She’s now in the hands of her creator. It seems to me any more political talk should cease for a while. The moral questions linger, however. And it has been argued that there is only one authentic Catholic position on the Schiavo case, and that it is that the feeding tube should have been kept in indefinitely, regardless of the wishes of the legal husband. Anything else is murder. But that is far too crude an assessment of the Catholic position. This pope recently declared that feeding tubes are not “extraordinary” or disproportionate methods of prolonging the life of the terminally ill. But this is not official Church doctrine – yet. The long tradition has been a balancing of various goods and evils. Here’s the money quote from the 1980 document that is most relevant here:
However, is it necessary in all circumstances to have recourse to all possible remedies?
In the past, moralists replied that one is never obliged to use “extraordinary” means. This reply, which as a principle still holds good, is perhaps less clear today, by reason of the imprecision of the term and the rapid progress made in the treatment of sickness. Thus some people prefer to speak of “proportionate” and “disproportionate” means. In any case, it will be possible to make a correct judgment as to the means by studying the type of treatment to be used, its degree of complexity or risk, its cost and the possibilities of using it, and comparing these elements with the result that can be expected, taking into account the state of the sick person and his or her physical and moral resources.
In order to facilitate the application of these general principles, the following clarifications can be added:
If there are no other sufficient remedies, it is permitted, with the patient’s consent, to have recourse to the means provided by the most advanced medical techniques, even if these means are still at the experimental stage and are not without a certain risk. By accepting them, the patient can even show generosity in the service of humanity.
It is also permitted, with the patient’s consent, to interrupt these means, where the results fall short of expectations. But for such a decision to be made, account will have to be taken of the reasonable wishes of the patient and the patient’s family, as also of the advice of the doctors who are specially competent in the matter. The latter may in particular judge that the investment in instruments and personnel is disproportionate to the results foreseen; they may also judge that the techniques applied impose on the patient strain or suffering out of proportion with the benefits which he or she may gain from such techniques.
It is also permissible to make do with the normal means that medicine can offer. Therefore one cannot impose on anyone the obligation to have recourse to a technique which is already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community.
When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted. In such circumstances the doctor has no reason to reproach himself with failing to help the person in danger.
You can argue both sides of this in the Schiavo case. A constantly infected feeding tube that has resulted in no tangible progress of any kind for over a decade? Is that “burdensome”? But what can “burdensome” mean for someone unable to feel or think? Notice that the church even allows for discontinuing “disproportionate” means of life-preservation on the grounds of expense alone. And you can see why: if the rule is that all persistently vegetative patients must be attached to feeding tubes indefinitely, then the costs to society would be stratospheric. At some point we could have as many not-dead-yet human beings suspended unconsciously in semi-life as we have in embryo factories at the other end of the human spectrum. My point is not that this case has been easy in Catholic moral terms. My point is precisely that it is not easy. Fifteen years with no brain waves at all? Keeping her in that state would have been just ordinary care? And at what point do we “accept the human condition” in the Church’s words? That’s the question. We can say, however, that Michael Schiavo’s record is certainly within the scope of the Church’s historical understanding of what the moral obligations toward his wife are. What we are seeing is how far this Pope has shifted the debate toward an absolutist position on life and death. He is the innovator. But he does not have a monopoly on what the Church as a whole believes. It’s a church; not a personal cult. Not yet, anyway.
The Dish 