Artificial Nutrition and Hydration for Infants with Life-Terminating Conditions: Rethinking the Catholic Position

Infants with life-terminating conditions (ILTCs) are those whose conditions prevent them from living more than two years. When these infants have difficulty assimilating food and fluids orally, doctors can provide nutrition and hydration through artificial means. While artificial nutrition and hydration (ANH) can provide benefits, it can also result in complications leading to pain and/or distress in addition to that which an ILTC may already be experiencing from one or more underlying conditions.

Many medical experts maintain that withholding or withdrawing ANH can help a patient’s body produce its own analgesics. I consider four categories of ILTCs: 1) infants who receive prognoses of two weeks or less; 2) infants who will live longer than two weeks but no more than two years and who are not suffering or in distress; 3) infants who are not dying, but are in distress from the use of ANH; and 4) infants who are not dying, but are in distress from their conditions and/or ANH. I argue that in addition to providing natural analgesics, withholding or withdrawing ANH is a form of comfort care that prevents the occurrence of further complications requiring additional medical treatments and keeps ILTCs content. Under certain circumstances, the withholding or withdrawing of ANH should be obligatory.

As it stands, the whole of Catholic teaching on ANH is inconsistent. Operating from the sanctity-of-life ethic, the Church teaches that ANH is an ordinary, therefore obligatory, form of care. But this position contradicts the view that any form of care presenting a grave burden to a patient and/or his family is extraordinary and therefore optional. In addition, by making ANH obligatory, the Catholic Church causes families to undergo heroic suffering (i.e., enduring more than what can be expected or asked of anyone), which the Church says is not required of everyone. I argue that rethinking the Catholic position on ANH will enable the Church to offer practical moral guidance for families to comfort ILTCs, help ILTCs and their families avoid heroic suffering, and provide spiritual care families of ILTCs need, all while still respecting the sanctity of life of every person.