♱ Introduction
The distinction between ordinary and extraordinary means has significant implications for healthcare providers and patients. Catholic Patients and families must be informed to protect themselves and make morally licit decisions about their care.
Historically, the phrase Ordinary Medical Care referred to treatments that were considered standard, common, or easily available, while Extraordinary means were those that were unusual, complex, or burdensome. The distinction was initially used to determine the moral obligation to preserve life, with ordinary means being considered obligatory and extraordinary means being optional.
Although we live in a time of ever-improving medical technology, much of patient care is provided by large medical corporations that have a vested interest in their own financial gain. These organizations set there own medical protocols. This makes the distinction between ordinary and extraordinary treatment no longer obvious or consistent nor necessarily ethical, and varies from state to state. *Catholics are advised to clarify the terms before agreeing or signing anything.
♱ General Classification
Ordinary Care:
- ♱ Standard or common treatments
- ♱ Easily available and accessible
- ♱ Proportionate to the patient’s condition
- ♱ Offers a reasonable hope of benefit
Extraordinary Care:
- ♱ Unusual or complex treatments
- ♱ Burdensome or invasive
- ♱ Disproportionate to the patient’s condition
- ♱ May not offer a reasonable hope of benefit
♱ The Secular World
A recent trend has been to classify tube feedings as Extraordinary Medical Care and could be withheld from the patient if so ordered by the court and or physician. This is done knowing that the denial of food from any person (sick or healthy) will always result in that person’s death. Ethically, treatments should only be withdrawn if they are useless or burdensome to the patient and tube feedings are not excessively expensive or burdensome to the patient. Quite the contrary, they maintain life and prevent the discomfort of hunger and thirst.
In recent years, there have been many court cases involving patient families petitioning the court to remove life-sustaining treatment such as hydration and nutrition, under the false label of “Extraordinary Care.” Some courts have gone even further and have stated that third parties do not need the approval of a court before a patient’s food and water is withdrawn unless there is disagreement, for example, among family members.
—– Versus —–
♱ The Catholic Position
In assessing when there is a duty to preserve life, the Catholic Church also distinguishes between ordinary and extraordinary medical care. Ordinary care is morally required because it preserves the patient’s life, but extraordinary means can be morally refused. Therefore it is critical to properly identify each type as it pertains to the individual:
Ordinary Care:
- ♱ Food or “Nutrition”
- ♱ Water or “Hydration”
- ♱ Rest/Relief
- ♱ Warmth
- ♱ Rehabilitative care
- ♱ All medical procedures that offer a reasonable hope for the patient’s improvement
Extraordinary Care:
- ♱ Experimental
- ♱ Unusual or complex treatments
- ♱ Excessive expense or inconvenience
- ♱ Does not offer a reasonable hope for the patient’s improvement
Since all human beings require basic nutrition to sustain life at all stages of development, (whether healthy or not), a feeding tube, if required to administer nutrients to a patient, is to be considered Ordinary means of preserving their life. Additionally, in our current modern age of medicine, there is nothing complex or risky about using a feeding tube.
Having concluded that a feeding tube is ordinary care and required to sustain life, the withdrawing of a feeding tube that results in the death of a patient by starvation, is a form of Euthanasia. The secular world’s argument for this deprivation is usually so-called, “relief of suffering” but it is really the intentional killing of a person by starvation and analogous to murder. The essential question is the preservation of human life. When there is a need for the relief of pain, pharmaceutical means can be used and there is no need to kill the patient to alleviate medical suffering.
In his address to the International Conference on LIFE SUSTAINING TREATMENTS AND VEGETATIVE STATE on March 20, 2004, Pope John Paul II reiterated the Catholic position that patients in a “vegetative state” or otherwise disabled, are entitled to the provision of food and water and withholding it is a form of euthanasia by omission:
“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.”
