Terri Schiavo and End-of-Life Decisions

An excellent piece appears in this week's COMMONWEAL (3/10/06):  Paul Lauritzen,  Caring at the End: How the Schiavo Case Undermined Catholic Teaching.  To read the whole piece, click here.   The concluding paragraphs follow:

Thus, to say that removing a feeding tube from a PVS patient is necessarily to aim at death is to conflate human action and natural events. It is to fail to recognize that dying is commonly associated biologically with a natural inability to eat or drink. If we do not conflate human and natural causality, it is perfectly sensible to say that a person suffering from a severe brain injury who cannot eat or drink is in fact dying, even if we can intervene and postpone that dying for years. Not starting or stopping artificial nutrition and hydration in such a case is not necessarily to aim at death, though one could intend death in such circumstances.

To conclude otherwise, it seems to me, is to succumb to a sort of hubris that repudiates any natural limits on human action. Callahan has captured the irony of this situation perfectly. “In the name of the sanctity of life, many who would consider themselves conservative and supporters of traditional religious values are forced into a slavery to medical possibilities, held in thrall by the false gods of technology.” The irony is particularly striking in relation to the Catholic commentators (Meilaender is not Catholic) who appear to adopt the Promethean attitude toward human embodiment and finitude that the tradition has long rejected.

There was a time when it would have been possible for Catholic writers, with the full weight of magisterial teaching behind them, to say that a life lived in a state of permanent unconsciousness with no apparent hope for a spiritual or social life was a terrible prospect, one that no person was obligated to embrace. In traditional Catholic teaching about the end of life, letting nature take its course in such a case made sense, not because such a life was regarded as worthless, but because in such a circumstance we confront the limits of human powers in the face of human vulnerability.

Both the view that providing nutrition and hydration for PVS patients is morally obligatory, and the position that providing a feeding tube is a form of care and not treatment, represent a shift in Catholic teaching. Understandably, commentators who have noted this shift have sought to downplay its significance, perhaps hoping that the change will be confined to cases involving persistent vegetative states. My own view, though, is that the changes are much more profound than anyone has acknowledged. They threaten to dismantle not simply Catholic teaching on end-of-life issues but much of Catholic moral theology generally. When natural constraints on human actions are treated so cavalierly, when what we can technically do appears to determine what we ought to do, the wisdom of the tradition that recognizes the goodness of our embodied existence and the fact that mere existence is not an ultimate good, seems to have been lost. If the ordeal of the Terri Schiavo case helps us to recognize the possibility of such a loss, it will not have been in vain.
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