300,000 Terri Schiavos.

From David Dayen at FireDogLake on the new ANH directive from the USCCB:

The US Conference of Catholic Bishops released an “Ethical and Religious Directive” this month that would ban any Catholic hospital, nursing home or hospice program from removing feeding tubes or ending palliative procedures of any kind, even when the individual has an advance directive to guide their end-of-life care. The Bishops’ directive even notes that patient suffering is redemptive and brings the individual closer to Christ.

The Catholic bishops have become more involved in political fights in recent years, particularly the issue of abortion coverage and immigration provisions in the current health care debate. This has caused a schism in the American Catholic community, which bubbled to a head yesterday with Rep. Patrick Kennedy (D-RI) being denied communion because of his position on choice.

More quietly, however, the Church has staked out a radical position on end-of-life care, without patients of the 565 Catholic hospitals and other Catholic care facilities even knowing about it. As Barbara Coombs Lee, president of Compassion and Choices, an advocacy group, put it, “When a patient goes to one of these facilities, they don’t know that they’re choosing Catholic dogma. The bishops see the hospitals as an extension of their ministry.”

The “Ethical and Religious Directives for Catholic Health Care Services” put out by the Catholic bishops would build upon a Papal allocution given in the wake of the controversial Terri Schiavo case, where the US Congress stepped in to keep Schiavo alive despite her persistent vegetative state and the wishes of her husband to end care. The papal elocution did state that the permanently unconscious should always have access to a feeding tube, but it did not have the force of doctrinal law behind it. “There was always some wiggle room” for Catholic care facilities, said Coombs Lee. Catholics were allowed to use something called a “benefit/burden balance” to determine the ethical, moral and compassionate result in any individual case.

Now, that wiggle room is gone. In the new directive, the bishops state that it is unethical and immoral to withhold or withdraw a feeding tube from patients, whether in cases of permanent unconsciousness, comas, or even cases of advanced dementia when the patient is unable to feed themselves.

This substitutes the wishes of the bishops for the stated wishes of families and the patients themselves, said Coombs Lee. Even if the family can produce an advance directive or living will, Catholic hospitals and nursing homes would be expected to maintain the feeding tubes. In addition, all Catholic health care workers are required by their faith to continue palliative care, according to the document. The directive even addresses patients. “These are directives for you, from the church,” said Coombs Lee.