Address delivered October 5, 1998 by Pope John Paul II to the bishops of California, Nevada, and Hawaii :

As ecumenical witness in defense of life develops, a great teaching effort is needed to clarify the substantive moral difference between discontinuing medical procedures that may be burdensome, dangerous, or disproportionate to the expected outcome--what the Catechism of the Catholic Church calls "the refusal of 'over-zealous' treatment" (2278; cf Evangelium Vitae, 65)--and taking away the ordinary means of preserving life, such as feeding, hydration, and normal medical care.

The statement of the United States bishops' pro-life committee, Nutrition and Hydration: Moral and Pastoral Considerations, rightly emphasizes that the omission of nutrition and hydration intended to cause a patient's death must be rejected and that, while giving careful consideration to all the factors involves, the presumption should be in favor of providing medically assisted nutrition and hydration to all patients who need them. To blur this distinction is to introduce a source of countless injustices and much additional anguish, affecting both those already suffering from ill health or the deterioration which comes with age, and their loved ones.