CATHOLIC HEALTH ASSOCIATION (CHA)
4455 Woodson Road 
St. Louis, MO 63134-0889

(314) 427-2500

Organizational overview:  The CHA, founded in 1915, serves as the professional association for Catholic hospitals, extended care facilities, and health care systems in the United States.  With 1200  member organizations, the CHA is the largest association of not-for-profit health care facilities in the country.  After several task forces of theologians, clergy, health care givers and ethicists deliberated over how suffering, pain management, and the dying process should be viewed in light of the Catholic tradition, the CHA issued a definitive statement on the subject entitled Care of the Dying, A Catholic Perspective. 

Position on tube feeding at the end of life

[T]he familiar terms 'ordinary' and extraordinary' can be very misleading when explaining the substance of this teaching. . . . The Vatican Declaration on Euthanasia has recognized the ambiguity of these terms and suggests that we might more effectively refer to “proportionate” and “disproportionate” treatment. . . . The moral focus [of the revised distinction] is not on the category of disease, the state of medical science, the type of treatment itself, or whether the treatment is simple, customary, non-invasive, or inexpensive.  Rather, the true ethical considerations focus on the proportion between the benefit the patient would be able to appreciate from the treatment and the burden the patient would endure.  For this reason, the principle is sometimes referred to as the burden/benefit principle.  To make proper use of this moral principle, we need to measure the proportionate benefits and burdens for each particular patient, and from the patient's perspective. . . in order to determine whether [the proposed treatment] provides a benefit proportionate to the burden the patient will have to bear.  If the reasonably foreseen benefits to that patient (such as cure, reduced pain, restored consciousness and bodily functions) outweigh the burdens to the patient or to others, then the treatment is morally obligatory.  But the treatment is not obligatory if it would be disproportionately burdensome or futile. . . . A treatment is futile when it offers no probable hope of success to restore the patient to a state of reasonable well-being (CHA 1993: 48-49).

 [T]he burden/benefit principle makes no moral distinction between withholding or withdrawing life sustaining treatment (whether it be a mechanical respirator, a cardiac pace-maker, a renal dialysis machine, antibiotics, or medically dispensed nutrition and hydration) when its use is futile or would produce burdens disproportionate to the benefits the patient could appreciate (CHA 1993: 49).

Citations

Catholic Health Association of the United States (CHA). 1993.  Care of the Dying: A Catholic Perspective.  St. Louis: Catholic Health Association of the United States.