End-of-Life End-Arounds seem to keep popping up. One of the “big ones” is the renaming of intrinsically evil actions like suicide to sound better, e.g., the, sadly, successful effort to rename Physician Assisted Suicide to the now so-called Medical Aid in Dying (MAiD).

As you might have guessed, however, it does not stop there…

An article was recently published authored by, among others, Dr. Timothy Quill and Dr. Thaddeus Pope, both long-time advocates for Physician Assisted Suicide, introduces “a framework that resolves competing ethical and clinical considerations in caring for those with advanced dementia,” which they are calling Minimal Comfort Feeding (MCF).

Basically, the idea is that for patients with advanced dementia, rather than offering them food at, say, mealtimes, we might rather offer them food/drink “only in response to signs of hunger and thirst.”

While we can, partially, applaud their attempt to find an option for oral nutrition and hydration that does not involve actively withholding food and water from those who have lost the ability to ask for it (which is very likely being done even as we write this), we feel confident in concluding that, regardless of the author’s hopes:

1. the risk of MCF morphing into actively withholding oral nutrition and hydration is too high for it to be a licit practice, and
2. even if MCF was carried out as the authors suggest, it is very likely illicit given that we have a positive duty to feed the hungry. Most assuredly, this positive duty does not extend to “force feeding” (as is made clear in the Catechism), but from that it does not follow that we can forgo offering*

If you would like the full text of the this article, you can request a reprint (PDF) from the corresponding author:

Hope A. Wechkin, MD
12822 124th Lane NE
Kirkland, WA 98034
hawechkin@evergreenhealthcare.org

*While this seems to be true, this should be qualified in that there may come a time in a person’s life where it is clear that he can take no oral nutrition or hydration, that this situation is irreversible, and continuing to offer such has become an undue burden. However, that would seem to be a relatively high bar, and, licit justification for deciding to no longer offer oral nutrition/hydration would not include that the person does “not want to continue living with this illness.”