Editorial

We need to maintain our Catholic perspective
on end-of-life issues

Earlier this year, Father Michael Place, a priest of the Archdiocese of Chicago and a moral theologian with many years of experience in the field of Catholic health care, offered some thoughtful reflections on a question of vital importance today.

Speaking at the Jesuit-run Fordham University in New York, Father Place discussed “the moral responsibility we have as individuals with regard to medically provided nutrition and hydration in general and how that general responsibility applies to persons in the persistent vegetative state.”

This topic gained front-page headlines last year when Terri Schiavo died in Florida nearly two weeks after her nutrition and hydration tube was removed.

Schiavo had been in what her doctors described as “a persistent vegetative state” for nearly 15 years.

Conflict in her family exploded into a regional, national and international debate over whether or not there was a moral obligation to provide her with food and water given the state of her condition.

According to Father Place, the complex moral principles that underlie such cases have made it difficult for theologians to arrive at “a broadly held theological consensus” on this and similar cases.

“While it is easy to agree that all life is sacred,” Father Place says, “it is not as easy to describe the moral responsibilities and obligations that follow.”

At the risk of oversimplifying a very important and complex issue, the contemporary Catholic perspective on cases like that of Terri Schiavo revolve around two fundamental principles.

On the one hand, as Pope John Paul II made clear in a papal allocution in March 2004, providing food and water to someone who is believed to be permanently unconscious is not “extraordinary care” even if the means are artificial. This means that unless other considerations or responsibilities make it impossible or extraordinarily burdensome to do so, there is an ordinary obligation to provide nutrition and hydration to persons in a “persistent vegetative state.”

On the other hand, Father Place suggests that the ordinary obligation that is present in cases like Schiavo’s is not an unconditional obligation in all end-of-life cases.

According to Father Place, “to say that we are always obligated to provide artificial nutrition and hydration unless death is imminent—and as long as nutrition is provided and suffering is alleviated—is inconsistent with Catholic realism. To always oblige the sustaining of physical life in this context is to require the heroic, ignore other relevant moral responsibilities and fail to appreciate the beauty of eternal life. To say that this is a good thing to do, that there might be benefits from such heroic activity, is not the same as saying it is morally required.”

As Father Place observes, the position articulated by Pope John Paul “seems to favor an extremely cautious understanding of what would constitute such exceptions [to the ordinary obligation to provide nutrition and hydration by artificial means.]”

In a culture that promotes euthanasia, abortion and “the increasingly utilitarian understanding of human life,” caution is necessary. The Catholic perspective takes these issues quite seriously—refusing to let nuanced moral decision-making be confused with indifference or moral laxity.

While Catholics agree that there are moral absolutes—the sacredness of human life is one of them—we also believe that God has given us the gifts of freedom, intelligence and conscience in order to make difficult decisions, to apply deeply-held moral principles to concrete situations and circumstances, and to make choices and take risks.

As Father Place says, “There is great wisdom in the nuances that are part of our obligations and responsibilities in the face of illness….To run from nuance to the security of black and white would be to betray our commitment as a pilgrim people to journey through complexity.”

Caution is required. So is an absolute commitment to defend the rights and human dignity of those who are most vulnerable. But in the final analysis, we must trust in the presence and power of the Holy Spirit.

“While admitting the power of evil, in the end we are optimists,” says Father Place. “We take seriously the fact that the reign of God is, albeit imperfectly, present in our midst.”

— Dan Conway

(Daniel Conway is a member of the editorial committee of the board of directors of Criterion Press Inc.) †