Culture of Love and Life- Euthanasia

References and resources in support of Catholic teaching on:

Value of Life
Quality of Life
What is Burdensome?
Intention of Act
Cognitive Function
Artificial Nutrition and Hydration
Living Wills
Awakening Centers
Challenges to the Magisterial Teaching
Death of Terri Schiavo
Netherlands Euthanasia Program

(Compiled June 2005)
by: Joan Crown
Respect Life Office, Archdiocese of Miami

Regarding “value of life” and the urgency to fight euthanasia:

Gospel of Life #64
When the prevailing tendency is to value life only to the extent that it brings pleasure and well-being, suffering seems like an unbearable setback, something from which one must be freed at all costs. Death is considered “senseless” if it suddenly interrupts a life still open to a future of new and interesting experiences. But it becomes a “rightful liberation” once life is held to be no longer meaningful because it is filled with pain and inexorably doomed to even greater suffering.

Furthermore, when he denies or neglects his fundamental relationship to God, man thinks he is his own rule and measure, with the right to demand that society should guarantee him the ways and means of deciding what to do with his life in full and complete autonomy. It is especially people in the developed countries who act in this way...

...In this context the temptation grows to have recourse to euthanasia, that is , to take control of death and bring it about before its time, “gently” ending one’s own life or the life of others. In reality what might seem logical and humane, when looked at more closely is seen to be senseless and inhumane. Here we are faced with one of the more alarming symptoms of the “culture of death”, which is advancing above all in prosperous societies, marked by an attitude of excessive preoccupation with efficiency and which sees the growing number of elderly and disabled people as intolerable and too burdensome. These people are very often isolated by their families and by society, which are organized almost exclusively on the basis of criteria of productive efficiency, according to which a hopelessly impaired life no longer has any value.

Gospel of Life #66

The height of arbitrariness and injustice is reached when certain people, such as physicians or legislators, arrogate to themselves the power to decide who ought to live and who ought to die. Once again we find ourselves before the temptation of Eden: to become like God who “knows good and evil”. God alone has the power over life and death: “It is I who bring both death and life.” But he only exercises this power in accordance with a plan of wisdom and love. When man usurps this power, being enslaved by a foolish and selfish way of thinking, he inevitably uses it for injustice and death. Thus the life of the person who is weak is put into the hands of the one who is strong; in society the sense of justice is lost, and mutual trust, the basis of every authentic interpersonal relationship, is undermined at its root.

Gospel of Life #89

In today’s cultural and social context, in which science and the practice of medicine risk losing sight of their inherent ethical dimension, health-care professionals can be strongly tempted at times to become manipulators of life, or even agents of death. In the face of this temptation their responsibility today is greatly increased. Its deepest inspiration and strongest support lie in the intrinsic and undeniable ethical dimension of the health-care profession, something already recognized by the ancient and still relevant Hippocratic Oath, which requires every doctor to commit himself to absolute respect for human life and its sacredness.....Causing death can never be considered a form of medical treatment, even when the intention is solely to comply with the patient’s request.

Regarding “quality of life”:

John Paul II - 2-19-05
“In our time the meaning which the expression “quality of life” is gradually acquiring is often far from this basic interpretation, founded on a correct philosophical and theological anthropology. Indeed, under the impetus of the society of well-being, preference is being given to a notion of quality of life that is both reductive and selective: it would consist in the ability to enjoy and experience pleasure or even in the capacity for self-awareness and participation in social life. As a result, human beings who are not yet or are no longer able to understand and desire or those who can no longer enjoy life as sensations and relations are denied every form of quality of life.”

CCC #2276
Those whose lives are diminished or weakened deserve special respect.

Florida Bishops, 1989
“We can never justify the withdrawal of sustenance on the basis of the quality of life of the patient.”

Mark Latkovic, S.T.D., Professor of Moral & Systemic Theology, Sacred Heart Seminary, Michigan
“....quality of life judgments are those which bear on the usefulness or burdensomeness of specific kinds of treatments for persons in specific kinds of conditions. These are not the same as quality of life judgments asserting that those persons’ lives are no longer of any value.”

Regarding “what is burdensome”:

Rev. Edward Richard, Moral Theology and Medica Ethics - Glennon Seminary, St. Louis
“Judgments about the quality of a person’s life are outside the scope of the concept of burden for the purposes of the moral evaluation of a treatment. The burden involved refers to the burden the treatment itself directly imposes upon the patient.....the burden and futility have to be interpreted in reference to the comfort and life-sustaining effects they afford to the patient and not to the cure, remedy or reversal of the disease or condition affecting the patient.”

“Life itself, even for the dying, is not to be considered a burden. In determining whether or not such a burden exists as to merit withholding or withdrawing food and water, one is
to look at the immediate burdens imposed by the treatment, not the “quality of life” of the patient.”

Reasonable hope of benefit: “Care of the person includes all those procedures, treatments, and medications which have benefits for the person’s comfort and sustenance. It is immoral to terminate such care simply because the person will have no hope of recovery.”

Msgr. William B. Smith, Archdiocese of New York
“The provision of nutrition and hydration can be burdensome when the provision by tube causes severe discomfort to the patient or when the patient’s body is not assimilating what is being provided. Such occurrences usually indicate that death is very near.”

Regarding intention of act:

Catholic Catechism #1755 - 1756
A morally good act requires the goodness of the object, of the end, and of the circumstances together. An evil end corrupts the action, even if the object is good in itself.
It is therefore an error to judge the morality of human acts by considering only the intention that inspires them or the circumstances which supply their context.

Rev. Edward Richard, Moral Theology & Medical Ethics, Glennon Seminary, St. Louis
“One need not have the intention of killing, if the action or omission of itself can and will cause death, death being the means through which suffering is eliminated.”

Regarding “cognitive function”:

In contradiction of theologian Kevin O’Rourke’s teaching that lack of cognitive function indicates the end of spiritual purpose – also those who want to separate body /soul/ spirit before death (dualism):

Catholic Catechism #363 - 367 is a human body precisely because it is animated by a spiritual soul...

For this reason man may not despise his bodily life. Rather he is obliged to regard his body as good and to hold it in honor since God has created it and will raise it up on the last day.

The unity of soul and body is so profound that one has to consider the soul to be the “form” of the body.

Dr. Gian Luigi Gigli, Pres. Of the Int’l. Federation of Catholic Medical Assoc.
“The vegetative state is a “pejorative term” which implies lack of humanity....for the Church, the patient in a vegetative state is a human person, in need of affectionate care.

Regarding the question of artificial “nutrition and hydration”:

Pope John Paul II - 3-20-04 allocution
...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...

(USA Today reports): 565 hospitals in the Catholic Health Assoc. consider feeding tubes for people in PVS ‘medical treatment’ which could be provided or discontinued based on evaluating the benefits and burden on patient and family.

Bishop Elio Sgreccia, Vice President of the Pontifical Council for Life
Director of the Bioethics Center of Rome’s University of the Sacred Heart
refuting the position:
“that when a person loses the use of reason, he or she ceases to be a person and then there is the possibility of interrupting feeding and hydration in order to facilitate his or her death”

He said: “As long as there is life in the person, that person continues to exist in all of his or her dignity, with all of his or her soul.”  He also said that, “a person cannot deny himself food and water through a will, should he fall into a vegetative state, as it would be suicide.”

National Catholic Bioethics Center:
In general, the provision of nutrition and hydration to the patient in PVS is proportionate and morally obligatory.

If the nutrition and hydration does not have a reasonable hope of benefit for what it is designed to do (nourish the body) or poses some excessive burden (such as serious medical complications) then it might be considered ethically extraordinary.

Florida Bishops:
Simply put, we are called to provide basic means of sustenance such as food and water unless they are doing more harm than good to the patient, or are useless because the patients’ death is imminent.

U.S. Bishops of California, Nevada and Hawaii
...a great teaching effort is needed to clarify the substantive moral difference between discontinuing medical procedures that may be burdensome, dangerous or disproportionate to the expected outcome and taking away the ordinary means of preserving life, such as feeding, hydration and normal medical blur this distinction is to introduce a source of countless injustices and much additional anguish.

Dr. Steve White, Florida Catholic Medical Assoc.
“There are two circumstances in which you could withhold or withdraw artificial hydration and nutrition:
1) the person is terminally ill and death is imminent (within days)
2) the person has an irreversible condition that prevents the assimilation of food and water”

Professor Janet Smith, Chair of Life Ehtics, Sacred Heart Major Seminary, Michigan
“The reasoning of John Paul II was that artificial nutrition and hydration is rarely if ever so costly for a PVS patient that it would be moral to remove it. He understands artificial nutrition and hydration to be basically on that same level as providing nutrition and hydration in any fashion at all. If death is imminent and the artificial nutrition and hydration system is painful and annoying and if withdrawing it would not hasten death but only make the patient more comfortable, then withdrawing it would be fine.”

Mark Latkovic, S.T.D., Professor of Moral & Systemic Theology, Sacred Heart Seminary, Michigan (refuting the comparison of a respirator to nutrition and hydration)
“Ventilation replaces the patients capacity to breathe whereas a tube does not replace the capacity to digest and merely delivers food to the stomach...A feeding-tube by which liquid is delivered to the patient’s stomach is no more medical treatment than a catheter by which it is drained from the patient’s bladder.”

Regarding “living wills”:

Bishop Elio Sgreccia, vice president of the Pontifical Council for Life
“A person cannot deny himself food and water through a will, should he fall into a vegetative state, as it would be suicide.” He added, “A doctor is not obliged to violate the deontological code itself, nor can he consider himself a simple executor of such a will.” (Vatican City, March 2004)

Declaration on Euthanasia -
Congregation for the Doctrine of the Faith - May 1980
“...some people speak of a “right to die” which is an expression that does not mean the right to procure death either by one’s own hand or by means of someone else, as one pleases, but rather the right to die peacefully with human and Christian dignity.”

Florida Bishops, 1989
“First, the document should clearly distinguish between a terminal condition in which death is imminent, and other conditions in which one could live a long time with easily provided medical care. Second, one should never ask for or demand euthanasia, mercy killing or the withholding of “ordinary means” of sustaining life. This is not only wrong for the signer of the document, but it also does a serious injustice to physicians, family and medical personnel to whom such immoral demands are made.”

Regarding “suffering”:

Pontifical Academy for Life, Dec. 2000
A request for death on the part of those in grave suffering is almost always the last expression of the patient’s heartfelt request for greater attention and human closeness as well as suitable treatment....One wonders whether the justification of the intolerability of the patient’s pain conceals instead the incapacity of the “healthy” to accompany the dying person through his difficult travail of suffering, to give meaning to human suffering... Human pain demands love and supportive sharing, and not the hasty violence of premature death.

Regarding “awakening centers” as proposed by John Paul II, 3-20-05:

Nancy Valko, spokesperson for the Nat’l. Assoc. of Pro-Life Nurses
“In America, it’s basically two months in a hospital and you’re out. They give you a choice between warehousing your loved one in a nursing home, taking them home, or pulling the plug. People need another choice.”

“Traumatic brain injuries are a significant health problem in the U.S., but the study and treatment of them are clouded with a sense of hopelessness.....I think what’s really motivating people is this tremendous fear of disability and dependency. Attitudes have consequences. People used to ask me how I can take care of someone who doesn’t recognize me. This is the problem in our society. It’s not whether they recognize me, it’s whether I recognize them. And I do.”

(Nancy greeted John Paul II’s statement about the ethical care of persons in a PVS state with tears of joy. In 2001, she was able to help a St. Louis man awaken from a coma. His doctors saw little hope that he would recover and recommended that the family withdraw treatment and let him die. Nancy used a few simple sensory stimulation techniques and gradually the man made a full recovery.)

Ethicists and Catholic theologians / institutions who challenge
John Paul II’s magisterial teaching:

Dominican Father Kevin O’Rourke, St. Louis
“...there is no benefit possible in maintaining the mere physical existence of PVS patients.” He also says that, “when a person is no longer able to exercise higher functioning he ceases to be a person.” (This is in direct contradiction to John Paul II’s allocution)

Ethicists Arthur Caplan and Dominic Sisti
describe the Pope’s statement as “flawed”, and “at odds with the way medicine has been practiced in the U.S. for well over a decade” and “fundamentally at odds with the American values of self-determination, freedom and autonomy”.

Sister Jean deBlois, C.S.J., Aquinas Institute, St. Louis
the Pope’s statement places “an unnecessary and unfounded burden on family members faced with treatment decisions on behalf of their loves ones” and that “artificial nutrition and hydration holds no comparison to a meal.”

Father John Tuohey, St. Vincent Medical Center, Portland, Oregon
treated the Pope’s statement as a “poorly argued thesis proposal by a misinformed student.”

Peggy Wilkers, president Fitzgerald Mercy Hospital Nurses Assoc., Pa.
She and other nurses would base their patient care “not on what the Pope says but on what the family wants.”

Catholic Health Association, Father Michael Place, president
“Until such time as we have a greater understanding of the meaning and intent of the pope’s allocution, Catholic hospitals and long term care facilities should continue to follow the U.S. Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services as interpreted by the diocesan bishop.”

(The secular reporter was perplexed regarding this answer - even this reporter said that he found the Pope’s statement very clear and explicit and he could not understand the apparent evasiveness of these Catholic experts.)

In contrast - those who respect the Holy Father’s words:

World Federation of Catholic Medical Assoc. and The Pontifical Academy for Life
called the Pope’s words “deeply inspiring.”

National Catholic Bioethics Center
“A welcome clarification of Catholic thinking on one of the most vexing and controversial issues in health care.”

Richard Doerflinger, Secretariat for Pro-Life Activities, Conf. Of Catholic Bishop
“An affirmation of human dignity”

Dr. Eugene Diamond - a participant at the international meeting in Rome devoted to Life Sustaining Treatments and the Vegetative State - March 2004
“The long standing debate concerning the definition of assisted nutrition as a medical treatment not required for those suffering from “the fatal disease of the inability” and lacking in a meaningful life since incapable of cognitive and affective function received scant support from the participants at the meeting and the Holy Father’s allocution. That position has been espoused principally by theologians such as Fr. Kevin O’Rourke, the late Fr. Richard McCormick and bioethical consultants to the Catholic Health Association.”

Mark Latkovic, S.T.D., Professor of Moral & Systemic Theology, Sacred Heart Seiminary, Michigan
“John Paul II has now spoken authoritatively on an issue that had been vigorously debated for over twenty years in the Catholic Church, and in doing so has given Catholic invaluable moral guidance for properly forming their consciences on such a difficult but vital end-of-life matter....the Pope has given the faithful a magisterial document that is not only consistent with the tradition, but one that is both fully informed by the current medical facts and sure to be pastorally helpful in real life health care situations.”

On the death of Terri Schiavo (3-29-05):

Cardinal Lozano Barragan, President of the Pontifical Council for Health Care:
described Schiavo’s death as “ a terrible murder, comparable to torture.”

Bishop Elia Sgreccia, President of the Pontifical Academy for Life:
“The removal of the gastric feeding tube from (Schiavo), in these conditions, may be considered direct euthanasia.”

Why then did Fr. Kevin O’Rourke, O.P., Professor of Ethics at Loyola University, Chicago argue that preserving Schiavo’s life would have been “blasphemy”?

Cardinal Keeler:
We are all diminished by this woman’s death, a death that speaks to the moral confusion we face today. Ours is a culture in which human life is increasingly devalued and violated, especially where that life is most weak and fragile.

Archbishop John Clement Favalora:
May God have mercy on those responsible for her death by starvation and may God reinvigorate all who respect life to continue to stand courageously for this justice issue.

Resource for Netherlands euthanasia information:
“Assisted Suicide and Euthanasia - Past and Present” by Dr. J.C. Willke

Mrs. Joan Crown is the Associate Director, Archdiocese of Miami Respect Life Office -Directs the operation of 6 crisis pregnancy centers; Coordinates the “Project Rachel” post-abortion healing program; Coordinator of annual lobby trip to Tallahassee “Catholic Days at the Capito; Supervises the pro-life educational efforts in 14 Catholic high schools and 118 parishes in the Archdiocese and is Editor of the pro-life educational newsletter “The Beginning”.


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