Abstract
The recent publication of the fifth edition of the Ethical and Religious Directives for Catholic Health Care Services on November 17, 2009, by mandate of the United States bishops, witnessed the eruption of a controversy in the U.S. with regard to nutrition and hydration for the seriously ill and dying. Among the major philosophical and moral thinkers in the field, there are some on the one hand who-out of respect for the wishes of the patient as expressed in normal situations-see no need for nutrition and hydration if such are the patient's wishes, even though they may have been expressed before the patient became ill. On the other hand, there are those who-out of respect for human dignity and with the understanding that any act of euthanasia is morally unacceptable-do not see how the interruption of life support can be acceptable unless it comes to be a burden and no longer a benefit under end-of-life conditions. In light of all this, the present article aims to provide reflections on the nature of assisted nutrition and hydration (ANH) and the obligation to use it in cases where clinical evidence requires it, with a particular focus on the ongoing bioethical debate in the U.S.