I don't believe anybody in the Cath-o-sphere was throwing arms up in exasperated sighs lamenting "oh me, oh my, there are simply no thoughts on a Catholic approach to palliative care! We have no idea what to do - if only Rome would put out a document!"
Having been through this recently, it was a lot messier and harder to translate the overall approach of Catholic palliative care to actual decisions than I anticipated. It was easy to say "yes, we want ordinary human care, it's time focus on pain relief over intervention, etc" and it was really, really hard to answer all the detailed questions every provider needed an answer to, what felt like every 10 minutes.
Maybe that kind of clarity can never be given by a document; and it certainly sounds like /this/ document isn't helping, but I appreciate that the Church is taking seriously the heavy burden families bear - and one that will only get harder to navigate as the surrounding culture's ethics diverge further
I would like to believe that the motivation for this document is precisely for people like Cally and others who struggle though these issues with family and often receive advice that is as clear as mud.
I recall some years ago when a family called me in a panic because the medical team was preparing to remove food and hydration from their 90+ year-old mother. I was fortunate to be able to meet with the family and the care team to discuss the situation. In this case, the woman was, what we call, "actively dying." Her body was shutting down and she was approaching renal failure. Hydration and food would have amounted almost to torture since she couldn't process food and water could actually build up in her lungs.
Still, having a priest tell the family that they weren't causing her death (or even accelerating her death) but providing the best palliative care was really helpful.
Not every family has the foresight to call their parish, and not every priest has the time to go to the hospital and discuss these questions with the care team.
I would really appreciate (for myself and my people) a simple, Q&A form booklet on end-of-life issues that would be readable and understandable by non-theologians (like me!),
Unfortunately, if Charlie's analysis is correct (and I have no reason to doubt it), this doesn't seem to qualify.
Also, before Joe comes after me: Yes, I am a priest. Yes, I do take the time to read the Pillar and even sometimes comment. I don't think it takes away from my ministry but actually helps and sometimes extends it.
everyone agrees that food and water is something that can be foregone or withdrawn if it's not effective or causes disproportionate harm relative to the benefit. the problem is that these are very rare contexts, and almost non-existent for those disabled people with disorders of consciousness. if you'd like a handbook, you might find this helpful
I also have a book coming out with Our Sunday Visitor on how a focusing on our tradition of a good death (strongly related to a good life) can resist bad mistakes at the end of life... including, most especially, aiming at one's own death.
Oh really? Who agrees that murdering and torturing someone to death through starvation and dehydration, the most vicious torture inhumanly possible, are acceptable?" What Nazis have you been palling around with? How are necessities of life ever "not effective?" If I locked you in a room without food and water, could I conclude that at a certain point it would no longer be of benefit to you? Since when did the self-evident heresy of proportionality in moral theology cease being a heresy?
Mate… when someone is acutely dying, and their organs are failing, they often can’t eat or drink because their kidneys, liver and stomach aren’t functioning and they often don’t want to. It’s not cruel to respect their desire not to eat or drink at that stage and forcing the issue does not prolong their life. This is very different to what Charles was noting for people with disorders of consciousness, but are otherwise functioning. The Nazi and heretic accusations are not charitable or accurate.
Name the medical condition where any person in any state can not receive an IV. How uncharitable do you have to be to repudiate the entirety of Catholic moral doctrine by accepting its absolute denial by the heretical notion of the notion of proportionalism, which has been condemned throughout the history of the Church as a heresy and grave moral crime, as it justifies any manner of immorality one chooses, including murder by euthanasia. I repeat anyone who trivializes the most cruel form of murder, the withholding of nutrition, especially water, is guilty of crimes against humanity on a par with Nazism. A life murdered through dehydration cannibalizes itself seeking moisture, and dies the most painful death humanly possible.
End of life morality has always been difficult in individual cases. Each case is unique. while overarching theology on this is helpful to patients and healthcare givers, it's often times difficult to make decisions. Especially in the emotional time of end of life. I hope the English translation actually helps to clarify things. And I hope the NCBC can put out good guidance too. as a Catholic physician/neurologist, I will follow this story.
What did Word on Fire or Bishop Barron have to say about the USCCB’s pro-life presidential candidate and his delusional (as always) statements to his nephew Fred Trump about Fred’s severely handicapped son?
If you mean “germane”, Barron’s eye on the Italian Curia/dicastery rather than our US flock makes it germane. Sorry I pay my subscription like everybody else. Your “dislike” is duly acknowledged.
So is your "dislike" of Bishop Barron and his commentary and lack thereof.
For what it's worth, I doubt you're going to win anyone to your point of view by bringing in this political angle on what is otherwise a piece about bioethics.
I simply don’t care for Bishop Barron’s temple moneychanging for his politics-from-the-pulpit and sticking his nose in dicastery issues when he has a diocese in the US to shepherd.
If I wanted more Bp. Barron politics and ethics from the pulpit, I would subscribe 💵 💰 to his “Word on Fire” Facebook page, currently advertising:
“How are Catholics supposed to engage in politics? What does the Church mean when she calls us to be “faithful citizens”
In this live seminar “Faith in the Public Arena,” you will learn why your participation in social and political life is part of the call to discipleship.
Any call to discipleship would include honoring the Eighth Commandment by not trivializing people to caricatures, including Trump, the second most lied about man in human history, the first being Our Lord. The second most lied about man, incidentally, by his actions as president, affected the saving of more lives than the actions of any man holding political power in the entirety of human history, not a trivial matter.
"[Y]our participation in social and political life is part of the call to discipleship."
That is sound Catholic teaching, according to the documents of Vatican II.
For instance, Apostolicam actuositatem, the decree on the Laity (promulgated November 18, 1965) says in chapter II, section 7e:
"The laity must take up the renewal of the temporal order as their own special obligation. Led by the light of the Gospel and the mind of the Church and motivated by Christian charity, they must act directly and in a definite way in the temporal sphere. As citizens they must cooperate with other citizens with their own particular skill and on their own responsibility. Everywhere and in all things they must seek the justice of God's kingdom. The temporal order must be renewed in such a way that, without detriment to its own proper laws, it may be brought into conformity with the higher principles of the Christian life and adapted to the shifting circumstances of time, place, and peoples. Preeminent among the works of this type of apostolate is that of Christian social action which the sacred synod desires to see extended to the whole temporal sphere, including culture."(2)
2. cf. Leo XIII, encyclical "Rerum Novarum:" A.A.S. 23 (1890-91) p. 47; Pius XI encyclical "Quadragesimo anno:" A.A.S. 23 (1931) p 190; Pius XII, radio message of June 1, 1941: A.A.S. 33 (1941) p. 207. Article 8:
I would like to “be enlightened” how any and all candidates are renewing “The temporal order…in such a way that, without detriment to its own proper laws, it may be brought into conformity with the higher principles of the Christian life and adapted to the shifting circumstances of time, place, and peoples. “
Clearly my phone's autocorrect isn't good at distinguishing the name "Germaine" from the word "germane." Your pedantic condescension is duly acknowledged.
I apologize for pedantic (spell check) condescension. I read this post immediately after taking the Eucharist to a poor homebound soul with dementia who is awake only 2 hours per day. At times I get frustrated that there is far more “analysis” - bioethics, near-death protocols, etc. - from the church than spiritual care and nourishment for the subjects (albeit impersonal) of all of this analysis. But as I digress, our church of missionary disciples needs first and foremost to care for and spiritually nourish real souls like those in Bishop Barron’s flock and our parishes. Again sorry 🙏 ☮️
<i>Given that even secular bioethicists like Fins have such concerns, this raises urgent questions about why and how the PAL came to approach the same issue-- of offering food and water to this vulnerable population-- from a very different direction.</i>
Urgent questions indeed. The coterie of theologues around Mons Paglia 'came to their approach' because they are insular, secular-minded, and not very concerned about adhering to Catholic tradition in any sense?
The imprecision of the documents that have come from the Vatican in the last decade or so drives theologians crazy. It is evident that some of the most poorly formed theologians ever are tasked with writing them. For centuries, the Vatican understood that theology matters and that theology is a precise science that also develops according to the authority that precedes it. More than just trying to be "push the envelope," liberals, I think the writers of these documents are poorly educated/third rate theologians who really don't know better.
Charlie, thanks so much for this and to The Pillar for publishing it.
I agree with you that the text of pamphlet does represent a more significant shift in teaching. In my view, where it does with regards to recognizing that ANH is often delivered via unambiguous medical means, I think it is a healthy development in the shift towards recognizing that it should be evaluated like every other medical intervention, by weighing its benefits, risks and burdens, including costs.
More broadly, it also appears to emphasize an important "anti-vitalist" corrective, recognizing that some pursue (or more frequently surrogates request on behalf of incapacitated patients) interventions for which the burdens are disproportionate to the benefits and, I think, issues important pastoral guidance against a "do everything" mentality that is rampant in American health care.
While the study group may indeed have proposed ideas that conflict with Catholic teaching, they are a subgroup of an advisory group and can't offer any teaching of their own. Also, I just can't imagine how vitalism is anything like a primary consideration at the moment, especially in the context of people with disorders of consciousness who are in desperate need of a civil rights movement, not more reasons for why they can be thrown away. Similarly, we have so much ableism in the culture right now, that we have to be focused on acting for the unqualified and equal value of their lives first, and only secondarily on the extraordinarily rare times where feeding them (which is a basic act of Christian love, not medical treatment) would not be in their benefit.
In addition, it is interesting to think about why so many members of the Academy were left out of consultation on this pamphlet. I know multiple members who would never have agreed with the pamphlets conclusions. That can't be a coincidence, can it?
I really think that true Catholic medical personal with experience all areas of human disease process and the neurological conditions of our most vulnerable citizens need to be consulted and allowed to contribute to this very difficult and complex issue. The committee has to be theologically correct and strong. There are too many individual situations to compile a one stop solution. As a nurse , I have had a hard time even with local hospice treatment. It has gone from a preparation and support for those with terminal condition, to something so different. Instead they promote the solution of giving morphine to drug a person until they are no longer able to take a breath. IT is not a one solution answer. IT is a very complicated moral decision that all aspects of the human condition needs to be investigated. Faith, medicine and education .
Also a nurse here who watched two parents die. One from brain cancer which followed a normal progression and the other after a profound stroke from a bowel issue that had a very low likelihood of being repaired. In both cases natural death was allowed to occur, but at no time was food/ water that could/would be taken denied. Though in both cases, a feeding tube would not have led to any significant prolongation of life. Both were gut wrenching decisions, but having personally done CPR on 95+ year olds who aren’t given the dignity of a natural death surrounded by their families, this issue is fraught with sharp corners and lack of the most basic of common sense, i.e. death comes to us all. We shouldn’t hasten it, nor should we be afraid to meet it when it comes for us.
88 pages counts as brief? Pretty sure 90% of this issue could be covered with a page or two of common terminology and definitions followed by an ethical analysis flow chart.
Is Archbishop Paglia the type of person who, if there is a pushback from the hoi polloi, bends slightly to the protests of the crowd? Or is he more of a "quod scripsi, scripsi" fellow? I notice that in today's modern Vatican Extended Universe without naming any examples or circumstances, it seems like there are some thought-leaders who are of one kind and some who are of the other (we like the former when they are wrong and the latter when they are right. I suppose we are therefore ambivalent about Pilate.)
“Quand les libéraux sont au pouvoir, nous leur demandons la liberté, parce que c’est leur principe, et, quand nous sommes au pouvoir, nous la leur refusons, parce que c’est le nôtre” (Montalembert, putting words in Veuillot’s mouth).
Really hard to take seriously the minds in charge of the Vatican these days when they are perfectly happy making broad sweeping generalizations about what Catholics must think about issues like the death penalty for criminals, climate change, or immigration, but when the question is "is it ok to kill Grandma?" suddenly they seem to recognize that it's a tough issue with lots of variables involved, each situation needs to be considered individually, etc.
“The Pontifical Academy for Life's new end-of-life text is meant to clarify, not further confuse complicated issues.”
Yep. Now this Orwellian Catholicism that demonic forces at today’s Vatican are telling Catholics, anxious to be as depraved as their secular counterparts, they can now be “cleared” to go ahead and murder the inconvenient lives among them, even in the most tortuous manner inhumanly possible to the victim, which is actually what occurs with the removal of ordinary means of sustaining life, which the anti-Catholics, now speaking for Catholic “clarity” at today’s Vatican, call “treatment” rather than ordinary means of food and water. I never realized that pizza and beer I had for lunch was really some kind of “treatment.” I suppose when you want to spit in the face of God rather than honor His moral demands that we be sacrificing as He called us to be and not be moral cowards, we can now realize we have the “clarity” to just call our cowardice, “complicated.”
If someone is angling to shut down an institute that is past its use by date by installing questionable leadership… can they just do it already? I think we’ve had enough.
As a catholic and an internal medicine doctor with some experience in palliative care, I'd say that, although in media and public opinion euthanasia being a very famous topic, in my practice (in Portugal) dysthanasia is a far away more common act.
Yes, I agree that euthanasia and assisted suicide are intrinsically moral acts and kind of euphemisms for assisted murder of the fragile, abandoned and desperated ones. But euthanasia requests on the medical practice are very rare, not to say in most of the times a cry for help in the utter fragility verbalized as a distorted desire to die.
But, the practice of asking (mostly by families, many of them even apparently devout catholic ones) or providing unappropriate care for people with a palliative goal of care (not just in agony or end-of-life state, but also in the terminal phase of disease) - dysthanasia- is very common. For someone who works on the field, trying to use the best communication techniques to explain it to the patient (and mostly to the families) is a daily them and definitely a challenge sometimes. We shall not confuse it to nihilism, because we doesn't stand there doing nothing. We evaluate all of the possible motives of suffer (physically and emotionally) and we act with many different nonpharmacological and pharmacological interventions in order to extinguish or atenuate them. Food and water aren't in many times a cause of suffer for the patients (for the families, yes, they definitely are!). That's a studied topic and can be experienced on the daily practice. Too much food can cause harms such as aspiration pneumonia and shortness of breath and cough. Too much water can cause harms such as lung oedema and shortness of breath. And so on.
A "vegetative state", as many call it, (I have some trouble with this definition) is definitely a serious topic and requires a complex management. But it's not at all the most common case were dysthanasia is a theme. Dysthanasia is or will be a theme for everyone of us while approaching the terminal part of life. So, without having read the document, I am at least happy for knowing that the Mystical Body of Christ is worried with the theme.
And in the end, we shall not forget what is the true Food for the Soul, the Holy Bread of Our Lord! (saying this also for me as a daily reminder)
you say a lot of things that are true here, but I'm not sure exactly what many of them have to do with what the article discusses? very few people argue that food and water is good in every single circumstance. almost everyone agrees there are times where it is not indicated as care. similarly, everyone agrees that there is over treatment in many circumstances. this article is focused on places where there is disagreement and cultural debates. I'd also caution you against using your experience as a physician as a kind of authority here, as for many it is less an authority and more indication of being captured by an ableist throwaway culture.
The Archdiocese of Edmonton (Alberta, Canada) has created a website called Hope & Dignity: A Catholic Response to Euthanasia and Assisted suicide for those who are dying, caregivers, clergy, health care providers, and more. It provides clear information and guidelines from Catholic teaching to help people when they don't have time (or inclination) to read an 88-page booklet. Visit: https://hopeanddignity.caedm.ca/
I have to apologize. I was directed to this article from another sight that claimed the author justified proportionality in this article. Without reading it, I made unfair comments. The article is more balanced.
Nonetheless, I will make the valid observation that it is impossible for our sins, in action and thought, to not corrupt every aspect of our subsequent thought, to make good seem evil and evil seem good. Catholics are as susceptible as everyone else to lie to themselves. So our sophistries create the twin rationalisms of proportionalism and consequentialism, that “accommodate” our thoughts and makes our evil doing seem benign. Both sophistries are predicated on the idea, unconsciously, that our judgments are superior to the imperatives of God, and both require obliviousness to the damage we do to the victims of our sins when our primary concern becomes eliminating the burdens of regret for sin and the nobility of sacrifice at the heart of Christianity.
Morality is never complicated. Were it complicated, God would have to be evil, stupid, cruel, selfish, stupid, deceitful, and more contemptuous of His creatures of the past then those self-congratulatory “progressives” of the present.
But God is not evil. We are. There is no such thing as “complicated” morality. We lie to ourselves when we do not want to live the gifts of sacrifice and suffering God gives to us. When we tell ourselves a lie that dehydrating someone to death, the single cruelest form of murder, can be benign, we lie to ourselves, no matter how many chest thumping theologians are prepared to say otherwise.
My only thought is: who was asking for this?
I don't believe anybody in the Cath-o-sphere was throwing arms up in exasperated sighs lamenting "oh me, oh my, there are simply no thoughts on a Catholic approach to palliative care! We have no idea what to do - if only Rome would put out a document!"
Having been through this recently, it was a lot messier and harder to translate the overall approach of Catholic palliative care to actual decisions than I anticipated. It was easy to say "yes, we want ordinary human care, it's time focus on pain relief over intervention, etc" and it was really, really hard to answer all the detailed questions every provider needed an answer to, what felt like every 10 minutes.
Maybe that kind of clarity can never be given by a document; and it certainly sounds like /this/ document isn't helping, but I appreciate that the Church is taking seriously the heavy burden families bear - and one that will only get harder to navigate as the surrounding culture's ethics diverge further
I would like to believe that the motivation for this document is precisely for people like Cally and others who struggle though these issues with family and often receive advice that is as clear as mud.
I recall some years ago when a family called me in a panic because the medical team was preparing to remove food and hydration from their 90+ year-old mother. I was fortunate to be able to meet with the family and the care team to discuss the situation. In this case, the woman was, what we call, "actively dying." Her body was shutting down and she was approaching renal failure. Hydration and food would have amounted almost to torture since she couldn't process food and water could actually build up in her lungs.
Still, having a priest tell the family that they weren't causing her death (or even accelerating her death) but providing the best palliative care was really helpful.
Not every family has the foresight to call their parish, and not every priest has the time to go to the hospital and discuss these questions with the care team.
I would really appreciate (for myself and my people) a simple, Q&A form booklet on end-of-life issues that would be readable and understandable by non-theologians (like me!),
Unfortunately, if Charlie's analysis is correct (and I have no reason to doubt it), this doesn't seem to qualify.
Also, before Joe comes after me: Yes, I am a priest. Yes, I do take the time to read the Pillar and even sometimes comment. I don't think it takes away from my ministry but actually helps and sometimes extends it.
everyone agrees that food and water is something that can be foregone or withdrawn if it's not effective or causes disproportionate harm relative to the benefit. the problem is that these are very rare contexts, and almost non-existent for those disabled people with disorders of consciousness. if you'd like a handbook, you might find this helpful
https://ignatius.com/now-and-at-the-hour-of-our-death-nhdp/
I also have a book coming out with Our Sunday Visitor on how a focusing on our tradition of a good death (strongly related to a good life) can resist bad mistakes at the end of life... including, most especially, aiming at one's own death.
Oh really? Who agrees that murdering and torturing someone to death through starvation and dehydration, the most vicious torture inhumanly possible, are acceptable?" What Nazis have you been palling around with? How are necessities of life ever "not effective?" If I locked you in a room without food and water, could I conclude that at a certain point it would no longer be of benefit to you? Since when did the self-evident heresy of proportionality in moral theology cease being a heresy?
Mate… when someone is acutely dying, and their organs are failing, they often can’t eat or drink because their kidneys, liver and stomach aren’t functioning and they often don’t want to. It’s not cruel to respect their desire not to eat or drink at that stage and forcing the issue does not prolong their life. This is very different to what Charles was noting for people with disorders of consciousness, but are otherwise functioning. The Nazi and heretic accusations are not charitable or accurate.
Name the medical condition where any person in any state can not receive an IV. How uncharitable do you have to be to repudiate the entirety of Catholic moral doctrine by accepting its absolute denial by the heretical notion of the notion of proportionalism, which has been condemned throughout the history of the Church as a heresy and grave moral crime, as it justifies any manner of immorality one chooses, including murder by euthanasia. I repeat anyone who trivializes the most cruel form of murder, the withholding of nutrition, especially water, is guilty of crimes against humanity on a par with Nazism. A life murdered through dehydration cannibalizes itself seeking moisture, and dies the most painful death humanly possible.
Interesting that the Ignatius book came out 13 years after the NY State Catholic Bishops published one by the same name. I wonder how they compare? https://www.nyscatholic.org/application/files/4517/0663/7893/End-of-Life-booklet-final.pdf
End of life morality has always been difficult in individual cases. Each case is unique. while overarching theology on this is helpful to patients and healthcare givers, it's often times difficult to make decisions. Especially in the emotional time of end of life. I hope the English translation actually helps to clarify things. And I hope the NCBC can put out good guidance too. as a Catholic physician/neurologist, I will follow this story.
What did Word on Fire or Bishop Barron have to say about the USCCB’s pro-life presidential candidate and his delusional (as always) statements to his nephew Fred Trump about Fred’s severely handicapped son?
https://www.washingtonpost.com/politics/2024/07/30/fred-trump-book-disabled-comment/
Or will that also be addressed on 9 November by the USCCB?
That's not really germaine to the topic of the article. This isn't about Trump, the USCCB, or any of that.
If you mean “germane”, Barron’s eye on the Italian Curia/dicastery rather than our US flock makes it germane. Sorry I pay my subscription like everybody else. Your “dislike” is duly acknowledged.
So is your "dislike" of Bishop Barron and his commentary and lack thereof.
For what it's worth, I doubt you're going to win anyone to your point of view by bringing in this political angle on what is otherwise a piece about bioethics.
I simply don’t care for Bishop Barron’s temple moneychanging for his politics-from-the-pulpit and sticking his nose in dicastery issues when he has a diocese in the US to shepherd.
If I wanted more Bp. Barron politics and ethics from the pulpit, I would subscribe 💵 💰 to his “Word on Fire” Facebook page, currently advertising:
“How are Catholics supposed to engage in politics? What does the Church mean when she calls us to be “faithful citizens”
In this live seminar “Faith in the Public Arena,” you will learn why your participation in social and political life is part of the call to discipleship.
Save your seat and get a FREE bonus book today at institute.wordonfire.org/seminar10!
Any call to discipleship would include honoring the Eighth Commandment by not trivializing people to caricatures, including Trump, the second most lied about man in human history, the first being Our Lord. The second most lied about man, incidentally, by his actions as president, affected the saving of more lives than the actions of any man holding political power in the entirety of human history, not a trivial matter.
"[Y]our participation in social and political life is part of the call to discipleship."
That is sound Catholic teaching, according to the documents of Vatican II.
For instance, Apostolicam actuositatem, the decree on the Laity (promulgated November 18, 1965) says in chapter II, section 7e:
"The laity must take up the renewal of the temporal order as their own special obligation. Led by the light of the Gospel and the mind of the Church and motivated by Christian charity, they must act directly and in a definite way in the temporal sphere. As citizens they must cooperate with other citizens with their own particular skill and on their own responsibility. Everywhere and in all things they must seek the justice of God's kingdom. The temporal order must be renewed in such a way that, without detriment to its own proper laws, it may be brought into conformity with the higher principles of the Christian life and adapted to the shifting circumstances of time, place, and peoples. Preeminent among the works of this type of apostolate is that of Christian social action which the sacred synod desires to see extended to the whole temporal sphere, including culture."(2)
2. cf. Leo XIII, encyclical "Rerum Novarum:" A.A.S. 23 (1890-91) p. 47; Pius XI encyclical "Quadragesimo anno:" A.A.S. 23 (1931) p 190; Pius XII, radio message of June 1, 1941: A.A.S. 33 (1941) p. 207. Article 8:
https://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_decree_19651118_apostolicam-actuositatem_en.html.
But I suppose, from what you've said that here, that you're not a fan of the Second Vatican Council.
Your final sentence could not be less correct.
I would like to “be enlightened” how any and all candidates are renewing “The temporal order…in such a way that, without detriment to its own proper laws, it may be brought into conformity with the higher principles of the Christian life and adapted to the shifting circumstances of time, place, and peoples. “
Clearly my phone's autocorrect isn't good at distinguishing the name "Germaine" from the word "germane." Your pedantic condescension is duly acknowledged.
I apologize for pedantic (spell check) condescension. I read this post immediately after taking the Eucharist to a poor homebound soul with dementia who is awake only 2 hours per day. At times I get frustrated that there is far more “analysis” - bioethics, near-death protocols, etc. - from the church than spiritual care and nourishment for the subjects (albeit impersonal) of all of this analysis. But as I digress, our church of missionary disciples needs first and foremost to care for and spiritually nourish real souls like those in Bishop Barron’s flock and our parishes. Again sorry 🙏 ☮️
Apology accepted.
Thanks for this great analysis, Charlie. Very helpful. Looking forward to the full letter & English translation.
<i>Given that even secular bioethicists like Fins have such concerns, this raises urgent questions about why and how the PAL came to approach the same issue-- of offering food and water to this vulnerable population-- from a very different direction.</i>
Urgent questions indeed. The coterie of theologues around Mons Paglia 'came to their approach' because they are insular, secular-minded, and not very concerned about adhering to Catholic tradition in any sense?
The imprecision of the documents that have come from the Vatican in the last decade or so drives theologians crazy. It is evident that some of the most poorly formed theologians ever are tasked with writing them. For centuries, the Vatican understood that theology matters and that theology is a precise science that also develops according to the authority that precedes it. More than just trying to be "push the envelope," liberals, I think the writers of these documents are poorly educated/third rate theologians who really don't know better.
I’d be very interested to read an article that looks into the question of formation for these theologians.
Charlie, thanks so much for this and to The Pillar for publishing it.
I agree with you that the text of pamphlet does represent a more significant shift in teaching. In my view, where it does with regards to recognizing that ANH is often delivered via unambiguous medical means, I think it is a healthy development in the shift towards recognizing that it should be evaluated like every other medical intervention, by weighing its benefits, risks and burdens, including costs.
More broadly, it also appears to emphasize an important "anti-vitalist" corrective, recognizing that some pursue (or more frequently surrogates request on behalf of incapacitated patients) interventions for which the burdens are disproportionate to the benefits and, I think, issues important pastoral guidance against a "do everything" mentality that is rampant in American health care.
Appreciate your thoughts,
Mike Redinger
While the study group may indeed have proposed ideas that conflict with Catholic teaching, they are a subgroup of an advisory group and can't offer any teaching of their own. Also, I just can't imagine how vitalism is anything like a primary consideration at the moment, especially in the context of people with disorders of consciousness who are in desperate need of a civil rights movement, not more reasons for why they can be thrown away. Similarly, we have so much ableism in the culture right now, that we have to be focused on acting for the unqualified and equal value of their lives first, and only secondarily on the extraordinarily rare times where feeding them (which is a basic act of Christian love, not medical treatment) would not be in their benefit.
In addition, it is interesting to think about why so many members of the Academy were left out of consultation on this pamphlet. I know multiple members who would never have agreed with the pamphlets conclusions. That can't be a coincidence, can it?
There are no *real* coincidences…
I really think that true Catholic medical personal with experience all areas of human disease process and the neurological conditions of our most vulnerable citizens need to be consulted and allowed to contribute to this very difficult and complex issue. The committee has to be theologically correct and strong. There are too many individual situations to compile a one stop solution. As a nurse , I have had a hard time even with local hospice treatment. It has gone from a preparation and support for those with terminal condition, to something so different. Instead they promote the solution of giving morphine to drug a person until they are no longer able to take a breath. IT is not a one solution answer. IT is a very complicated moral decision that all aspects of the human condition needs to be investigated. Faith, medicine and education .
Also a nurse here who watched two parents die. One from brain cancer which followed a normal progression and the other after a profound stroke from a bowel issue that had a very low likelihood of being repaired. In both cases natural death was allowed to occur, but at no time was food/ water that could/would be taken denied. Though in both cases, a feeding tube would not have led to any significant prolongation of life. Both were gut wrenching decisions, but having personally done CPR on 95+ year olds who aren’t given the dignity of a natural death surrounded by their families, this issue is fraught with sharp corners and lack of the most basic of common sense, i.e. death comes to us all. We shouldn’t hasten it, nor should we be afraid to meet it when it comes for us.
88 pages counts as brief? Pretty sure 90% of this issue could be covered with a page or two of common terminology and definitions followed by an ethical analysis flow chart.
Is Archbishop Paglia the type of person who, if there is a pushback from the hoi polloi, bends slightly to the protests of the crowd? Or is he more of a "quod scripsi, scripsi" fellow? I notice that in today's modern Vatican Extended Universe without naming any examples or circumstances, it seems like there are some thought-leaders who are of one kind and some who are of the other (we like the former when they are wrong and the latter when they are right. I suppose we are therefore ambivalent about Pilate.)
“Quand les libéraux sont au pouvoir, nous leur demandons la liberté, parce que c’est leur principe, et, quand nous sommes au pouvoir, nous la leur refusons, parce que c’est le nôtre” (Montalembert, putting words in Veuillot’s mouth).
Really hard to take seriously the minds in charge of the Vatican these days when they are perfectly happy making broad sweeping generalizations about what Catholics must think about issues like the death penalty for criminals, climate change, or immigration, but when the question is "is it ok to kill Grandma?" suddenly they seem to recognize that it's a tough issue with lots of variables involved, each situation needs to be considered individually, etc.
“The Pontifical Academy for Life's new end-of-life text is meant to clarify, not further confuse complicated issues.”
Yep. Now this Orwellian Catholicism that demonic forces at today’s Vatican are telling Catholics, anxious to be as depraved as their secular counterparts, they can now be “cleared” to go ahead and murder the inconvenient lives among them, even in the most tortuous manner inhumanly possible to the victim, which is actually what occurs with the removal of ordinary means of sustaining life, which the anti-Catholics, now speaking for Catholic “clarity” at today’s Vatican, call “treatment” rather than ordinary means of food and water. I never realized that pizza and beer I had for lunch was really some kind of “treatment.” I suppose when you want to spit in the face of God rather than honor His moral demands that we be sacrificing as He called us to be and not be moral cowards, we can now realize we have the “clarity” to just call our cowardice, “complicated.”
If someone is angling to shut down an institute that is past its use by date by installing questionable leadership… can they just do it already? I think we’ve had enough.
As a catholic and an internal medicine doctor with some experience in palliative care, I'd say that, although in media and public opinion euthanasia being a very famous topic, in my practice (in Portugal) dysthanasia is a far away more common act.
Yes, I agree that euthanasia and assisted suicide are intrinsically moral acts and kind of euphemisms for assisted murder of the fragile, abandoned and desperated ones. But euthanasia requests on the medical practice are very rare, not to say in most of the times a cry for help in the utter fragility verbalized as a distorted desire to die.
But, the practice of asking (mostly by families, many of them even apparently devout catholic ones) or providing unappropriate care for people with a palliative goal of care (not just in agony or end-of-life state, but also in the terminal phase of disease) - dysthanasia- is very common. For someone who works on the field, trying to use the best communication techniques to explain it to the patient (and mostly to the families) is a daily them and definitely a challenge sometimes. We shall not confuse it to nihilism, because we doesn't stand there doing nothing. We evaluate all of the possible motives of suffer (physically and emotionally) and we act with many different nonpharmacological and pharmacological interventions in order to extinguish or atenuate them. Food and water aren't in many times a cause of suffer for the patients (for the families, yes, they definitely are!). That's a studied topic and can be experienced on the daily practice. Too much food can cause harms such as aspiration pneumonia and shortness of breath and cough. Too much water can cause harms such as lung oedema and shortness of breath. And so on.
A "vegetative state", as many call it, (I have some trouble with this definition) is definitely a serious topic and requires a complex management. But it's not at all the most common case were dysthanasia is a theme. Dysthanasia is or will be a theme for everyone of us while approaching the terminal part of life. So, without having read the document, I am at least happy for knowing that the Mystical Body of Christ is worried with the theme.
And in the end, we shall not forget what is the true Food for the Soul, the Holy Bread of Our Lord! (saying this also for me as a daily reminder)
Bernardo
you say a lot of things that are true here, but I'm not sure exactly what many of them have to do with what the article discusses? very few people argue that food and water is good in every single circumstance. almost everyone agrees there are times where it is not indicated as care. similarly, everyone agrees that there is over treatment in many circumstances. this article is focused on places where there is disagreement and cultural debates. I'd also caution you against using your experience as a physician as a kind of authority here, as for many it is less an authority and more indication of being captured by an ableist throwaway culture.
Sorry if it seemed as an authorative tone, it wasn't my goal.
I also wasn't criticizing your article and again sorry if it seemed so.
I was just using this opportunity to comment a less discussed but much more common subtopic on the theme.
Thank you!
The Archdiocese of Edmonton (Alberta, Canada) has created a website called Hope & Dignity: A Catholic Response to Euthanasia and Assisted suicide for those who are dying, caregivers, clergy, health care providers, and more. It provides clear information and guidelines from Catholic teaching to help people when they don't have time (or inclination) to read an 88-page booklet. Visit: https://hopeanddignity.caedm.ca/
BTW, I plan to share this article on the website.
I have to apologize. I was directed to this article from another sight that claimed the author justified proportionality in this article. Without reading it, I made unfair comments. The article is more balanced.
Nonetheless, I will make the valid observation that it is impossible for our sins, in action and thought, to not corrupt every aspect of our subsequent thought, to make good seem evil and evil seem good. Catholics are as susceptible as everyone else to lie to themselves. So our sophistries create the twin rationalisms of proportionalism and consequentialism, that “accommodate” our thoughts and makes our evil doing seem benign. Both sophistries are predicated on the idea, unconsciously, that our judgments are superior to the imperatives of God, and both require obliviousness to the damage we do to the victims of our sins when our primary concern becomes eliminating the burdens of regret for sin and the nobility of sacrifice at the heart of Christianity.
Morality is never complicated. Were it complicated, God would have to be evil, stupid, cruel, selfish, stupid, deceitful, and more contemptuous of His creatures of the past then those self-congratulatory “progressives” of the present.
But God is not evil. We are. There is no such thing as “complicated” morality. We lie to ourselves when we do not want to live the gifts of sacrifice and suffering God gives to us. When we tell ourselves a lie that dehydrating someone to death, the single cruelest form of murder, can be benign, we lie to ourselves, no matter how many chest thumping theologians are prepared to say otherwise.