Q. Could you clarify the church’s position on refusal of food and hydration when making out health care directives and living wills? (Also, is it true that once a feeding tube has been inserted, it cannot be removed before death?) (Levittown, Pennsylvania)
A. The overriding principle in Catholic teaching is that one is obliged to use ordinary means to preserve his or her life but is permitted to forgo extraordinary means. In most situations, artificial nutrition and hydration would be considered ordinary means.
And so, the Ethical and Religious Directives for Catholic Health Care Services published by the U.S. Conference of Catholic Bishops state, “In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally” (No. 58).
However, particular circumstances may override this presumption, and if the provision or continuation of medically assisted feeding would cause significant discomfort, it becomes morally optional.
In such situations, one must weigh the benefits and burdens, and here the intention is paramount: If the intention of removing a feeding tube is to end the patient’s life, that would of course be immoral; but if the intention is simply to discontinue a burdensome treatment that is not being assimilated by the patient and is instead causing significant discomfort, it would certainly be moral to remove it.
In making these difficult end-of-life decisions, I have found a helpful resource to be CatholicEndofLife.org, a website produced by the New York State Catholic Conference. And if I were formulating an advance directive (or guidance for my health care proxy), I think that I might include language something like the following, offered by the National Catholic Bioethics Center, based in Philadelphia:
“I wish to follow the moral teachings of the Catholic Church and to receive all the obligatory care that my faith teaches we have a duty to accept. However, I also know that death need not be resisted by any and every means and that I have the right to refuse medical treatment that is excessively burdensome or would only prolong my death and delay my being taken to God.”
Q. I recently attended a funeral Mass for a friend — not at my own parish. The pastor informed the family of the deceased that there could be no eulogy given in church — before, during or after the funeral Mass. They were quite upset because they had already asked a family member to deliver the eulogy. (Mayfield, New York)
This same parish had for years allowed family members or friends to speak and eulogize their loved one during a funeral Mass; the change in policy came with the arrival of a new pastor, who said that eulogies should never have been allowed previously, and he cited canon law in support of that. What is the official position of the church, or is it up to the discretion of the local pastor?
A. The pastor may have been referring not to canon law but to the Order of Christian Funerals, which is the church’s guidebook for such celebrations. The guidebook does say that “there is never to be a eulogy” (No. 27). But that section is meant to offer guidance to the priest-celebrant with regard to the homily.
It reminds the celebrant that a Catholic funeral is not to consist in the glorification of the deceased (even less, the “canonization”); the funeral Mass instead is meant to use the scriptural readings to highlight the redemptive power of Christ’s resurrection, to pray for the deceased and to comfort the mourners by reminding them that eventual reunion awaits in heaven.
The same Order of Christian Funerals says in a later section that “a member or a friend of the family may speak in remembrance of the deceased before the final commendation begins” (No. 170). Some dioceses have their own regulations, limiting the length of those remarks. (Three or four minutes would be typical.)
Recently, I have noticed that some parishes move these family remarks up to the beginning of the liturgy — perhaps feeling that if the speaker strays from the purpose of the Mass, the celebrant can “rescue” the situation by returning to the themes of resurrection and reunion. In the end, though, much of this does depend on the discretion of the local pastor, who I hope would take into account the feelings and desires of the grieving family.
Questions may be sent to Father Kenneth Doyle at firstname.lastname@example.org and 30 Columbia Circle Dr., Albany, New York 12203.