Vatican rules on nourishment for vegetative patients

Vatican City - The Vatican, ruling on a debate that has divided Catholic hospitals, said on Friday it was wrong to stop administering food and water to patients in a vegetative state even if they would never regain consciousness.

In a document approved by Pope Benedict, the Vatican's doctrinal department said tube-feeding such patients presumed to be near death was "ordinary" care that should not be discontinued because the patients still had human dignity.

The document was bound to prompt further debate among bioethicists, especially in the extensive health system the Church maintains in many countries, over how far doctors should go in using the latest scientific methods to sustain life.

It reaffirmed a position taken by the late Pope John Paul in 2004 during a heated debate in the United States about ending artificial feeding for the severely brain-damaged Terri Schiavo. She was taken off her feeding tube and died in 2005.

"The administration of food and water even by artificial means is, in principle, an ordinary means of preserving life," the one-page document said, adding the aim of such nourishment was to "prevent death by starvation and dehydration".

Even when food and water are administered by artificial means, it was wrong to discontinue them because even a person in a permanent vegetative state had "fundamental human dignity".

The Church opposes euthanasia but teaches that extraordinary -- that is, overly aggressive and possibly painful -- means of artificial life support can be stopped if the family wishes.

The Vatican ruling came in response to questions put forward by the U.S. Catholic Bishops Conference after debate among Catholic ethicists and hospitals there on what constitutes ordinary and extraordinary life support.

In an interview with Vatican Radio, the doctrinal department's undersecretary, Father Augustine Di Noia, rejected arguments that the life of someone in a vegetative state was not worth living and therefore could be ended.

"Life is a gift from God and the Church has consistently taught that it is a gift that is not subject to the determination and decision, really, of anyone -- including the person himself or herself who is ill," he said.

The latest Vatican clarification was prompted by a debate that has been going on for years but intensified after John Paul condemned ending nourishment for those in a vegetative state.

Some bioethicists at Catholic hospitals in the United States questioned that speech, saying it overturned long-standing Church teaching and was so vague that it needed further study.

Some also questioned how authoritative it could be, since John Paul was himself frail and near death at the time and could have been overly influenced by aides.

The Catholic Health Association called for careful study of the statement and advised member hospitals in the meantime to continue providing artificial nutrition and hydration only as long as the benefits outweighed the burdens involved.

Bioethicists opposed to the unconditional use of feeding tubes argue that such nourishment can keep the bodies of brain-dead patients functioning even though the person is effectively dead. They say this is wrong for both the patient and the family.