March 8, 2006

J.P. Hubert Jr. MD FACS
Catholic Biomedical Ethicist

©CCWVA

Recently, multiple revisionist Catholic writers including some “Catholic” Theologians have opined on the significance of the Terry Schiavo case asserting that it was morally licit to remove her feeding tube, thus insuring that she would die of dehydration. This author has rebutted them in the past.[1] Unfortunately, various writers continue to promulgate opinions which contradict constant Catholic magisterial teaching as if it were compatible with orthodox Catholic belief and practice. The latest article adds to the perfidy by incredibly; alleging that the late Holiness Pope John Paul II’s 2004 allocution on the Persistent Vegetative State was itself “revisionist.”[2]

In the past several days, Paul Lauritzen PhD, in an article for Commonweal Magazine 3/7/2006 entitled: “Revisiting Schiavo case – Feeding-tube removal raised question about Catholic end-of-life teachings” joined a number of other Catholic writers all of whom question the clear teaching of the Magisterium and that of our late Holy Father His Holiness John Paul II on the issue of the obligatory nature of providing nutrition to patients in whom a diagnosis of persistent vegetative state (PVS) has been made or those otherwise severely disabled patients who are unable to provide for their own sustenance. In so doing, Mr Lauritzen has quoted incorrectly, incompletely and out of context from Vatican statements in an apparent attempt to establish the antithesis of actual magisterial teaching. For example, he writes:

“To see what assumptions are embedded in the claim that Schiavo was euthanized, it is useful to consider the definition of euthanasia set out in the Vatican’s 1980 Declaration on Euthanasia. According to the declaration, euthanasia is ‘an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated. Euthanasia’s terms of reference, therefore, are to be found in the intention of the will and in the methods used.’

Framed in this way, the Schiavo case throws into sharp relief a central moral question raised by the prospect of withdrawing a feeding tube from any patient in a persistent vegetative state (PVS). Do we inevitably intend death when we remove a feeding tube from a PVS patient?”

First the Declaration on Euthanasia was promulgated in 1981 a reference for which is included in the bibliography. Second, the short quotation selected is so diminutive and out of context as to be unintelligible. Third, Professor Lauritzen commits the same error that so many revisionist (dissenting) Catholic moral theologians do by incorrectly asserting that the only morally relevant issue is that of “intent” carefully avoiding the other two important components of every moral decision that of the “object rationally chosen” and the “circumstances.” According to orthodox Catholic teaching, if the object rationally chosen is morally illicit, the moral act can never be made licit by appealing to a purportedly admirable “intent” which is what Mr. Lauritzen attempts to do in the short snippet included above.

With regard to the issue of providing sustenance to a person in whom a diagnosis of PVS has been made, the Magisterium has spoken definitively that food and water are ordinary supportive care not medical treatment and to withhold them irrespective of the “intent” is gravely immoral.[3] Removing a feeding tube from such a person, (a PVS patient) who is totally dependent upon it for food and water is to choose to kill them by omission (object rationally chosen). In other words, the object rationally chosen is morally illicit and thus the moral act is illicit irrespective of the intent or circumstances. This was pointed out explicitly by Pope John Paul II in 2004.[4] He wrote:

“The obligation to provide the ‘normal care due to the sick in such cases’ (Congregation for the Doctrine of the Faith, ‘Iura et Bona,’ p. IV) includes, in fact, the use of nutrition and hydration… Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission (emphasis mine).

In this regard, I recall what I wrote in the Encyclical Evangelium Vitae, making it clear that "by euthanasia in the true and proper sense must be understood an action or omission which by its very nature and intention brings about death, with the purpose of eliminating all pain"; such an act is always "a serious violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person" (n. 65).”

Professor Lauritzen attempts to play the “word game” by emphasizing the significance of the word “direct”[5] with respect to euthanasia essentially positing that ...