By Genevieve Pollock

BALTIMORE, Maryland, NOV. 18, 2009 ( The U.S. Ethical and Religious Directives for Catholic Health Services were updated to include more specific guidelines on artificial nutrition and hydration for patients in a persistent vegetative state.

This update was approved Tuesday by the U.S. bishops' conference during their annual fall general assembly currently taking place in Baltimore. The gathering began Monday and will end Thursday with a day of prayer.

On Monday, Bishop William Lori of Bridgeport, Connecticut, chairman of the conference's Committee on Doctrine, explained the need for revising the health care directives.

The document, which was last updated in 2001, based its guidelines on providing medically-assisted nutrition and hydration for patients on a reference from 1992, "Nutrition and Hydration: Moral and Pastoral Reflections."

At that time, the bishops' published reflection noted that "Catholic theologians may differ on how best to apply moral principles to some questions not explicitly resolved by the Church's teaching authority."

Bishop Lori noted the need to revise this statement in order to include two authoritative teachings on this issue that were issued in 2004 and 2007.

In March 2004, Pope John Paul II spoke on this topic in an address to participants in an international congress organized by the World Federation of Catholic Medical Associations and the Pontifical Academy for Life.

Later, in Aug. 2007, the Congregation for the Doctrine of the Faith issued a statement titled "Responses to Certain Questions of the United States Conference of Catholic Bishops Concerning Artificial Nutrition and Hydration."


The questions had been sent by the bishops in 2005, months after Florida woman Terri Schiavo, who was living in a vegetative state from having sustained brain-damage, died 13 days after having her feeding tube removed.

Bishop Lori noted that these statements from the Holy See "rendered impossible" the positions of some theologians who were opining on the matter.

Thus, he called for the revision of the directives to include necessary clarifications. At the same time, he stressed the continuity of the Church's teaching, noting that this is not a change in doctrine, but a specification.

The revision was approved Tuesday by the prelates, with 219 voting for it and 4 opposing it.

The prelate explained in a press conference Tuesday evening that this revision was meant to state "as simply as possible" for practitioners and teachers the guidelines about when medically-assisted nutrition and hydration becomes burdensome.

He told his fellow bishops that now the responsibility for making sure that these guidelines are implemented is theirs as they shepherd their local dioceses.