The National Catholic Bioethics Quarterly

Volume 10, Issue 3, Autumn 2010

Patrick Guinan, MD
Pages 481-488

Is Assisted Nutrition and Hydration Always Mandated?
The Persistent Vegetative State Differs from Dementia and Frailty

There is controversy in the Catholic medical ethics community surrounding assisted nutrition and hydration (ANH). Recently, the Ethical and Religious Directives for Catholic Health Care Services were amended to make ANH “obligatory.” The persistent vegetative state is cited specifically in the document, and the sentence following its mention states that ANH is “optional” when it cannot be expected to “prolong life” or when it would be “excessively burdensome.” For patients suffering from other medical conditions, such as dementia and frailty, ANH may be excessively burdensome and may not prolong life. For these patients, ANH may be of no real benefit and may even have significant morbidity and mortality. Competent individuals with these conditions can ethically elect to forgo ANH. National Catholic Bioethics Quarterly 10.3 (Autumn 2010): 481–488.