End-of-Life Treatment and Religious Restrictions

Rally in Kingston, NY

The controversy sparked by the Terri Schiavo end-of-life decision-making case alerted the public that some conservative religious leaders do not approve of family decisions to remove artificially administered nutrition and hydration (commonly known as feeding tubes) from patients who are in a persistent vegetative state.  Fundamentalist Protestant leaders and Bishops of the Roman Catholic Church were among the most outspoken critics of the decision by Schiavo’s husband, Michael, to remove her feeding tube. They pressured the Bush administrations in both Florida and Washington, D.C., to undertake an unprecedented level of government action seeking – ultimately unsuccessfully – to block removal of the feeding tubes.

Might other families be subjected to the kind of interference that these conservative Christians brought to bear in the Schiavo case? Will the Schiavo case change patients’ rights to direct their end-of-life care? See our Question and Answer sheet on the Schiavo case .

This is a problem that could occur at any hospital – but is of special concern at religiously-sponsored hospitals and nursing homes. Religious health care restrictions at these institutions can interfere with patients' ability to direct their end-of-life care. Some religiously-affiliated hospitals and nursing homes can deny patients and their families the right to make these kinds of treatment decisions based on religious doctrine. For example, Catholic hospitals are governed by the Ethical and Religious Directives for Catholic Healthcare Services, which are issued by the United States Conference of Catholic Bishops. Those Directives specify that patients’ end-of-life decisions will be honored unless they conflict with Catholic moral teaching.

What is that teaching?  Cardinal William H. Keeler of Baltimore, chairman of the U.S. Conference of Bishops’ Committee for Pro-Life Activities, warned on March 9, 2005, that “Deliberately to remove them (food and water) in order to hasten a patient’s death … would be a form of euthanasia, which is gravely wrong.” In a March 24, 2005, statement after Schiavo’s feeding tubes had been removed, Cardinal Keeler applauded the efforts of Schiavo’s parents “to keep Terri from a death by starvation” and thanked President Bush, members of Congress and public officials in Florida for their efforts to “give her a chance to live.” He concluded that “God will call Terri Schiavo to Himself when it is her time to die. It is not for us to determine when that time is.”1

The MergerWatch Project and a coalition of concerned health advocacy organizations wrote to the Catholic Health Association of America to ask for clarification on whether member Catholic hospitals would honor patients’ end-of-life care wishes, if they conflicted with the statements from Cardinal Keeler and other Catholic leaders. The letter further inquired as to whether Catholic hospitals would be disclosing any restrictions on honoring patients’ end-of-life directives. To date, there has been no response.