Papal address leaves hospitals in quandary

A statement by Pope John Paul II that health care providers are morally obliged to provide food and water to patients in persistent vegetative states has left church officials uncertain what impact it would have at the more than 600 Catholic hospitals in the United States.

The statement, made March 20 but translated into English only on Thursday, raised questions in the church’s decades-long debate over how far health care providers should go to keep alive people who have been in deep comas for long periods.

Among them: How might the pope’s stance affect a patient who has made an advanced directive ordering physicians to remove feeding tubes after he or she has slipped into an irreversible coma?

Catholic officials said it could be months or longer before the U.S. Conference of Catholic Bishops — the American church’s governing body — or the Vatican provided clarification on how Catholic hospitals should apply the pope’s words.

"We are waiting for an analysis from our moral theologians, who will look at every angle," said Cardinal William Keeler, who oversees the six Catholic hospitals in the Archdiocese of Baltimore. "As to its full implications, I’m really not clear yet."

Even if the pope’s speech, which does not have the authority of a papal encyclical, is interpreted strictly, Catholic health officials suggested it might not affect many patients. The Rev. Michael Place, president of the Catholic Health Association, which oversees the nation’s 624 Catholic hospitals, said he doubted many of the patients they treat fit the kind described in the pope’s speech.

The pope’s comments came after a Vatican-sponsored symposium on the scientific and ethical issues surrounding people in vegetative states. In his speech, the pope said that even such people retain human dignity and have a right to be monitored for clinical signs of eventual recovery. Denying food and water would constitute "euthanasia by omission," he said.