Under guidelines adopted by the largest Christian retirement community in the Pacific Northwest, food, water, and oxygen cannot be withdrawn from nursing-center patients who need artificial life support.
Crista Ministries in Seattle, Washington, developed the guidelines in response to a controversy caused by the organization’s role in withholding artificially administered food and water from two patients in 1985 (CT, Mar. 6, 1987, p. 17). One of the patients had suffered a stroke that made it necessary to feed her through tubes. The patient’s family obtained medical certification that she had no chance of recovering, and obtained a physician’s directive to remove the feeding tube. After Crista refused to comply with the request, the family obtained a court order. The patient was moved to another facility, where she died.
Five months later, another patient’s family ordered an end to artificial feeding. This time Crista complied. Discontinuing tube feeding in certain cases is considered acceptable, according to recent legal rulings and current ethical standards of the American Medical Association. But Crista’s actions raised controversy within the Christian community.
Crista Ministries is part of a far-reaching, $30 million nondenominational initiative that includes a relief organization (World Concern) and a service that provides listings of Christian vocational opportunities (Inter-cristo). The organization’s board of trustees appointed a committee to investigate procedures at the nursing center. The committee proposed the new guidelines, which affirm the authority of Scripture and the special worth of human beings in God’s creation.
Life-Support Guidelines
As a general principle, the guidelines recognize that “the informed and competent patient has the right to refuse or forgo treatment” within legal limits that prohibit euthanasia, or deliberate mercy killing. Medical treatment is automatically given preference, unless the patient’s condition is irreversible and death is imminent.
“Food, water and oxygen, and the necessary and natural supports for life, will be provided as long as such provision is not detrimental to other aspects of the patient’s physical well-being,” the guidelines state. A similar approach governs pain medication.
Other life-sustaining medical treatments can be ended—in accordance with a patient’s advance directions—when three physicians concur that the patient faces imminent death from an irreversible illness. If a mentally incompetent patient did not provide advance directions, the patient’s immediate family can make a decision to end treatment.
Crista is forming an ethics committee, including a physician, nurse, and clergyman, to implement the new guidelines and provide ongoing advice. Patients choosing treatment options not permitted under the guidelines will be transferred to other facilities upon request.
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