UPDATE: The 5th edition of the ERDs can be found at <www.usccb.org/meetings/2009Fall/docs/ERDs_5th_ed_091118_FINAL.pdf>.
The following letter was sent, BEFORE I was able to locate the new edition on the internet....
I have noticed that two documents approved at the November 09 meeting of the U.S. Bishops were quickly and readily available on the internet:
In light of the widely reported updates to the USCCB's Ethical & Religious Directives for Catholic Health Care Service, it is confusing as to why an earlier version of the ERDs continues to be posted - especially in light of its needed revisions & potential misuse by some.Back in 1995, Section 120 of the Vatican's Charter for Health Care Workers stated that "The administration of food and liquids, even artificially, is part of the normal treatment always due to the patient when this is not burdensome for him: their undue suspension could be real and properly so-called euthanasia." The 2001 Introduction to Part 5 of the USCCB's Ethical and Religious Directives for Catholic Health Care Services (4th ed.) stated that,
- "Some state Catholic conferences, individual bishops, & the USCCB Committee on Pro-Life Activities (formerly an NCCB committee) have addressed the moral issues concerning medically assisted hydration & nutrition....
- "These statements agree that hydration & nutrition are not morally obligatory either when they bring no comfort to a person who is imminently dying or when they cannot be assimilated by a person's body. The USCCB Committee on Pro-Life Activities' report, in addition, points out the necessary distinctions between questions already resolved by the magisterium & those requiring further reflection, as, for example, the morality of withdrawing medically assisted hydration & nutrition from a person who is in the condition that is recognized by physicians as the 'persistent vegetative state' (PVS)."
In retrospect, it appears that the wording of this section was subject to misinterpretation. Just shortly before he died, Pope John Paul II certainly made clear that "the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering" As per the Vatican's 2007 Responses to Certain Questions of the USCCB Concerning Artificial Nutrition and Hydration,
- "The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented....
- "A patient in a 'permanent vegetative state' is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means."
Especially in light of such forthright clarification, the 2/13/09 statement from the Consortium of Jesuit Bioethics Programs strikes me as scandalous:
- "In July 2007, seven directors of bioethics programs at Jesuit universities came together to form the Consortium of Jesuit Bioethics Programs, dedicated to informing and influencing medical-ethical debates within the Catholic Church and the larger society. As one of our first outreach tasks, our consortium decided to address the subject of ANH....
"the pope’s [2004] statement included some assertions that surprised many involved in health care....Some theologians believe these statements represent a departure from long-standing Roman Catholic bioethical traditions. - "The current U.S. Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services (fourth edition, 2001)....would appear not to align with John Paul’s 2004 allocution....
- "Subsequent statements by the Congregation for the Doctrine of the Faith (CDF) and the Vatican have seemed to uphold a stringent reading of the pope’s statement....We wish to warn against making hasty generalizations from recent Catholic teaching....
- "We believe that the current edition of the Ethical and Religious Directives properly acknowledges the importance both of long-standing principles and of individual discernment-and we hope that as the U.S. bishops consider revising specific directives, they will preserve that balance."
As reported last month by the Catholic News Service,
"In presenting the revised text Nov. 16, Bishop Lori said the directives, last revised in 2001, 'were written long before' Pope John Paul II's March 2004 address to an international conference on 'Life-Sustaining Treatments and the Vegetative State' and the Vatican Congregation for the Doctrine of the Faith's August 2007 reply to questions raised by the USCCB on artificial nutrition and hydration....Bishop Lori said the changes were needed 'particularly since the recent clarifications by the Holy See have rendered untenable certain positions that have been defended by some Catholic theologian and ethicists'"
I imagine that there must be some sort of reason why the 5th edition of the ERDs has yet to be posted. In the interim, it seems critical to remove the 4th edition from the internet.
