{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T08:05:01Z","timestamp":1779609901608,"version":"3.53.1"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Linacre Q"],"abstract":"<jats:p>\n                    The seventh edition of the Ethical and Religious Directives for Catholic Health Care Services states, \u201cIn principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally.\u201d Most of the discussions around medically assisted nutrition and hydration have focused on enteral nutrition. The present article aims to argue that the obligation to provide nutrition and hydration, in principle, extends to providing parenteral nutrition for patients who cannot take in food through their intestines so long as the intervention does not constitute a grave burden, does not entail excessive expense, and provides a reasonable hope of efficacy. There are several medical conditions in which either short- or long-term total parenteral nutrition (TPN) is required and is accepted as the standard of care. The inability to tolerate nutrition enterally should not be either a death sentence or a condonation of passive euthanasia via dehydration and starvation if death is not imminent. Fr. Tadeusz\n                    <jats:xref ref-type=\"bibr\">Pacholczyk<\/jats:xref>\n                    , in discussing death and feeding tubes stated that, \u201cOur death, in other words, should result from the progress of a pathological condition, not from a lack of food or water if it could have been readily and effectively offered to provide comfort and support to a patient.\u201d Proceeding with TPN is a proportionate method of assisted nutrition and hydration that has the potential to aid in the prolongation of life worth living, as well as preventing unnecessary death via dehydration and starvation.\n                  <\/jats:p>","DOI":"10.1177\/00243639261450677","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T13:20:23Z","timestamp":1779283223000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Total Parental Nutrition as a Proportionate Means of Conserving Life"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7759-3034","authenticated-orcid":false,"given":"Michael","family":"Bernhardt","sequence":"first","affiliation":[{"name":"Walter Reed National Military Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"Congregation for the Doctrine of the Faith. 1980. Declaration on Euthanasia. The Holy See May 5. https:\/\/www.vatican.va\/roman_curia\/congregations\/cfaith\/documents\/rc_con_cfaith_doc_19800505_euthanasia_en.html."},{"key":"e_1_3_2_3_1","unstructured":"Congregation for the Doctrine of the Faith. 2007a. \u201cCommentary.\u201d The Holy See August 1. https:\/\/www.vatican.va\/roman_curia\/congregations\/cfaith\/documents\/rc_con_cfaith_doc_20070801_nota-commento_en.html."},{"key":"e_1_3_2_4_1","unstructured":"Congregation for the Doctrine of the Faith. 2007b. Responses to Certain Questions of the United States Conference of Catholic Bishops Concerning Artificial Nutrition and Hydration. The Holy See August 1. https:\/\/www.vatican.va\/roman_curia\/congregations\/cfaith\/documents\/rc_con_cfaith_doc_20070801_risposte-usa_en.html."},{"key":"e_1_3_2_5_1","unstructured":"Congregation for the Doctrine of the Faith. 2020. Samaritanus Bonus. The Holy See September 22. https:\/\/press.vatican.va\/content\/salastampa\/en\/bollettino\/pubblico\/2020\/09\/22\/200922a.html."},{"key":"e_1_3_2_6_1","volume-title":"Ordinary and Extraordinary Means of Conserving Life","author":"Cronin Daniel Anthony","year":"2011","unstructured":"Cronin Daniel Anthony. 2011. Ordinary and Extraordinary Means of Conserving Life. Philadelphia, PA: National Catholic Bioethics Center."},{"key":"e_1_3_2_7_1","unstructured":"DeLegge Mark H. 2024. \u201cGastrostomy Tubes: Complications and Their Management.\u201d UpToDate October 16. https:\/\/www.uptodate.com\/contents\/gastrostomy-tubes-complications-and-their-management."},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.02.006"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/002436311803888186"},{"key":"e_1_3_2_10_1","unstructured":"Griffin Ian. 2024. \u201cParenteral Nutrition in Premature Infants.\u201d UpToDate October 15. https:\/\/www.uptodate.com\/contents\/parenteral-nutrition-in-premature-infants."},{"key":"e_1_3_2_11_1","unstructured":"John X. X. I. I. I. 1963. Pacem in Terris. The Holy See April 11. https:\/\/www.vatican.va\/content\/john-xxiii\/en\/encyclicals\/documents\/hf_j-xxiii_enc_11041963_pacem.html."},{"key":"e_1_3_2_12_1","unstructured":"John Paul I. I. 1995. Evangelium Vitae. The Holy See March 25. https:\/\/www.vatican.va\/content\/john-paul-ii\/en\/encyclicals\/documents\/hf_jp-ii_enc_25031995_evangelium-vitae.html."},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"John Paul I. I. 2004. To the Participants in the International Congress on \u201cLife-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas.\u201d The Holy See March 20. https:\/\/www.vatican.va\/content\/john-paul-ii\/en\/speeches\/2004\/march\/documents\/hf_jp-ii_spe_20040320_congress-fiamc.html.","DOI":"10.3233\/NRE-2004-19402"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.06.016"},{"key":"e_1_3_2_15_1","volume-title":"Making Sense of Bioethics: Column 018: Are Feeding Tubes Required?","author":"Pacholczyk Tadeusz.","year":"2006","unstructured":"Pacholczyk Tadeusz. 2006. Making Sense of Bioethics: Column 018: Are Feeding Tubes Required? The National Catholic Bioethics Center, November 18. https:\/\/www.ncbcenter.org\/making-sense-of-bioethics-cms\/column-018-are-feeding-tubes-required."},{"key":"e_1_3_2_16_1","unstructured":"Seres David. 2024. Nutrition Support in Critically Ill Adult Patients: Parenteral Nutrition.\u201d UpToDate November 19. https:\/\/www.uptodate.com\/contents\/nutrition-support-in-critically-ill-adult-patients-parenteral-nutrition."},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.8232"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1179\/002436311803888483"},{"key":"e_1_3_2_19_1","unstructured":"United States Conference of Catholic Bishops. 2025. Ethical and Religious Directives for Catholic Health Care Services. https:\/\/www.usccb.org\/resources\/ERDs-7th-ed-Approved_2025-11-12.pdf."},{"key":"e_1_3_2_20_1","volume-title":"New Charter for Health Care Workers","author":"Zimowski Zygmunt.","year":"2017","unstructured":"Zimowski Zygmunt. 2017. New Charter for Health Care Workers. Philadelphia, PA: National Catholic Bioethics Center."}],"container-title":["The Linacre Quarterly"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00243639261450677","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00243639261450677","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00243639261450677","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T07:51:42Z","timestamp":1779609102000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00243639261450677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":19,"alternative-id":["10.1177\/00243639261450677"],"URL":"https:\/\/doi.org\/10.1177\/00243639261450677","relation":{},"ISSN":["0024-3639","2050-8549"],"issn-type":[{"value":"0024-3639","type":"print"},{"value":"2050-8549","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"article-number":"00243639261450677"}}