A committee of the nation's Roman Catholic bishops, addressing a question that has divided their ranks, has issued a warning against the increasingly widespread practice of withdrawing food and liquid from irreversibly unconscious patients.
But calling the statement "our first word, not our last word," the panel acknowledged that Catholic teaching had not reached definite conclusions on all the moral questions surrounding withdrawal of treatment.
The 9,000-word statement was issued yesterday by the Committee for Pro-Life Activities of the National Conference of Catholic Bishops. The 52-member Administrative Committee of the conference authorized its publication.
"We are gravely concerned about current attitudes and policy trends in our society that would too easily dismiss patients without apparent mental faculties as non-persons or as undeserving of human care and concern," the statement said.
But it added that Catholic theologians were divided about removing all artificial life supports, including feeding tubes, from those in a "persistently vegetative state."
Legitimate differences could even arise about applying well-established moral principles to specific cases, the bishops said.
They urged Catholics and others to pursue these issues while, in the meantime, being "guided by a presumption in favor of medically assisted nutrition and hydration."
Labeled "a resource paper," the document is not meant to be binding on Catholics, said Bishop James T. McHugh of Camden, N.J., who oversaw the drafting of the statement. "It doesn't reject out of hand all other approaches," he said, "but having considered them, this gives a clear signal in one direction."
The committee, which focuses on abortion and euthanasia, is one of the most important panels of the bishops' conference. It includes four cardinals and some of the nation's most prominent archbishops among its 11 members and 10 consultants.
In the last few years, prominent Catholic theologians, individual bishops and even some state conferences of bishops have issued contrasting opinions on withdrawing food and fluids from the permanently comatose.
All have drawn upon traditional Catholic teaching that distinguishes between directly taking patients' lives, which is always forbidden, and forgoing life-extending treatments, which is permissible when the treatments are futile or very burdensome.
One group of theologians holds that medically supplied nourishment and fluid can be considered futile when there is no possibility that the patient will ever regain consciousness. In their opinion, the total care involved in prolonging the life of a comatose patient can be viewed as a burden.
Another group of theologians believes that sustaining physical life alone is a benefit, and only when death is imminent can artificial life support be considered truly futile.
They limit the burdens of tube-feeding to those that the treatment directly causes, such as pain or psychological repugnance, neither of which can be experienced by the permanently comatose.
The bishops' committee favors the latter view. They fear that dangerous precedents will be created by minimizing the value of physical life, even without consciousness, or by looking to the overall state of the comatose patient in estimating the burden of treatment.
The statement did not rule out the removal of feeding tubes in some cases of patients in a persistently vegetative state, but said such a state should not be considered a reason for withdrawing life support.