I am confused about this debate. I read what the USCCB wrote and this is what I got. The issue of enteral feeding for the USCCB and the Pope are the same…The difference is that the Pope did not address TPN/Hyperalimentation which is feeding through the venous system when the GI tract fails.
These are the two documents I read:
usccb.org/prolife/issues/euthanas/nutend.htm
The USCCB do not permit the removal of enteral tube feeding. This is the tube inserted through either the nose or mouth into the stomach or tubes inserted surgically typically into the bowel. This only works with a gastrointestinal system that is functioning. This is what Terri Shiavo had and it appears the JPII, and the Bishops agreed, although they did not go into as great of detail as the Pope. In addition, it appears they wrote this in 2002 and the Pope wrote his in 2004.
We reject any omission of nutrition and hydration intended to cause a patient’s death. We hold for a presumption in favor of providing medically assisted nutrition and hydration to patients who need it.
What the Pope did not address was TPN/hyperalimentation, the Bishops did and it was based on the clinical studies done throughout the world regarding the clinical outcome of the use of TPN. This is supplemental feeding introduces through the venous system. The major indication for TPN is the total failure of the gastrointestinal tract to perform its normal function. The major complication is sepsis and infarction in the gut, which most often results in death. TPN does not decrease the morbidity and mortality of patients without GI functioning. It is used successfully in acutely ill patients, but not in chronic long-term conditions. Therefore weighing the medical risks is necessary when initiating TPN because you would not want to hasten death and you always want to feed the gut when ever possible. I would think they should not have even mentioned the cost in their statement because the medical outcome and clinical status always outweighs the cost.
Parenteral or intravenous feeding is generally considered “more hazardous and more expensive” than enteral feeding. It can be subdivided into peripheral intravenous feeding (using a needle inserted into a peripheral vein) and central intravenous feeding, also known as total parenteral feeding or hyperalimentation (using a larger needle inserted into a central vein near the heart). Peripheral intravenous lines can provide fluids and electrolytes as well as some nutrients; they can maintain fluid balance and prevent dehydration, but cannot provide adequate nutrition in the long term…helping critically ill patients to survive acute illnesses where the prognosis had previously been nearly hopeless," but its feasibility for life-long maintenance of patients without a functioning gastrointestinal tract has been questioned.
Terri Shiavo and anyone in a coma, PVS or other illness where they are not able to orally consume food the mode of feeding, is tube feeding.
Where do the Bishops and Pope disagree? I certainly would go with the highest authority the Pope in my direction of care and belief in my faith, but I believe this may be the error of misunderstanding medical jargon and not a true conflict in their statements.
The Pope went into greater detail describing the disability and status of the patient where as the Bishops went into greater detail in defining the medical treatment. The statements cannot be directly compared in addition the Bishops wrote their statement in 2002 and stated it was their initial response and it would not be their last, then the Pope clarified another aspect.
Please let me know if you all are reading a different statement by the Bishops than I am. I was previously an ICU nurse, I currently teach nursing students part-time at a Catholic university and I am the Clinical Quality Specialist at my hospital (Catholic), so I certainly want to be completely informed so that I know for myself and as I guide my students and hospital protocol in the right direction.
Sorry so wordy but I want to be 100% sure about the formation of morality and faith in my students and being that I guide protocol at a Catholic hospital we must make sure they fall inline with Catholic teaching. Thanks~ P