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The National Catholic Bioethics Quarterly

Volume 16, Issue 3, Autumn 2016

Barbara Golder, MD, E.Wesley Ely, MD, John Raphael, Ashley K. Fernandes, MD, Annmarie Hosie, RN
Pages 435-448

Assisted Nutrition and Hydration as Supportive Care during Illness
Bedside Application of Catholic Moral Teaching

Confusion surrounds Catholic teaching on the use of assisted nutrition and hydration (ANH), specifically the question of when, if ever, its refusal or removal is ethical. This paper focuses on two often-neglected considerations: (1) the relationship between means (feeding) and mechanism (how the food is delivered), and (2) an assessment of proportionality of the mechanism from the patient’s perspective. The authors draw on two critical principles of Catholic moral teaching: only ordinary means are required, and proportionality is subject to the perspective of the patient, not just that of experts or the culture. The mechanisms that provide food and water have distinct benefits and burdens. Their proportionality is properly subject to analysis by the patient or surrogate, who determines which mechanism is acceptable in the patient’s situation.