REASONS OFFERED for DISCONTINUING LIFE-SUSTAINING TREATMENT in PATIENTS IN A PERSISTENT VEGETATIVE STATE

From the Catholic Community:

Our tradition does not demand heroic measures in fulfilling the obligation to sustain life.  A person may legitimately refuse even procedures that effectively prolong life, if he or she believes they would impose excessively grave burdens on himself or herself, or on his or her family and community.  Catholic theologians have traditionally viewed medical treatment as excessively burdensome if it is:

[1] “too painful,

[2] too damaging to the patient’s bodily self and functioning,

[3] too psychologically repugnant to the patient,

[4] too restrictive of the patient’s liberty and preferred activities,

[5] too suppressive of the patient’s mental life, or

[6] too expensive.”

 NUTRITION and HYDRATION Moral and Pastoral Reflections 1992 (Resource Paper from the Committee for Pro-Life Activities of the National Conference of Catholic Bishops; April 2, 1992]

From the Secular Community:

Decisions to withhold or withdraw life-sustaining treatment for formerly competent patients who are not terminally ill generate an additional layer of ethical concern, presumably because such decisions inescapably are based on quality-of-life judgments. In considering the category of severely debilitating but nonterminal conditions, one might think, for example, of a stroke victim who is desperately compromised, yet in a relatively stable state, and thus is not terminally ill. Or one might think of an Alzheimer's patient who is already significantly debilitated and on a progressively (but slowly) worsening trajectory. I believe that a significant number of people, thinking prospectively, would conclude that they would not want their life to be prolonged in such states, giving one or more of the following reasons: life in such a state is:

[1] humanly meaningless,

[2] undignified for a human being,

[3] burdensome to self,

[4] burdensome to family (or perhaps to society as a whole)

Persistent Vegetative State, Prospective Thinking, and Advance Directives, Thomas a Mappes,  Kennedy Institute of Ethics Journal - Volume 13, Number 2, June 2003, p. 119

REASONS OFFERED for CONTINUING LIFE-SUSTAINING TREATMENT in PATIENTS IN A PERSISTENT VEGETATIVE STATE INCLUDE:

1) Nutrition and hydration are part of the normal care that should always be offered to the sick and (or perhaps especially) to the gravely disabled.

2) Food and fluids can prevent the suffering that may arise from dehydration, hunger and thirst.

3) Discontinuing life-sustaining measures often entails a pro-euthanasia moral position

4) Some of those who are allegedly irreversibly comatose may possess a conscious mental life

5) “Comatose patients are capable of setting up powerful moral fields without which certain segments of the human community [i.e those who care for and defend the interests of the unconscious] could not optimally flourish[...] those who share the concern of making themselves as good as they can be , need seriously to reconsider the nature of their relationships with the conscious.”

Numbers 4 and 5 above are taken from :Philosophical Reflections on Coma. Contributors: A.A. Howsepian .  The Review of Metaphysics. Volume: 47. Issue: 4. 1994.

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