Some hold that the revision to directive 58 of the Ethical and Religious Directives for Catholic Health Care Services—which sought to incorporate the language of Pope John Paul II’s 2004 statement regarding the obligation to provide patients in a persistent vegetative state—represents a threat to patient’s end-of-life decisions. I argue this position is unfounded. The revision to the directive, and the statements that inspired this linguistic modification, do not represent a substantive change in the Church’s teaching. I support this position (...) based on two claims. First, in his statement, the Holy Father speaks of food and water and care personnel’s obligation to provide them as relative to the patient’s status as a person. That is, relative to the patient’s human nature, food and water represent a per se useful means for preserving life and, as such, should be considered ordinary and obligatory. Second, since his teaching is directed toward care personnel, John Paul II does not discuss the patient’s judgment of the means with the assumption that the Tradition has already clearly established the legitimacy of patients refusing means they judge to be extraordinary. Finally, I argue that one of the effects of the Pope’s statement is that it manages to reaffirm the Church’s teaching on euthanasia and ordinary and extraordinary means without institutionalizing a particular theologian’s vision of anthropology. (shrink)

The COVID-19 pandemic highlights the relevance of adequate decision making at both public health and healthcare levels. A bioethical response to the demand for medical care, supplies and access to critical care is needed. Ethically sound strategies are required for the allocation of increasingly scarce resources, such as rationing critical care beds. In this regard, it is worth mentioning the so-called ‘last bed dilemma’. In this paper, we examine this dilemma, pointing out the main criteria used to solve it and (...) argue that we cannot face these ethical issues as though they are only a dilemma. A more complex ethical view regarding the care of COVID-19 patients that is focused on proportional and ordinary treatments is required. Furthermore, discussions and forward planning are essential because deliberation becomes extremely complex during an emergency and the physicians’ sense of responsibility may be increased if it is faced only as a moral dilemma. (shrink)

The Catholic moral tradition has consistently offered the distinction between ordinary and extraordinary means as a framework for making end-of-life decisions. Recent papal allocutions, however, have raised the question of whether providing artificial nutrition to patients in a persistent vegetative state is to be considered ordinary and thus morally obligatory in all cases. I argue that this “revisionist” position is contrary to Catholic teaching and that enforcing such a position would endanger the ability of Catholic health care institutions to minister (...) to all their constituents. (shrink)