Perspectives on Directive 58

The United States Conference of Catholic Bishops recently revised directive 58, on the use of artificial nutrition and hydration, in its Ethical and Religious Directives for Catholic Health Care Services. Although the revision clarifies that the use of artificial nutrition and hydration is ordinary, proportionate, and therefore, in principle, morally obligatory, the ethical debate surrounding this issue continues. Furthermore, many clinicians remain confused about the implications of this directive, as well as its application to specific cases. This article seeks to clarify both the implications and the practical application of directive 58, pointing out that providing artificial nutrition and hydration is part of normal care giving, and there are few instances in which such care can be licitly withheld or withdrawn from a patient.