Thursday, March 31, 2005

the pope's "living will" and on the murkiness of the Church's teaching on feeding tubes and ventilators

A report from Reuters quotes America magazine's editor Rev. Thomas Reese S.J. as saying that the Pope effectively wrote his own "living will" when he delivered on March 20, 2004 an allocution (speech) to the participants in the International Congress on "Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas." This allocution expressed the Pope's view that artificial nutrition and hydration (ANH) constitute "a natural means of preserving life, not a medical act." He added that "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." This is the basis for the Church's call not to remove Terri Schiavo's feeding tube, whose death was just announced today.

Reese, commenting on the artificial nasal tube administered on the Pope recently to help feed him, said that "It would be very difficult to unplug him if it came to that," in light of the Pope's own words in his allocution.

Anyway, the article from Reuters correctly points out that "The Catholic Church has traditionally taught that doctors and families could end artificial life-extending measures in good conscience if a dying patient's prospects seemed hopeless." So when the Pope made this allocution last year, it seemed to have left many moral theologians scratching their heads (I remember that I wondered about the Pope's statement as well when I heard it last year).

And the reason is because the Church's moral tradition has never been "vitalist" with regards to issues such as this. Vitalism is the belief that earthly life is an absolute value and that it must be preserved by all means and whenever possible. As we all know feeding tubes and ventilators have the effect of keeping all of us alive indefinitely. The Church knows that no one is to be kept from dying if death is inevitable, knowing that eternal life is a greater good. I mean, isn't this part of the whole message of Easter? Anyway, as I noted in an earlier post, Pope Pius XII and the Declaration on Euthanasia from the Congregation of the Doctrine of the Faith articulated this Church teaching. The article then quotes Rev. James Keenan S.J., ethics professor at Boston College, saying that "We've [the Church] spent centuries letting people figure out how they want to go to meet God, and now we have these fairly intrusive claims on a patient."

Also, and a very big also, the Pope's allocution left things a bit murky, because of the fact that this is a mere "speech"--an allocution (stay tuned for an upcoming post on the hierarchy of papal pronouncements). The point is, allocutions are not dogmatic pronouncements and do not require an assent of faith. If any amendment in the Church's teaching has to be made, the usual route is for the pope to consult with the College of Bishops. So, Keenan comments that "The Pope can say any number of things but he has to tell the bishops' conferences when they have to change something...He hasn't done this."

One of the things therefore that this sad event with Terri Schiavo has done is to expose a rather confusing aspect of the Church's teaching on artificial nutrition and hydration. The Church has to articulate a clearer teaching on this for the sake of patients and their families.

Read the article from Reuters here.

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