Is it ethical to disconnect feeding tubes from vegetative patients?
Introduction
The Christian faith holds that all human life, even in a severely compromised state like a Persistent Vegetative State (PVS) where a person is awake but has lost all higher brain function, possesses inherent and equal dignity because they are created in the image of God (Genesis 1:27). The ethical challenge is distinguishing between killing (which is forbidden) and allowing nature to take its course when life is terminal.
The core of the debate is classifying the feeding tube itself: Is it basic comfort care, or a medical intervention?
Main: The Distinction Between Ordinary and Extraordinary Means
Christian bioethics traditionally uses the categories of "ordinary" and "extraordinary" means of care to determine which interventions are morally obligatory and which can be refused.
1. Ordinary Care (Obligatory)
Ordinary care refers to medically simple, non-burdensome treatments that offer a reasonable hope of benefit.
Sustenance as Basic Care: Most Christian traditions (including Catholic, Orthodox, and many Evangelical ethicists) classify basic nutrition and hydration (food and water) as fundamental, ordinary care. Since the feeding tube merely delivers this basic sustenance—it is not curing the underlying condition, but simply replacing the function of eating—it is generally seen as morally obligatory and should not be withdrawn.
The Prohibition Against Starvation: Intentionally withdrawing food and water with the goal of causing death is viewed as an act of euthanasia (a deliberate action to end a life), which is rejected by Christian doctrine as a violation of the sanctity of life.
2. Extraordinary Means (Optional)
Extraordinary means (also called medically futile care) refer to treatments that are excessively burdensome, expensive, painful, or offer no reasonable hope of benefit.
When the Tube is Futile: The consensus shifts when the feeding tube is no longer effective or is causing harm. If the body is actively dying and can no longer process the nutrients (e.g., severe infections, organ failure), or if the tube itself is the source of severe suffering (e.g., constant infections, bleeding), the intervention can be classified as medically futile or extraordinary.
Allowing Natural Death: In these limited cases, the removal of the feeding tube is ethically permissible, not as an act of killing, but as an act of accepting the finality of the terminal disease. The patient dies from the underlying condition (e.g., massive brain damage), not from the intentional withdrawal of basic care.
Conclusion
Is it ethical to disconnect feeding tubes from vegetative patients? Generally, no, because basic sustenance is viewed as ordinary care and withdrawing it to cause death is considered euthanasia.
However, the decision must be made with prudence and prayer by the family and physicians, guided by two ethical boundaries:
Motive: The motive must never be to intentionally cause death or relieve the burden on the family/society.
Futility: Withdrawal is only justified if the sustenance is proven to be medically futile or excessively burdensome to the dying patient.
The Christian mandate is to protect life until God chooses to end it naturally.
