A friend of mine and I had an argument over Terri Schiavo as to whether food and water should be stopped to allow her to die. I said that to do so would really be like killing her. She said that she is going to die anyway. Is there any Church teaching on this matter?
The question of withdrawing food and water from a person who is disabled, in a coma or what is called a persistent vegetative state has become a moral battleground. This question has come into the spotlight with the case of Terri Schiavo, who, when she was 26, collapsed (under suspicious circumstances), was deprived of oxygen, and was left severely disabled. Presently, she is receiving nourishment through a feeding tube, which her husband wants to have removed. A court battle has ensued between the husband and Terri’s parents, who want nourishment to continue. What then is the moral guidance in this and similar situations?
This spring, Pope John Paul II addressed the International Congress on “Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas.” In his teaching, the Holy Father took exception to the term “persistent vegetative state.” Generally, this term refers to a patient who shows no sign of self-awareness or of the surrounding environment, is unable to react to specific stimuli and seems unable to interact with others. The problem with the terminology is that it tends to reduce the human person to a vegetable. When a person is no longer considered as human but as a vegetable, then that person could be euthanized, like a sick animal or a diseased plant. The same is true when we think of the unborn child as a “fetus” or “the product of conception” rather than as a “baby”; the former terminology is used to justify abortion and assuage consciences.
The Holy Father asserted, “I feel the duty to reaffirm strongly that the intrinsic value and personal dignity of every human being do not change, no matter what the concrete circumstances of his or her life. A man, even if seriously ill or disabled in the exercise of his highest functions, is and always will be a man, and he will never become a ‘vegetable’ or an ‘animal.’ Even our brothers and sisters who find themselves in the clinical condition of a ‘vegetative state’ retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as His sons and daughters, especially in need of help” (no. 3).
Therefore, society must not lose sight of the human dignity of the individual, even if diagnosed as being in a “persistent vegetative state.” Such a person deserves the same care as anyone else. The pope affirmed the following principles, which uphold the dignity of the sick person: First, the sick person, even if diagnosed as being in a persistent vegetative state, has a right to basic health care (nutrition, hydration, cleanliness, warmth, etc.). Second, he has a right to treatment to prevent complications related to his confinement in bed. Third, he has the right to appropriate care for rehabilitation, and to be monitored for signs of recovery; one must never give up hope of at least a partial recovery (no. 4).
A key point is the first principle: the sick person has a right to basic health care, which includes nutrition and hydration. This principle is long-standing in Catholic healthcare ethics, and has been enunciated clearly by Pope Pius XII in 1957 and the Sacred Congregation for the Doctrine of the Faith’s “Declaration on Euthanasia” in 1980. Pope John Paul II stated, “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” (no. 4).
To deny a person food and water is to sentence that person to a slow, painful death, i.e. to euthanize that person. Remember, by definition euthanasia is “an action or omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated” (“Declaration on Euthanasia”). In other words, euthanasia involves the purposeful termination of life by a direct action, such as lethal injection, or by an omission, such as starvation or dehydration. As our Holy Father taught in Evangelium Vitae, “…euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person” (no. 65).
Instead, positive action must be taken by showing compassion. The pope taught, “True compassion leads to sharing another's pain; it does not kill the person whose suffering we cannot bear” (Evangelium Vitae,” no. 66).
In these cases, such compassion is twofold: First, as our Holy Father stated, families with loved ones in such a condition need support: assistance with the care of the loved one, financial aid, access to care facilities and rehabilitation programs, and spiritual counseling and guidance.
Second, true compassion entails helping these most vulnerable members of our society and defending their dignity. Remember in the Gospel of St. Matthew, our Lord described the Last Judgment (25:31-46) and how the sheep were separated from the goats, the righteous from the damned; to the righteous, Jesus said, “For I was hungry and you gave me food, I was thirsty and you gave me drink.” The Christian then can show true compassion by feeding those with difficulties by hand, so as to prevent the use of artificial means for feeding and hydrating. I remember when I was at my first assignment at St. Mary Church in Alexandria, I offered Mass every Friday at Woodbine Nursing Home and afterward would visit the patients who could not attend Mass. I was always impressed by an elderly gentleman (who was not Catholic) who would be there every Friday sitting with his wife suffering from Alzheimer’s disease. He would feed her by hand, like a little child. Granted, the task was difficult, time-consuming and required much patience. However, the task for him was an act of love.
For those patients like Terri Schiavo who receive food and water through an artificial means, like a feeding tube, we too can show compassion for them and their families, through prayer, support, presence and other kinds of care. True compassion entails giving care, not killing. Our Holy Father in his recent address stated, “…I exhort you, as men and women of science responsible for the dignity of the medical profession, to guard jealously the principle according to which the true task of medicine is ‘to cure if possible, always to care’” (no. 7).
Fr. Saunders is pastor of Our Lady of Hope Parish in Potomac Falls and a professor of catechetics and theology at Notre Dame Graduate School in Alexandria. If you enjoy reading Fr. Saunders' work, his new book entitled Straight Answers (400 pages) is available at the Pauline Book and Media Center of Arlington, Virginia (703/549-3806).
(This article courtesy of the Arlington Catholic Herald.)