Pope John Paul II said Saturday the removal of feeding tubes from people in vegetative states was immoral, and that no judgment on their quality of life could justify such "euthanasia by omission."
John Paul made the comments to participants of a Vatican conference on the ethical dilemmas of dealing with incapacitated patients, entering into a debate that has sparked court battles in the United States and elsewhere.
The pope said even the medical terminology used to describe people in so-called "persistent vegetative states" was degrading to them. He said no matter how sick a person was, "he is and will always be a man, never becoming a 'vegetable' or 'animal.'"
In a vegetative state, patients are awake but not aware of themselves or their environment. The condition is different from a coma, in which the patient is neither awake nor aware. Both, however, are states in which the patient is devoid of consciousness.
If the vegetative state continues for a month, the patient is said to be in a persistent vegetative state; after a year without improvement, the patient is said to be in a permanent vegetative state.
Providing food and water to such patients should be considered natural, ordinary and proportional care — not artificial medical intervention, the pope told members of the conference, which was organized by the World Federation of Catholic Medical Associations and the Pontifical Academy for Life, a Vatican advisory body.
"As such, it is morally obligatory," to continue such care, he said.
Since no one knows when a patient in a vegetative state might awaken, "the evaluation of the probability, founded on scarce hope of recovery after the vegetative state has lasted for more than a year, cannot ethically justify the abandonment or the interruption of minimal care for the patient, including food and water," he said.
Similarly, he said that someone else's evaluation of the patient's quality of life in such a state couldn't justify letting them die of hunger or thirst.
"If this is knowingly and deliberately carried out, this would result in a true euthanasia by omission," he said.
John Paul has consistently voiced opposition to euthanasia, which the Vatican defines as "an action or omission that by its nature and intention" causes death to end pain. It says euthanasia always is a violation of God's law.
The issue over removing feeding tubes has prompted several court cases and legislation in the United States, Australia and elsewhere.
In a highly publicized case in Tampa, Fla., the husband of a severely brain-damaged woman, Terri Schiavo, has battled her parents for years to have his wife's feeding tube removed so she can die. He says she wouldn't have wanted to be kept alive with it.
The issue has involved the state legislature as well as the governor, who was given the authority to have the feeding tube reinserted after the woman's husband had it removed.
In his comments, John Paul said families of such ill people needed more emotional and economic support, so that they can better care for their loved ones. In addition, he said, society should commit more money to find cures for them.