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Catechism of the Catholic Church, 2494

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Court ruling to allow dehydration of patients without legal scrutiny is criticised by Catholic Church


A bishop has spoken out against a new legal ruling that will allow vegetative and minimally conscious patients to be dehydrated to death without recourse to the courts.

Auxiliary Bishop John Wilson of Westminster, a moral theologian, said the judgement by the Supreme Court, Britain’s highest court, was flawed because it was rested on the classification of artificial hydration and nutrition as medical treatments which could be withdrawn at any time.

“Artificial nutrition and hydration … are not treatment. They do not cure anything,” said Bishop Wilson.

“In whatever way they are delivered, food and water for a person in a persistent vegetative state fulfil the same purpose as for any other person. They keep them alive as part of their basic care. They prevent death by malnutrition and dehydration,” he said.

“Patients in persistent vegetative states are some of the most vulnerable in our society. It is not an act of compassion to remove their food and drink in order to cause their death.

“Equally, it cannot be in a patients’ best interests, whatever their level of consciousness, to have their life intentionally ended.

“Our care for those in such situations is the test of our common humanity and our solidarity with some of the most fragile of our brothers and sisters.”

The Catholic bishops of England and Wales said in Cherishing Life, a 2004 document, that it would “cross the line from reasonable withdrawal of inappropriate treatment into the realm of passive euthanasia” to deliberately cause death by the denial of fluids.

The remarks of Bishop Wilson came just weeks after Bishop Philip Egan of Portsmouth, a former vicar general of the Diocese of Shrewsbury, warned Catholics to be alert to possible deliberate killings of seriously-ill patients in state-funded hospitals.

In a “pastoral message” to clergy and laity following a report into the Gosport Hospital scandal, he said that Catholics must be “ever be vigilant to the policies, values, priorities and procedures” that operate within the NHS.

“If you or a loved one is terminally ill, consider whether it might be practicable to die at home,” he said.

“Ask whether it is possible for drugs to be used that do not totally withdraw consciousness and a chance to pray and commune with family and friends,” he continued. “As next of kin, gently insist on being involved in decisions. It might be appropriate to ask staff for a second opinion or a re-evaluation of treatment.”

Bishop Egan said that it was “not morally permissible until the very last to withdraw feeding and hydration”.

The ruling by the Supreme Court means that where doctors and relatives agree that death is in the “best interests” of a patient in vegetative or minimally conscious state then food and fluids could be taken away without an application to the Court of Protection.

But where future disagreement exists, the parties are advised to make an application to the courts for a decision to be made.

The ruling was issued following the examination of the case of a man in his 50s who became severely brain-damaged following a heart attack in June last year.

The High Court ruled that the courts could be bypassed if there was agreement between doctors and relatives and the Official Solicitor appealed against the judgement to the Supreme Court, which published its opinion in spite of the man, known only as Y, dying from sepsis in December.

The ruling will affect up to 24,000 patients in the UK, according to Care Not Killing, the anti-euthanasia coalition, which includes the Catholic Church.

Nikki Kenward (pictured), the Shropshire-based campaign director of Distant Voices, a group working for improved end-of-life care, said that, as a person who has experienced what it was like to have been “locked in” for five months, the “ruling touches me and alarms me a great deal”.

“I was able to understand everything that was going on around me. The thought that medics and my family might be discussing my ‘best interests’ with no way of responding leaves me aghast,” said Mrs Kenward of Aston on Clun.

“What I knew for sure was that I wanted to live no matter what,” she said, adding: “To talk of ‘best interest’ and the usual ‘quality of life’ stuff is to put into the hands of those a power of which none of us is worthy.”

But Natalie Koussa of Compassion in Dying, a group seeking to change the law on “assisted dying”, welcomed the judgement.

“It means that what’s best for the individual can be decided by their medical team and loved ones, and acted upon more quickly, rather than spending months or even years waiting for a court decision,” she said.

“The court’s decision today also recognises the fact that sometimes, sadly, it is in someone’s best interests to withdraw treatment. It will allow those closest to a person – their loved ones and medical team – to feel supported and empowered to make the right decision for the person, even when it is a difficult one.”