Caring to the End: Food and Hydration “In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally. This obligation extends to patients in chronic and presumably irreversible conditions (e.g. the ‘persistent vegetative state’) who can reasonably be expected to live indefinitely if given such care. Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be ‘excessively burdensome for the patient or (would) cause significant physical discomfort, for example, resulting from complications in the use of the means employed.’ For instance, as a patient draws close to inevitable death from an underlying progressive and fatal condition, certain measures to provide nutrition and hydration may become excessively burdensome and therefore not obligatory in light of their very limited ability to prolong life or provide comfort.”19 Adherence to this directive is binding for all Catholics. Transferring off a case to protect one’s conscience may be necessary when it is violated.(see p. 34) Conversing with Dying Patients & Family Let no one who approaches you go away without that trust in My mercy which I so ardently desire for souls (1777). Nurses and other medical professionals often refrain from discussing spiritual or pastoral care needs with their patients because they either believe that it is beyond their professional competence, or their comfort zone, or simply because they are afraid of death. It is much easier for a seasoned nurse or a doctor to speak about death to a dying person, yet all must 72
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