as a moral agent with fundamental rights (primarily the right not to be killed).

Hydration and nutrition by intubation may cause great discomfort for some patients and a great burden for caregivers. For this reason, the author neither promotes AHN for its own sake nor advocates its use in prolonging the patient's life for its own sake, without any concern for its quality But the author challenges the tacit assumption that one can easily dismiss such a life-sustaining measure on the grounds of excessive burdensomeness, or completely deny the benefits inherent in the very continuance of human life. This is not to say that the circumstances of a given case (and more specifically, the situation of a given PVS patient), have no relevance in the decision-making process. Indeed, one must always attend to the...