Other Voices Cry Out
to Heaven on Behalf of Terri Schiavo
The
Catholic League for Religious and Civil Rights
Population Research Institute
Statement
of John C. Willke, M.D.
President of Life Issues Institute, Inc.
Interim
Pastoral Statement On Artificial Nutrition and Hydration
by Bishop Rene Gracida
Physicians
for Compassionate Care
Canadian Catholic Bioethics
Institute
From
The Catholic
League for Religious and Civil Rights The
Supreme Court of the State of Florida exhibited an arrogant abuse of power
when it overturned “Terri’s Law” on September 23, 2004.
With a reckless disregard for the will of the people, the court
invalidated a law passed by the legislature, thereby leaving a defenseless
woman vulnerable to a painful death by starvation and dehydration. Terri
Schiavo, though brain damaged, is not dying.
Nor does it appear that receiving nutrition through a tube causes
her undue burden. In
addition, she left no instructions as to her wishes regarding end-of-life
decisions. The
Catholic League for Religious and Civil Rights supports Governor Jeb Bush
in appealing the court’s decision.
The Catholic League urges that the Supreme Court of the State of
Florida (and any subsequent court that may hear the case) reconsider the
judgment and affirm the right of Terri Schiavo to live. The
cruelty of the fate that currently awaits Terri Schiavo should not be lost
on anyone. Please join us in
supporting Governor Bush’s attempts to keep her alive. Sincerely, William Donohue, Ph.D. President, The Catholic League for Religious and Civil Rights ~ Statement
in Support the Life of Terri Schiavo Steven
V. Mosher Front
Royal, Virginia The
Population Research Institute wishes to add its voice to that of the
Catholic Medical Association and other groups in support of preserving
the life of Terri Schiavo. Feeding and hydration by no means constitute
"heroic measures" in attempting to preserve life. Terri
Schiavo is not terminally ill. She has a loving family able and willing
to care for her. She is able to respond to love with love. She is a
human being, deserving of the love and care her parents are gladly
giving. The
evil of euthanasia consists not in letting someone die a natural death
by removing extraordinary measures but in making
someone die by removal of simple humane measures such as feeding and
hydration, or the administration of a lethal substance. Removal of food
and hydration would result in a cruel, painful and unnecessary death for
Terri Schiavo. Any
court ordered euthanasia, apart from the great evil of ending this
woman's life would also set an extremely dangerous precedent along the
already precipitous "slippery slope" on which our society is
already embarked. Who would be safe? Who is then to determine whose
"life is unworthy of life" to paraphrase the title of a tract
circulating in Germany during the Third Reich? No
human being or judicial body has the authority to determine the value or
quality of another human being's life, no matter how hopeless it
outwardly appears. Suffering does not detract from the value or quality
of any life, rather it often calls forth the best in us which makes us
most fully human at our best. By definition, compassion is our ability
to "suffer with" another in love, not treat them as an
inconvenience to be removed from our midst in the name of
"mercy" or "compassion." We
therefore wholeheartedly reject any attempt to end the life of Terri
Schiavo. Steven
W. Mosher
~
Cecilia H. Martin, Catholic Media Coalition member, received an email from Dr. Saxer of the Catholic Medical Association (CMA) on Sept. 26, 2004 which included the following: “I
am posting a resolution that was proposed and passed at the meeting. As
you can see the CMA are and always have been very supportive of
continuing Terri's treatment. Anyway we can be effective would be our
pleasure. Thanks
and God bless, Robert
J Saxer M.D. Executive
Vice President CMA CMA
Annual Meeting, September 24, 2004 Whereas, the medical
ethical and legal issues involved in the duty to provide nutrition and
hydration to PVS patients have become prominent in the United States as a
result of the legal battle on behalf of Terri Schiavo, a Florida patient
who has required assisted nutrition and hydration by gastric feeding tube
for many years, and Whereas, Governor Jeb
Bush and the Florida legislature have passed "Terri's Law"
protecting the right of patients with prolonged impairment of
consciousness to receive assisted nutrition and hydration, -- a law which
is being challenged in the courts with regards to it's constitutionality,
therefore be it Resolved: that the
CMA expresses it's support of Florida's "Terri's Law" which
upholds the right to assisted nutrition and hydration of Terri Schiavo, a
Florida patient with prolonged impairment of consciousness, with a
diagnosis of the so-called "Persistent Vegetative State", as
well as the rights of other patients with prolonged impairment of
consciousness, and further be it Resolved
that the CMA thanks Florida Governor Jeb Bush and the Florida Legislature
for defending the right of patients afflicted with prolonged impairment of
consciousness to receive assisted nutrition and hydration. "'. (Resolution submitted by Dr. George Isajiw, Past President) Statement
of John C. Willke, M.D., Letter
to Cecilia Martin, CMC Member, author of Confusion in the Pews November 1, 2004 Dear Cecilia Martin, I would like to add my voice to those protesting the "de facto" execution of Terri Schiavo. I have followed her case quite closely, including the pleadings from her estranged husband, her family and the courts It seems quite clear to me as a physician that she is not in a vegetative state, she certainly seems quite able to respond by facial expression and emotionally to her parents, to others and to comments being made. It will be a total tragedy if they are allowed to kill her by starvation and dehydration. What this lady needs is first of all a thorough medical examination by competent neutral medical authorities. Then I would suspect that rehabilitative therapy might be able to improve her condition substantially. On a very pragmatic vein, I would suggest considering that she obtain a divorce, returning her to the custody of her parents. It also would be interesting if along with this her husband would be asked to surrender any remaining insurance money, which as we all know was supposed to be used for her rehabilitation. God bless you for all your efforts. Sincerely, J.C.
Willke, M.D. Bishop Rene H. Gracida A Dissent
From The "Interim
Pastoral Statement On Artificial Nutrition And Hydration" Issued
By The Texas Conference Of Catholic Health Facilities And Some Of The
Bishops Of Texas Recently
the Texas Catholic Conference in Austin released the final text of the
document approved by the Texas Catholic Conference of Health Facilities
and sixteen of the twenty-one Bishops of Texas. I had declined to sign
the document because I consider it to be seriously flawed. It
seems to me that the document gives a higher priority to efforts to
relieve the burden caused by a serious illness rather than efforts to
protect the sick person's right to life. The document deals with the
withdrawal of nutrition and hydration from a seriously ill patient. This
whole matter is one which is being debated by the legal and medical
professions as well as by theologians and ethicists. The Holy See has
this whole controversial area of morality under review and will
undoubtedly issue a major declaration on the subject sometime in the
next year or two. In
the meantime, I would have preferred to see my fellow Bishops of Texas
issue a document which would have made a stronger statement in support
of the sick person's right to receive food and drink as the basic
necessities of life. My
specific objections to the text of the statement which was recently made
public, are: 1.
In the title and throughout the text, the phrase "artificial
nutrition and hydration" is used. This is inaccurate: the food and
water used are not artificial. It is medically appropriate to speak of
"artificially assisted nutrition and hydration." It is the
mode of assistance that is artificial. 2.
Under "Basic Moral Principles" the Declaration on Euthanasia
is used selectively. As the title of that document indicates, one must
begin with a rejection of euthanasia—defined by the Declaration as
"an action or an order that all suffering may in this way be
eliminated." Only
"after" one has established that an omission of care or
treatment is not directly intended to bring about death should one turn
to the complex task of assessing benefits and burdens. The question of
intention is central here: If the removal of a life-sustaining procedure
is intended to avoid an unreasonable burden of the procedure, so that a
quicker death is only an unintended side-effect of the decision, it is
not a case of euthanasia. 3.
Also not treated here is the question whether artificially assisted
feeding may be classified as "normal care" rather than
"treatment." The "Declaration" says normal care must
be provided even when one has removed "forms of treatment that
would only secure a precarious and burdensome prolongation of life"
for an imminently dying patient. Whether
tube feeding may constitute "normal care" is not currently
resolved by the Magisterium; three non-magisterial bodies (Pontifical
Council Cor Unum, editorial board of La Civilta Cattolica, and a working
group of the Pontifical Academy of Sciences) have issued statements
answering the question in the affirmative. If tube feeding has some
aspects of "normal care," this would strengthen the
presumption in favor of providing it in most cases. 4.
The inclusion of burdens on "others—family, care provider, or
community"—is more broadly stated than in existing Church
documents. The Declaration on Euthanasia speaks of the "patient
himself" validly making a self-sacrificing decision not to burden
other: when those "others" are the agents making the decision,
other factors (including the Golden Rule) come into play. "All"
long-term care for seriously impaired patients is a "burden"
on the community, but it may be a burden that has to be willingly
shouldered: "The respect, the dedication, the time and means
required for the care of handicapped persons, even of those whose mental
faculties are gravely affected, is the price that a society should
generously pay in order to remain truly human" (Document of the
Holy See for the International Year of Disabled Persons, 1981.) 5.
The phrase about "investment in medical technology and personnel
disproportionate to the expected results" is taken from a paragraph
in the Declaration on Euthanasia that concerns "the most advanced
medical techniques," especially those "at the experimental
stage." This document applies the phrases to life-supporting means
generally. 6.
I know of no Church document that says treatment is disproportionate
when it involves "inequitable resource allocation." This could
be a broad loophole for communities saying that severely impaired
persons are not worth the money. The phrase should be clarified or
deleted. 7.
The restrictive statement that "maintenance of life" is a
benefit only when it involves reasonable hop of recovery" could
ground discriminatory withholding of life preserving means from people
with incurable disabilities. It
vitiates the principle that everyone has the same basic "right to
life" regardless of age or condition, which in Catholic social
teaching means that every person has the same basic right to the
necessities that sustain life. Life is "always a good." How
can it be a good without being a benefit? 8.
The equation between "foregoing" and "withdrawing"
is an oversimplification. What of cases where initiation of tube feeding
entails the transient risks and burdens of minor surgery under general
or local anesthesia, but its maintenance does not involve these burdens?
Must this change in the burden/benefit calculus be ignored? 9.
The claim that the NCCB Pro-Life Committee came to the "same
conclusion" is overstated. The Committee's chief message was
rejection of any efforts at "intentionally hastening the deaths of
vulnerable patients by starvation or dehydration"; as was said in
point #2 above, the text under consideration does not have this focus. Also,
the Pro-Life Committee document clearly supports tube feeding that can
"effectively preserve 'life' without involving too grave a
burden"; the present draft, as noted above, judges effectiveness in
terms of preserving "life with reasonable hope of recovery,"
which is a different standard. 10.
The question of "cause of death" is a major open question in
the current debate. This text overstates the importance of that
question, because traditional moral teaching puts great weight on
"intention." It
also understates the causal role of an omission of nutrition and
hydration in hastening death, in cases where a patient could have
survived in a medically stable condition for years with continued
feeding. The phrase "proximate physical means" is obscure, and
should have been replaced by "proximate physical cause of
death." One can recognize that the omission is the proximate cause
leading to death, while reaffirming that the hastening of death is
"praeter intentionem" in some cases. 11.
The claim that all these decisions are made "by the patients
themselves and by no one else" is not supported in the Church
documents. The Declaration says "account will have to be taken of
the 'reasonable' wishes of the wishes of the patient 'and the patient's
family,' as also of 'the advice of the doctors' who are specially
competent in the matter." In
cases of doubt "it pertains to the conscience either of the sick
person, 'or' of the doctors, to decide, in the light of moral
obligations and of the various aspects of the case." In the
Declaration a major "moral obligation" binding on
"all" decision makers is the rejection of euthanasia by action
or omission. Theses qualifications are all absent from (even explicitly
rejected by) the document. 12.
To say the "morally appropriate" withdrawal of tubal feeding
is not "abandoning the person" is a truism. It is equally true
to say: "The morally inappropriate withdrawal of tube feeding 'is'
abandonment of the person." This
leaves us nowhere, because the text gives no guidelines on when the
burdens of artificially assisted feeding are grave enough to render this
means optional (except for the overboard standard cited above that
whatever the patient says is right). 13.
The statement that the patient should not be impeded from "taking
the final step" has an ominous sound to it; it might give the
impression that hastening death can be directly intended. A phrase like
"accepting the inevitability of death " would have been
better. 14.
The phrase "threat 'of' life" on page 5, line 19 is, I hope, a
misprint for "threat 'to' life." The presumption seems to be
that death from a life-threatening condition is the "normal
consequence" that should occur, and one needs a special reason to
"impede" this "normal" state of affairs. The
burden of proof should go the other way: We have a "prima
facie" obligation to save someone's life unless there is a special
reason (e.g., ineffectiveness, grave burdensomeness) not to do so. One
senses here a very passive model for human action in the world in cases
of preventable death—one that does not comport well with the stated
"presumption" in favor of averting death. 15.
The document as a whole should have distinguished more clearly between
two classes of patients: Those who are dying soon no matter what we do
for them (e.g., terminal cancer patient), and those who are medically
stable and are "not" dying if provided with continued
nutrients and fluids. A
much more permissive standard is possible for the former class of
patients, for whom continued feeding may become strictly useless in
prolonging life. A strong presumption could be established in favor of
life-sustaining feeding for the latter class, rebuttable in cases of
excessive burden. A
strong presumption here is especially important because, in some
celebrated cases, tube feeding has apparently been withdrawn from the
latter class of patients precisely because they are "not"
dying and someone wants death to occur (see ACLU brief in the Hector
Rodas case, cautionary statements by ethicist Daniel Callahan, and
concurring opinion by Judge Lynn Compton in the Elizabeth Bouvia case). This statement was published in the May 25, 1990 edition of the "Diocesan Press." Physicians
for Compassionate Care Governor Jeb Bush and the Florida Legislature were right. They protected Terri Schiavo from being dehydrated to death--purposefully and coldly, despite the fact that she is not terminally ill and has not requested any such action. Now, liberal judges in the Florida Supreme Court have callously removed the protection Governor Bush and the Florida Legislature provided for this vulnerable woman. The progression from voluntary assisted-suicide for the terminally ill to involuntary mercy killing of those who are unable to defend themselves is inevitable once a society devalues the life of any one of its most valuable members. I applaud the goodwill and concern of all those attempting to protect Terri Schiavo from being put to death merely because she is gravely ill and unable to defend herself. N.
Gregory Hamilton, M.D. And
from the President of Physicians for Compassionate Care… Canadian Catholic Bioethics Institute Hello, A representative of your organization called to ask us to support your website in the concerns over "Terri's Law". I said that our Institute had written a document this June concerning ANH (Artificial Nutrition and Hydration) in PVS (Persistent Vegetative State) cases, and that we would be happy to have that serve as our supporting statement. If it is helpful to you, it may be accessed at: Canadian Catholic Bioethics Institute: With every good wish for your good work, Dr.
Moira McQueen, ~ The Catholic Media Coalition is grateful for all these expressions of support for Terri Schiavo. |