To supplement Tom and Rob's comments on Rick's excellent questions, I think the Archbishop Tutu situation raises some extremely complicated, and very important, additional questions about how we engage in dialogue with people of faith traditions other than our own. His disagreement with the Church on issues such as abortion and contraception demands a different sort of engagement and response by a Catholic university than, for example, a Catholic politician speaking on peace and reconciliation. I'm not saying the Catholic institution should NOT respond and engage on those issues, just that we have to acknowledge the additional delicacy of interfaith dialogue in this situation.
I also think we need to spend more time thinking about, figuring out, and practicing constructive dialogue about deeply divisive issues in general, especially as academics. For example, on a purely emotional level, I absolutely loved Bollinger's courageous audacity in his introduction to Ahmadinejad. But was that really the most constructive way to engage him intellectually in the way we are trying to assert a University is uniquely required (and positioned) to do? In a recent conversation I had with a member of the Columbia faculty, he suggested a more intellectually responsible way to challenge someone like Ahmadinejad might have been to provide in his introduction a list of difficult questions that Bollinger hoped Ahmadinejad would be addressing in his remarks. If those questions are NOT, in fact, addressed in the talk, Bollinger might then have an even stronger platform for criticism afterwards. I'm not sure that would work in that particular context, but I do think we need to think about how we, as universities, can constructively foster dialogue and debate, rather than simply providing platforms for assertions of positions on divisive issues.
Monday, October 8, 2007
A reader had the following comment on Paul Wojda's question about advance directives about withdrawing food & water in PVS:
Under what circumstances would the burdens of ANH (artificial nutrition & hydration) justify its discontinuation for patients in PVS? [Obviously, if such an intervention were futile, it would not be morally obligatory to pursue (or morally blameworthy to discontinue).] Given the nature of PVS, it wouldn't be right to say that the burdens come in the form of physical or emotional suffering. The Explanatory document issued by the Vatican seemed to suggest that the expense of ANH is not usually prohibitively burdensome. Indeed, the general "exceptions" to the norm of continued ANH sketched out by the document seem quite narrow:
“When stating that the administration of food and water is morally obligatory in principle, the Congregation for the Doctrine of the Faith does not exclude the possibility that, in very remote places or in situations of extreme poverty, the artificial provision of food and water may be physically impossible,”
“Nor is the possibility excluded that, due to emerging complications, a patient may be unable to assimilate food and liquids, so that their provision becomes altogether useless. Finally, the possibility is not absolutely excluded that, in some rare cases, artificial nourishment and hydration may be excessively burdensome for the patient or may cause significant physical discomfort, for example resulting from complications in the use of the means employed.”
“These exceptional cases, however, take nothing away from the general ethical criterion, according to which the provision of water and food, even by artificial means, always represents a natural means for preserving life, and is not a therapeutic treatment. Its use should therefore be considered ordinary and proportionate, even when the “vegetative state” is prolonged.”
So it is difficult (though not impossible) to imagine a case in which discontinuation of ANH would be morally sound. It is doubly difficult to imagine how one could anticipate with certainty (and describe with legal clarity) these cases such that he or she could accordingly formulate his or her advance directive.
While the CDF document and explanatory text do not squarely address the question raised by Paul, they do strongly indicate that the circumstances in which a PVS patient would be burdened by ANH are exceedingly rare.
Thursday, October 4, 2007
My colleague in UST's Catholic Studies Department, Paul Wojda, had the following question about the recent CDF Responses to the USCCB on withdrawing food & hydration from persons in a persistant vegetative state.
I have yet to see any official consideration of whether an individual may legitimately decide (through an advance directive) whether to withdraw or forego tube feeding in these circumstances. As I read the CDF clarification it really doesn’t say anything new. The commentary is at pains to point out the continuity between Pius XII and JPII on this issue, but that too never addresses the issue from the “agent’s” perspective.
May a Catholic, in good conscience, and through an advance directive, elect that tube-feeding be withdrawn upon diagnosis of PVS?
The CDF statement simply doesn’t address this question, as far as I can tell.
My own answer would be that, yes, a Catholic may do so, based on longstanding principles informing end-of-life decision-making, i.e., determination of excessive burden and hope of success. I believe that Pius XII’s famous statement reinforces this position quite clearly.
I think it's a particularly interesting question to consider in light of the recent press coverage of Pope John Paul II's medical treatment during his last days. Of course JP2 was not in a PVS, but it raises the possibility that he might have been exercising his own judgement about tube feeding toward the end of his life, and prompts me, too, to wonder whether he might legitimately have made such a decision for himself in an advance directive.
Saturday, September 29, 2007
OK, Rob and Mark, and other critics of Catholic congregational music, here's your chance. The National Association of Pastoral Musicians is taking an on-line survey in which you can rate congregational singing in your parish, your community, and the Church in general.
