WHAT CAN NOW BE DONE TO PROTECT AGAINST STARVATION AND DEHYDRATION.

For many years, the pro-life movement has emphasized that providing food and fluids is part of the normal care that every human being is entitled to receive. NRLC's Will to Live advance directive proclaims, "Food and water are not medical treatment, but basic necessities. I direct my health care provider(s) and health care agent to provide me with food and fluids orally, intravenously, by tube, or by other means to the full extent necessary both to preserve my life and to assure me the optimal health possible."

Whatever their religious affiliations or beliefs, pro-lifers can only be profoundly grateful to Pope John Paul II for his clear statement on the obligation to provide food and fluids. As more fully reported in Richard Doerflinger's article on page one, in a March 20 speech the Pope said:

"I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.

"The obligation to provide the `normal care due to the sick in such cases' includes, in fact, the use of nutrition and hydration. The evaluation of probabilities, founded on waning hopes for recovery when the vegetative state is prolonged beyond a year, cannot ethically justify the cessation or interruption of minimal care for the patient, including nutrition and hydration. Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission." (Citations omitted.)

Tragically, in the United States, ever since the mid-1980s the overwhelming weight of court opinions, legislation, and medical practice in hospitals and other health care institutions - - including most Catholic facilities - - has been contrary to this fundamental principle. In the 1990 case of Cruzan v. Director, a majority of the U.S. Supreme Court concluded there is a constitutional right to reject artificially provided food and fluids. Since that decision, the balance of new Justices appointed (Souter, Thomas, Ginsburg and Breyer) has certainly not favored the pro-life viewpoint.

What Can Now Be Done?

First - - whatever one's religious views - - the papal statement should stimulate everyone who has not already done so to take the necessary action to protect family members from being starved and dehydrated. Because so many in the medical and legal fields are hostile to the provision of food and fluids for those they deem to have a poor "quality of life," it is essential that everyone complete a legal advance directive specifying, among other treatment decisions, that food and fluids be provided. The proper form for each state may be downloaded from www.nrlc.org/euthanasia/willtolive/index.html.