-
How is the papal
allocution to be understood in relationship to the teachings
on this issue found in Evangelium Vitae and the Declaration
on Euthanasia?
-
Does the papal
allocution apply only to persons in a persistent vegetative
state or to a broader population of patients?
-
How should the
following sentence from the allocution be interpreted:
"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"?
-
Does the papal
allocution imply that Catholics be told that they may not
refuse, either verbally or in their advance directives,
artificial nutrition and hydration (ANH) should they come to
be in a persistent vegetative state or have a terminal
illness?
-
Would requests to
withdraw ANH, either verbally or in advance directives, not
be honored in a Catholic health care facility? How would
Catholic health care facilities handle such requests from
patients who are other-than-Catholic?
-
If a patient or
surrogate wished the withdrawal of ANH, would that patient
either not be accepted into a Catholic facility or need to
be transferred? Would a transfer be complicated by EMTALA,
which requires that all patients be stable before being
transferred to another facility?
-
Would transfer of
a patient to another facility for the purpose of withdrawal
of ANH be considered cooperation with evil (euthanasia by
omission) and morally illicit?
-
If a physician
continues to provide ANH against the wishes of the patient
or surrogate, could that physician be accused of battery or
be sued for malpractice?
-
Would physicians
who refuse to withdraw ANH be violating standards of medical
practice?
-
What would happen
to physicians and administrators in Catholic health care
facilities who refuse to comply with the teaching on the
basis of conscience, professional obligations, or standards
of care?
-
How might the
papal allocution impact palliative care programs in Catholic
health care facilities?
-
Would Catholic
health care facilities that do not withdraw ANH be at
variance with state and federal statutes (e.g., advance
directive statutes and the Patient Self-Determination Act)
and JCAHO standards?
-
How might Catholic
health care facilities that are sole providers in a region
deal with requests for the withdrawal of ANH?
-
In some instances,
might insurance companies refuse to pay for what they might
deem to be "futile treatment"?
-
What will be the
likely impact on long-term care facilities and families in
caring for patients receiving ANH on a prolonged basis?
-
Would families
have to absorb some or most of the costs of prolonged care?
-
What might be the
impact on existing and future partnerships with
other-than-Catholic organizations?
-
Will the papal
allocution fuel the claim of Catholics for a Free Choice and
other organizations that in Catholic health care facilities
"patients are not allowed to die"?
-
Does the papal
allocution imply that ANH would also be required for
patients with other conditions in which they are unable to
eat (e.g., ALS, Parkinson's, stroke, Huntington's)?
-
What does the
allocution imply about the care of patients with anorexia
nervosa and bulimia in Catholic hospital psychiatric
departments?
-
Could the papal
allocution have the unintended consequence of encouraging
euthanasia and physician-assisted suicide by engendering a
fear of having one's dying or vegetative state prolonged?
