Prelate warns on tube-feed ruling

Sydney
8 June 2003

Prelate warns on tube-feed ruling

By Chris Lindsay

A court decision to allow the cessation of artificial tube-feeding of a 68-year-old woman suffering from progressive dementia has very serious implications, says the Archbishop of Melbourne, Archbishop Denis Hart.

Justice Stuart Morris of the Victorian Supreme Court ruled the woman’s guardian would now be able to decide whether it is “time to allow her to die with dignity”.

Archbishop Hart said: “To regard tube-feeding as an optional medical treatment which can be removed at the direction of a guardian potentially affects all the elderly, handicapped and unconscious who rely upon such assistance.

“We do not believe that Parliament ever intended that such vulnerable people - people not otherwise dying - should be deprived of food and water.”

The judge ruled that the artificial food and hydration being provided to the woman, who is known only as “BWV”, was a medical procedure rather than palliative care, and therefore could be refused.

Archbishop Hart said: “There are many situations where tube-feeding should not be initiated or continued: for example, if a patient’s death is imminent, or their body is unable to absorb the food or water, or the tube-feeding imposes grave burdens.

“In such cases death should be accepted and prepared for and the focus should shift to keeping patients as comfortable, pain-free and peaceful as possible, and giving them and their family the best of pastoral care.

“Just when that point comes is a clinical judgment which we rightly entrust to our highly professional and ethical doctors and nurses in conjunction with the patient and family.”

Archbishop Hart said Catholic health services will never co-operate in or condone a decision deliberately to shorten someone’s life, whether actively or by neglecting to provide basic needs.

“We trust that no one will attempt to compel Church hospitals, nursing homes or health professionals to act in this way,” he said.

“That would be a major violation of people’s consciences and would compromise the ability of Australia’s largest private health and aged care provider to fulfil its mission.

“Our hearts go out to BWV and her family. We continue to pray for them and for all vulnerable people in our community,” he said.

Sr Liz Hepburn, director of ministry and ethics for Catholic Health Australia, said that in practice the decision “won’t make much difference to the way health care is carried out in Victoria”.

“Ethical decisions still have to be taken in regard to treatment and withholding treatment,” she said.

Fr Anthony Fisher, director of the John Paul II Institute for Marriage and Family, says: “She is not in pain. Not on a life-support machine. Not dying. That’s the problem.

“Strictly speaking she is not in a coma now. ‘BWV’ has progressive dementia (Pick’s disease), but she will not die of it. She will die of ‘undernutrition and renal failure’ as medical experts told the court.”

He said no one should judge the family. “When people have slow degenerative illnesses it is often the bystanders who suffer most.”

He says the danger is the precedent.

“Can a guardian just walk in and say ‘you must stop the feeding’ when it is clear to the medical staff it should be kept going?” he asked.