Required for Survival: Food & Water as Moral Default

The May-June 2005 issue of Liguorian Magazine featured an article by Mark Miller, CSsR, entitled “The Controversy Surrounding Feeding Tubes.” I sent the following letter in response. It was not printed, and I never received a reply.
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Editor:

The May 2005 issue of Liguorian includes several beautiful tributes to Pope John Paul II, for which I commend you. His life of love and service, particularly in his role as Pope, was marked by holiness, fidelity to Truth, and tireless efforts on behalf of the world's most vulnerable.

The quality of your memorial section devoted to our beloved John Paul II makes the brief article by Fr. Mark Miller, CSsR, on feeding tubes all the more jarring. Fr. Miller rightly refers to the Pope's March 2004 allocution making it clear that the provision of food and water – even through a tube – must always be considered a part of ordinary care. But then Miller completely undermines the weight of the Holy Father's teaching by contrasting it with the work of “other moral theologians” who see food and water as optional – depending on “context and circumstances.”

This is pure relativism and is exactly the kind of muddled moralizing that John Paul was addressing. The last paragraph of Fr. Miller’s essay refers to “no swallowing ability, no awareness, and no sensation” – an apt description of a person in a persistent vegetative state, or any unconscious state for that matter. Where Fr. Miller makes a serious error is in following that description with the phrase, “the body slowly shuts itself down in a painless process.” This would occur only if there were an underlying and untreatable pathology that would inexorably lead to death, or if the individual were denied the ordinary elements required for survival – including, namely, food and water.

That is the crucial point: When food and water are withheld such that a person dies as a direct result, the only conclusion possible is that a willful homicide has occurred. How can it be otherwise? Obviously, when the provision of nutrition and hydration are no longer serving any purpose at all, and in fact become burdensome – even to the recipient – then it may be discontinued. But such a situation was not being addressed by the Pope’s allocution in the spring of 2004; he was addressing a narrowly prescribed set of circumstances, and it seems providential that, almost exactly a year later, the exact circumstance he had referred to burst into the public eye with the battle over Terri Schiavo.

Of course consideration must be made for the particular circumstances of individual cases, but what the Holy Father did (and admirably well, in my own opinion) is to help us know the limits of what can be debated, even in the hard cases. No one is claiming that food and water must be provided at all costs until the very last breath has passed one's lips; what the Pope declared is that no one should ever die from starvation and dehydration – and that is precisely what happens when feeding tubes are discontinued in the absence of underlying pathologies that naturally lead to death.
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