By the time this column appears, the case involving Terri Schiavo, the patient in Florida who had been living in a “persistent vegetative state” for 15 years, will very probably have been resolved.
Even though one long and bitter stage of the controversy has come to an end, important moral issues will remain long after this tragic event has been forgotten by the general public.
Some truly astonishing things were said during the course of this debate. A lawyer for Terri Schiavo’s parents claimed that she would suffer eternal damnation if the feeding tubes were withdrawn because such an action would be contrary to her religious beliefs. An editorial in the Vatican’s official newspaper, L’Osservatore Romano, declared that the withdrawal of the feeding tubes would be tantamount to capital punishment of the innocent.
Even a high-ranking U.S. church official like Cardinal Theodore McCarrick, Archbishop of Washington, characterized the court-ordered removal of Mrs. Schiavo’s feeding tube as a “form of euthanasia,” which the Catholic Church condemns as “gravely immoral.”
Indeed, the church does condemn euthanasia, but the question that was begged here is whether the withdrawal of the feeding tube in this particular case, and in cases similar to it, would have been, in fact, an act of euthanasia.
The traditional teaching of the Church — both officially and in the writings of Catholic moral theologians — points in a different, more broadly gauged direction. Since the days of Pope Pius XII (1939-58), when medical technology began making enormous and unprecedented advances in life-prolonging procedures, the church has always distinguished between ordinary and extraordinary means of preserving life.
The Catechism of the Catholic Church notes that a failure to employ ordinary means of preserving life would be tantamount to euthanasia (n. 2277).
On the other hand, “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected” (n. 2278).
A similar position was adopted by the United States Conference of Catholic Bishops in their statement of 2001 entitled, “Ethical and Religious Directives for Catholic Health Care Services.”
“A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community” (n. 56).
“A person may forego extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community” (n. 57).
“There should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient” (n. 58).
“The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching” (n. 59).
The Catholic bishops of Florida cited this statement in expressing their own views on the Terri Schiavo case. What distinguished their approach and that of the U.S. Conference of Catholic Bishops from so many theologically careless and erroneous statements made in the heat of controversy, by both private individuals and political leaders, was their balance and careful nuance.
We were not dealing here with a simple choice for or against life — the “culture of life” vs. the “culture of death.” Other moral concerns were also at stake, and none more important than the distinction that has long been part of Catholic moral teaching, between ordinary and extraordinary means of preserving life.
According to the courts, Terri Schiavo had been in a “persistent vegetative state” for some 15 years. Her only legally recognized guardian, namely, her husband, testified that his wife’s wishes were that she not be kept alive by the extraordinary means that had been employed on her behalf.
Given the content and scope of Catholic moral teaching on cases of this sort, the matter was never as open-and-shut as some people made it out to be.
Father McBrien is a professor of theology at the University of Notre Dame.