Faith and Feeding Tubes.

• Author: Golder, Barbara
• Position: RELIGION

Legislation concerning feeding tubes has rekindled controversy about end-of-life care. Too often, discussion occurs in a polarized context because, from the beginning, the legal perspective seems to be that patients either would be fed by a feeding tube or not fed at all. That is not acceptable to the sizable number of people, not all of them religious, who view feeding as comfort, not medical, care. Opponents of bills facilitating advance orders to remove feeding tubes legitimately claim that such legislation makes it easier to starve patients, contrasting this with removal of respirators: mechanical support is removed but the patient's access to air is not.

Ethicists are divided on this, but one thing is certain: there is a difference between removing a feeding tube and completely withholding food and water and removing a feeding tube and administering food and water by other means so that the person can take in nourishment as his or her condition permits. In one case, the individual really does die of inflicted starvation. In the other, he or she arguably dies as a result of the underlying physical condition preventing the person from taking in sufficient food and water to live. After all, one basic biologic principle is that, without the ability to breathe and take in nourishment, an organism dies.

That distinction is extremely important. Catholic teaching, in particular, requires support of life from conception to natural death. Perhaps it is time to have a discussion about the word "natural." Not even Catholic teaching requires that every conceivable means be used to extend life as long as possible. There is a great deal of space for discussion between those two ideas and it bears exploring.

Circumstances make a big difference. A patient well might accept a feeding tube in the immediate post-stroke period because, in that case, the tube supports a lost function that may be regained with time and treatment. It may be a very different situation when the person has passed the recovery period without regaining that ability. Catholic teaching does not require provision of extraordinary care--care that is too burdensome, expensive, dangerous, or disproportionate. Moreover, that determination always is individual because that which is too burdensome to one may not be for another.

One may not refuse food and water with the intent of causing death; one may refuse it because it is too painful or difficult to take. One may refuse any particular...