Last week, this blog briefly covered the news regarding the new statement from the Vatican clarifying the Church’s position on the obligation to provide food and water by artificial means in countries with advanced technology and resources.
In the entry on the AJOB Bioethics Blog, Kelly Hills expresses these concerns:
The clarification becomes important because although Catholic doctrine does oppose euthanasia, it allows for the cessation of heroic, futile (extraordinary, and potentially painful) efforts. At question, then, has been whether or not tube-nourishment constitutes extraordinary or heroic efforts that are therefore optional under Catholic doctrine.
Ultimately, this affects more than “just” Catholics – many hospitals around the world are run by Catholic organizations who will feel bound by the ruling, and will enforce the decisions stemming from it regardless of whether or not the patient themself is Catholic.
The concern expressed here is a little premature. Catholic ethicists in the U.S. have been at the forefront of pushing the idea that tube-feeding is “extraordinary treatment” and that there is no obligation to provide it to people in PVS. In fact, organizations such as the Alliance of Catholic Health Care supported the legal efforts in California to allow the removal of a feeding tube from Robert Wendland, who was in what is now called a “minimally conscious state.” The brief that the Alliance signed was endorsed by 43 bioethicists and would have made it much easier to legally end the lives of people who are conscious but unable to communicate effectively or consistently.
And, in fact, in a September 21 article in the Chicago Tribune, Catholic ethicist James Walter expressed his fears about the Vatican statement on people in “minimally conscious state.”:
Particularly vulnerable are patients who are minimally conscious and who may be suffering acutely from their disabilities but are unable to express themselves, Walter said.
More than 100,000 patients in the U.S. have this type of extreme cognitive disability.
Walter is the director of Loyola Marymount University’s bioethics institute, in California where the battle over the life of Robert Wendland and other people under guardianship was waged.
As to the idea that this will bring deaths through feeding tube removal to a halt? Let’s be real – even when institutions want to change course, they’re unable to turn on a dime.
And it’s doubtful that many of them will want to go along. And they already have their “spin” in hand. In the Tribune article, the Rev. Michael Place of Resurrection Health Care showed his organization is ready:
“We now have a clarity in principle we did not have,” but individual cases will still need to be decided on their own, he said.
Translation: We’ll find reasons to justify our actions as we protect the status quo. Everyone can take a deep breath and relax. People will still be able to die through denial of treatment, even if they never expressed a wish one way or another. –Stephen Drake