Joe Kral’s article, The End of the Texas Impasse: The Moral Case for HB 3074, published on April 6 in the Truth & Charity Forum, offers some useful contributions to the problematic debate regarding Texas’ legislation of artificially administered nutrition and hydration. However, HB 3074 is a deeply flawed bill and should not be supported.
HB 3074 seeks to remedy the current law in Texas, which treats artificially administered nutrition and hydration as medical treatment rather than ordinary care. Texas State Representative Drew Springer has filed HB3074 to try to remedy this problem. The bill states that artificially administered nutrition and hydration must be provided:
unless, based on reasonable medical judgment, providing artificially administered nutrition and hydration would: 1) Hasten the patient’s death; 2) Seriously exacerbate other major medical problems not outweighed by the benefit of the provision of the treatment; 3) Result in substantial irremediable physical pain, suffering, or discomfort not outweighed by the benefit of the provision of the treatment; 4) Be medically ineffective; or 5) Be contrary to the patient’s clearly stated desire not to receive artificially administered nutrition or hydration” (see HB 3074, introduced version, pg. 9, lines 18-27 through pg. 10, lines 1-4).
While the bill represents an improvement to an existing situation, there are still serious problems with the proposed solution. Three of the five conditions, in which artificial means of nutrition and hydration would not be provided, are morally permissible and not controversial. However, there are some difficulties with the fourth condition and fatal flaws with the fifth condition.
The fourth condition uses the term: “Be medically ineffective.” This term is ambiguous and needs clarification. In “Responses to Certain Questions of the United States Conference of Bishops Concerning Artificial Nutrition and Hydration of August 1, 2007, The Congregation of the Doctrine of the Faith asks:
Is the administration of food and water (whether by natural or artificial means) to a patient in a “vegetative state” morally obligatory except when they cannot be assimilated by the patient’s body or cannot be administered to the patient without causing significant physical discomfort?
They respond with the following answer:
Yes. 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.
The text of HB3074 could be improved by stating that providing nutrition and hydration is medically ineffective when it does not accomplish its proper finality, which is providing nutrition and hydration.
The fifth condition is much more problematic. It states that nutrition and hydration should be given unless it would “be contrary to the patient’s clearly stated desire not to receive artificially administered nutrition or hydration.” But this would be suicide by the patient and on the commission of assisted suicide by the medical personnel.
The teaching of the Church that directly addresses the fifth point is found in the document of the Congregation for the Doctrine of the Church, Declaration on Euthanasia, Iura et bona which states:
“By euthanasia is understood an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated. Euthanasia’s terms of reference, therefore, are to be found in the intention of the will and in the methods used. It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself (emphasis added) or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly, nor can any authority legitimately recommend or permit such an action.”
St. John Paul II in Evangelium vitae, n. 89 teaches:
Absolute respect for every innocent human life also requires the exercise of conscientious objection in relation to procured abortion and euthanasia. “Causing death” can never be considered a form of medical treatment, even when the intention is solely to comply with the patient’s request (emphasis added). Rather, it runs completely counter to the health- care profession, which is meant to be an impassioned and unflinching affirmation of life.
No person should be deprived of, or has a right to refuse, artificially provided food and water when it fulfills its intended objective, which is to provide nutrition and/or hydration. However, if their provision causes significant pain or discomfort in the very last stages of life ― when inevitable death is truly imminent ― then it may be permissible to withdraw them to avoid pain and suffering. For example, if a stomach tube is causing a person pain, and the person is near death, nutrition would not do him any good, and it would be permissible to remove the stomach tube.
In all cases of withdrawal of nutrition and hydration, three conditions must be met:
(1) The withdrawal must not be intended to cause or hasten the death of the patient;
(2) The current form of feeding causes significant pain or is contraindicated; and
(3) The person is so close to death that further nutrition will do him no good, and he will die naturally before the resultant hunger and thirst cause significant pain.
Therefore, to refuse artificially provided nutrition and hydration when it can still do a person good by fulfilling its intended objective — to provide nutrition or/and hydration — is tantamount to the commission of suicide.
A doctor who collaborates with these wishes of his patient is assisting in a suicide. Doctors have both a right and the duty to conscientious objection to fulfilling the immoral wishes of their patients.
The United States Conference of Catholic Bishops (USCCB) recognized the danger posed by the pro-euthanasia mentality in such cases when it stated the following in their document: “Nutrition and Hydration: Moral and Pastoral Reflections,” April 1992:
The harsh reality is that some who propose withdrawal of nutrition and hydration from certain patients do directly intend to bring about a patient’s death, and would even prefer a change in the law to allow for what they see as more “quick and painless” means to cause death. In other words, nutrition and hydration (whether orally administered or medically assisted) are sometimes withdrawn not because a patient is dying, but precisely because a patient is not dying (or not dying quickly) and someone believes it would be better if he or she did, generally because the patient is perceived as having an unacceptably low “quality of life” or as imposing burdens on others.
HB 3074, while representing an improvement on the existing law, is morally objectionable and should be opposed. It cannot be considered simply an imperfect law, but rather a deeply flawed bill. The fourth point lacks precision, and the fifth point is far worse as it mandates assisted suicide and violates the rights of medical personnel to conscientious objection.
Monsignor Ignacio Barreiro is the director of Human Life International’s office in Rome. He was ordained a priest for the Roman Catholic Archdiocese of New York on Nov. 14, 1987. From the beginning of his priestly ministry, Monsignor Barreiro was involved in the Pro-Life and Traditional Latin Mass apostolates. He received his licentiate and doctorate degree in Systematic Theology from the University of the Holy Cross, in Rome, Italy. For a period of time in the 1990s, Msgr. Barreiro served in the Priestly Fraternity of St. Peter.
Since September 1998, Msgr. Barreiro has been the Executive Director of the Rome office of Human Life International. In Rome, he started an apostolate with priests and seminarians from all over the world who are studying in the Eternal City. Msgr. Barreiro has published hundreds of articles on theological and life issues, and historical subjects in popular and scholarly publications. He was appointed a Chaplain of His Holiness on March 26, 2004.
