Food and water: symbol and reality

The act of giving food and water to the needy and helpless is a reality that reflects the communitarian aspect of the human family and our commitment to nurture our more vulnerable members. The technology that delivers artificial nutrition and hydration to an irreversibly comatose patient is, some would say, a symbol of that reality. As a symbol, what does it communicate, to whom, and for whose benefit? The critical examination of the ethics surrounding this issue requires the careful navigation of one of the busiest intersections, where ethics, law, technology, medicine, and the Church enter, converge, and exit--each with its own preoccupation and destination. Symbols are a type of representation that point beyond themselves to something else. If the act of giving food and water is symbolic, to what reality does it point? Surely this reality is care--that most human and humane attention that we give to one another at the most basic level of need. But is this care realized when a patient who is dying is tethered to the technology of artificial nutrition and hydration against his or her will? The meaning communicated by this symbol in such a case is intended only for the care givers and society. For patients who have lived in the spirit of Christian faith, the message may be a death-denying one, out of keeping with the hope of resurrection and eternal life.