Nutrition for patients in a vegetative state: basic care or treatment?

Abstract

There are two apparently irreconcilable positions in response to the question as to whether it is morally permissible to suspend nutritional support to patients in a vegetative state. On the one hand, there is nutrition invariably understood as basic care and, therefore, mandatory. On the other, there is the idea that assisted nutrition is therapy and, consequently, is always optional.

Two relevant questions become confused in this discussion: Is assisted nutrition a basic measure or is it a treatment? And, morally speaking, is assited nutrition optional or mandatory? To answer these questions adequately, one must consider the obligation to care each person has with respect to their own health and that of others who are entrusted to our care. Not all treatment under any circumstance should be regarded simply as “optional”. In each case, the most appropriate course, from an ethical standpoint, is to judge proportionality. This paper offers a critical review of current positions on the problem of medically assisted nutrition in patients who are in a vegetative state, with special emphasis on thinking rooted in Catholic moral tradition, and proposes a method for analyzing the problem, based on the principle of therapeutic proportionality.