It is a rare person who has not heard of the recent cruel homicide of the Florida woman, Terri Schiavo. Everyone, it seemed, had a strong opinion on the subject. Yet, despite clear moral teachings on the evils of euthanasia, there are Catholics¹ who boast support for euthanasia and doctor-assisted suicide.[i]
Are these Catholics¹ badly formed and ignorant of their Church¹s infallible teachings on the dignity and sacredness of all human life? Is it the fault of Catholic clergy for not preaching the Church¹s teachings from the pulpit?
In view of the clarity and frequency of the Church¹s up-to-date teachings, which reflect modern medical advances on the subject, these Catholics dissenting opinions seem to be willful and conscious disregard of those infallible teachings. Let us look at one example.
Most recently, a devout Catholic contacted this writer. She bemoaned that she could not persuade members of her Catholic family to reject the evils of euthanasia, especially in light of Terri¹s Schiavo¹s plight. Her own Catholic mother, who begot fourteen children, recently instructed the family not to allow the ordinary means and palliative care of nutrition and hydration¹ if she should ever require it. The daughter provided a copy of the mother¹s specific written directive:
³I do not want to be kept alive by a feeding tube. I do not want to be a burden¹ to anyone. I do not want to be kept on life support.¹ If I become seriously ill, just pull¹ everything and let me go naturally.¹ If the quality of my life¹ is not good, I do not wish to remain alive.²
The daughter next asked:
³My mother agreed with Michael Schiavo action to murder his wife, Terri, and Mom was very upset that I would suggest anything other than pulling Terri¹s feeding tube. She said she had no quality of life. What does the Catholic Church teach for people who are terminal¹ who choose starvation and dehydration and who actually put that in writing?²
Unfortunately, in most of these euthanasia cases, the families hotly disagree among themselves about whether nutrition and hydration¹ should be withdrawn. The family quarrel usually ends up in legal hassles and broken relationships.
Bishop Rene Henry Gracida, Bishop Emeritus of Corpus Christi, in an interview with this writer, offers the Church¹s teaching on this problem:[ii]
³Some Catholics would argue that they are simply following their conscience and that the Church allows them to do so. They choose to forget that the Church says that one can only safely follow an INFORMED CONSCIENCE, i.e., a conscience that has been formed and illuminated by the teachings of the Church. The Church has given clear and explicit guidelines regarding the removal of a feeding tube through which nutrition and hydration¹ is supplied to a sick person.
³All persons who wish to remain in communion with the Catholic Church, to receive Holy Communion and the other Sacraments, must assent to the teachings of the Church in matters of faith and morals.[iii]
³If a person supports euthanasia and assisted-suicide through the illicit rejection or removal of a feeding tube, they are not in communion with the Church. They have separated themselves from the Church.²
A terminally ill or dying person does have the right to refuse extra-ordinary¹ medical means so long as nothing is done or omitted with the intention to hasten or cause the person¹s death. Compassionate family members, doctors and nurses will continue to provide the person with ordinary care and treatment, which include nutrition and hydration, comfort care, and effective pain management.
Julie Grimstad, Executive Director of Life is Worth Living, Inc.,¹ explained in an interview with this writer the very important differences between ordinary¹ and extra-ordinary¹ means:
³What constitutes "ordinary" (obligatory) and "extra-ordinary" (optional) medical means varies with the individual circumstances. The same means could be judged ordinary in one situation and extra-ordinary in another. For instance, a ventilator may be used temporarily to save the life of a critically injured person or it may be used to prolong the life of a dying person. In the first instance, a ventilator usually would be considered ordinary means. In the second, it usually would be considered extra-ordinary means, that is, means that could be refused. Refusal of extra-ordinary means is not a sin.
³It is the physician who makes the judgment that a particular treatment is extra-ordinary under the circumstances. It must always be the patient, if capable of making medical decisions, who decides whether or not to refuse the treatment. If the patient wishes to fight for every last moment of life, that is his/her right!²[iv]
Depending on the individual patient's circumstances, the degree of pain and suffering caused by the treatment, the risk involved, or the burdensomeness to the patient, examples of extra-ordinary means could include:
· Kidney dialysis
· A ventilator
· Experimental drugs and devices
· Debilitating surgeries or drugs
· Medical treatments that exploit the patient [enticements to participate in drug trials for the sake of mankind¹ that may add pain and suffering while hastening death]
· Medical treatments that push a patient beyond their physical and psychological capacity [this list is merely illustrative, not exhaustive].
However, it is imperative to understand that a sick, terminally ill, or dying person does not have the right to kill him or herself. Withholding or refusing ordinary means¹ or palliative care,¹ such as nutrition and hydration,¹ would be murder or suicide, and a grave mortal sin, [v] except in rare circumstances; e.g., kidney or stomach cancer, where the food and water cannot be assimilated by the body. [vi]
Nutrition and hydration¹ is not extra-ordinary¹ treatment nor is it life support.¹ It is not even a medical act.¹ Nutrition and hydration¹ is ordinary means, proportionate and moral palliative care, and something that must not be denied. Whether nutrition and hydration¹ is naturally taken by mouth by the patient, or fed to the patient by someone else, or artificially delivered to the patient by a feeding tube, it is still ordinary means,¹ and palliative care.¹[vii]
The subjective error of judgment into which one can fall in good faith does not change the objective nature of this murderous rejection of a required feeding tube.[viii] One who plots suicide through premorbid wishes in a Living Will¹ or another written directive with the intention of setting an example for others also takes on the gravity of scandal.[ix] Voluntary co-operation in suicide is contrary to the moral law.
A Catholic cannot prescind from the Church¹s mediation and canonical laws binding upon one¹s conscience.[x] We are not "free" to follow an erroneous or uninformed conscience. We are required to seek out the truth from the Church and her teachings.[xi] We are not free¹ to believe one teaching of the Magisterium and not another.
The Church¹s clear moral teachings on Euthanasia are the same for all men, no matter their age, their quality of life,¹ whether they are sick, terminally ill, or dying.[xii] To deprive ordinary, palliative care, such as simple food and water,¹ is not ³allowing a person to die a naturally.² Instead, it would be a grave and evil act of murder [or suicide]. [xiii]
The Sacred Congregation for the Doctrine of the Faith declared:
³It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly, nor can any authority legitimately recommend or permit such an action.²[xiv]
The dangerous, ubiquitous phrase, quality of life¹ does not factor into what kind of treatment a person must receive. The late Pope John Paul II, who virtuously struggled with his own illness and who later received his nutrition and hydration through a feeding tube,¹ said specifically on Terri¹s behalf that a person¹s dignity does not depend on his ³quality of life² which nowadays is sometimes interpreted as merely the ability to experience pain or pleasure, or to think rationally.[xv]
As God¹s children, we must resist yielding to ephemeral cultural and moral trends or cultural relativism. Pope Benedict warns that Christians must reject a conception of pluralism that reflects moral relativism.[xvi]
This is Christian ethics we speak of, but also the natural law of mankind, a principle of human civilization, infused upon every created person¹s heart, mind, and soul when God forms them in the womb.
Instead of Catholic leaders and laity promoting the Church¹s moral teachings, many are in fact the cause for much of the confusion. This writer has received more than a few communications from distraught readers who allege their pastors wrongly supported the withdrawal of Terri¹s nutrition and hydration¹ from their pulpits.
An April 8, 2005, a three-year Gallup Poll revealed that 32% of Catholics who consistently attend Sunday Mass morally accept doctor-assisted suicide or euthanasia. The number increases to 48% of Catholics who infrequently attend Sunday Mass. Is our Catholic pastors¹ silence from the pulpit to blame for this dissent from the Church¹s clear teachings on euthanasia?
Various news media sources reported Catholic clergy across the nation have made no secret of their support for the March 31, 2005 doctor-assisted murder of Terri Schiavo. What we have here is disobedience to magisterial teachings from Catholic priests, theological professors, ethics professors,[xvii] and laity.[xviii]
In a recent article, Catholic World News cited a survey revealing that almost 90% U.S. Catholic physicians supported medical treatments and ethical stances contrary to Church teachings.[xix]
In March 2004, Pope JPII gave an address to a large group of physicians. Here is an excerpt:
"I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.
"The obligation to provide the normal care due to the sick in such cases¹ includes, in fact, the use of nutrition and hydration. The evaluation of probabilities, founded on waning hopes for recovery when the vegetative state is prolonged beyond a year, cannot ethically justify the cessation or interruption of minimal care for the patient, including nutrition and hydration. Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense, it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission.
"In this regard, I recall what I wrote in the Encyclical Evangelium Vitae making it clear that "by euthanasia in the true and proper sense must be understood an action or omission which by its very nature and intention brings about death, with the purpose of eliminating all pain"; such an act is always "a serious violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person" (n. 65). [Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004.)
What can you and I do? Print out the substantiating documents provided within this essay and distribute them to your bishops, pastors, family members, and friends. Educate and convince others to the saving truths of the Church¹s clear teachings on nutrition and hydration.¹
©Barbara Kralis 2005, all rights reserved.
[i] ³By euthanasia is understood an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated.² Part II, Declaration on Euthanasia, by Franjo Cardinal Seper, Prefect of The Congregation for the Doctrine of the Faith (CDF), May 1980. Cf. Evangelium vitae n.65.
[ii] On May 25, 1990, Bishop Gracida, Bishop Emeritus of Corpus Christi, TX, issued ³A Dissent From The Interim Pastoral Statement On Artificial Nutrition and Hydration¹ Issued by the Texas Conference of Catholic Health Facilities and Some of the Bishops of Texas.² Bp. Gracida declined to sign the document because he considered it to be seriously flawed regarding the withdrawal of nutrition and hydration¹ from seriously ill patients.
[iii] The Code of Canon Law c. 915 states: ³Those upon whom the penalty of excommunication or interdict has been imposed or declared, and others who obstinately persist in manifest grave sin, are not to be admitted to Holy Communion.²
[iv] Julie Grimstad, Executive Director of Life is Worth Living,¹ is a member of Pro-Life Wisconsin¹s speakers bureau. She is a board member and contributing author to the Human Life Alliance¹ newsletter ³Euthanasia: Imposed Death.²
[vii] Pope John Paul II, 3/20/04 address to a group of physicians at the Congress, Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas.¹
[viii] Cf. CCC, n. 2277.
[ix] Cf. CCC, n. 2282
[x] Cf. CCC, nos. 2276-2283.
[xi] Dignitatis Humanae On the right of the Person and of communities to Social and Civil Freedom in Matters Religious,¹ Pope Paul VI, 12/7/65.
[xii] Congregation for the Doctrine of the Faith, Iura et Bona, p. IV); cf. Pontifical Council "Cor Unum", Dans le Cadre, 2, 4, 4; cf. Pontifical Council for Pastoral Assistance to Health Care Workers, ³Charter of Health Care Workers,² 1995, n. 120.
[xiii] Bishop Elio Sgreccia, President of the Pontifical Academy for Life, 3/11/05, interview with Vatican Radio. Cf CWNews.com story, 3/22/05, ³Grave sin to remove feeding tubes.²
[xv] Letter of Pope John Paul II, to President of the Pontifical Academy for Life, in the general assembly of the Pontifical Academy for Life, 2/19/05, Rome, ³On The Occasion of a Study Congress on Quality of Life and Ethics of Health.²
[xvi] ³The Risks of Relativism Fallacies that confront Benedict XVI,² published by Zenit.org, 4/30/05, by the then Cardinal Joseph Ratzinger, referring to ever-changing trends in contemporary thought.
[xvii] Fr. David O¹Leary, Medical Ethics professor at Tufts University dissents from Vatican teachings on 4/2/05 here:
Cf. ³Wrestling with the Final Call,² by Jay Tolson, USNews.com: ³The Rev. John Paris, S.J., a Roman Catholic priest and professor of bioethics at Boston College, says that the removal of an artificial feeding tube is consistent with 400 years of Catholic teaching on the use of extraordinary means to preserve life. He says that his view is reflected in the practices of American Catholic hospitals.²
[xviii] ³Outlines Care of Persons in PVS,² by Fr. John T. Zuhlsdorf, published by The Wanderer Newspaper, 4/1/04. ³For example, Fr. Kevin O¹Rourke, OP, a scholar at Loyola University¹s Neiswanger Institute for Bioethics and Health policy, has been arguing that giving nutrition and hydration to a persistently unconscious person is of no real benefit, since it does not in itself restore the person to the use of his higher cognitive functions. Giving nutrition and hydration¹ only preserves, in his view, biological life, rather than human life. Thus, he seems to chop the human person into pieces. They have relative worth according to the extent of the use of higher function. O¹Rourke has argued that there is a presumption against giving nutrition and hydration to PVS people²
Cf ³Schiavo Case Puts Priest on Hot Seat,² by Judith Graham, Sun-Sentinel.com, 4/24/05 regarding the popular Fr. O¹Rourke, as well as bioethics professor James Walter at Loyola Marymount University in Los Angeles.
Barbara Kralis, the article's author, writes for various Christian and conservative publications. She and her husband, Mitch, live in the great State of Texas, and co-direct the Jesus Through Mary Catholic Foundation. She can be reached at: Avemaria@earthlink.net