Statement of the Catholic Medical Association on the case of Mrs. Terri Schindler-Schiavo
by Catholic Medical Association
An essential part of the mission of the Catholic Medical Association is to uphold the principles of Catholic faith and morality in the practice of medicine. As an organization we cannot make specific medical judgments regarding an individual patient's diagnosis because this requires direct, intimate involvement in the patient's care. However, we can and will comment on the application of Catholic moral principles which the Church has given us to determine when medically assisted nutrition and hydration can legitimately be withdrawn in a patient who is not terminally ill or imminently dying.
In the case of Mrs. Schiavo, public testimony by physicians who have examined her indicate she suffers from a severely impaired state of consciousness, although there is disagreement whether she meets all of the medical criteria for the "persistent vegetative state." What is clear from the public record is that since 1990, due to her severely limited state of consciousness, Mrs. Schiavo has been dependent upon medically assisted nutrition and hydration administered by gastric tube. She requires this support to survive because she is unable to feed herself. She is not terminally ill or in imminent danger of death and she has no problem assimilating the nutrition provided. She left no advanced directive. Therefore, decisions on her behalf are being made by relatives based on their best recollection of what she had previously stated regarding end of life care.
Catholics do have a degree of autonomy regarding decisions for care at the end of life. We are guided by the Church's teaching that obliges one to use ordinary or proportionate means of preserving life, but allows foregoing extraordinary or disproportionate means of care. Euthanasia, which is "an act or omission which of itself or by intention, causes death in order to eliminate suffering" (Catechism #2277) is always forbidden. The current controversy is whether the decision to withdraw her medically assisted nutrition and hydration resulting in her death, constitutes an act of euthanasia.
The Ethical and Religious Directives for Catholic Healthcare state that "hydration and nutrition are not morally obligatory either when they bring no comfort to a person who is imminently dying or when they cannot be assimilated by a person's body." (Part Five: Issues in Care for the Dying) However, Directive #58 states "there should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient."
Furthermore in an ad limina visit with American Bishops in 1998, Pope John Paul II said, "As ecumenical witness in defense of life develops, a great teaching effort is needed to clarify the substantive moral difference between discontinuing medical procedures that may be burdensome, dangerous or disproportionate to the expected outcome, and taking away the ordinary means of preserving life such as feeding, hydration and normal medical care. The presumption should be in favor of providing medically assisted nutrition and hydration to all patients who need them."
Finally, a pastoral statement of the Bishops of Florida (Mrs. Schiavo lives in Florida) published in 1989 adds further clarification to this difficult issue as follows; "In most cases there is not an excessive burden in the artificial administration of nutrition and hydration. The total care of the patient may be a burden, but it is the burden of this particular treatment that must be judged, not the burden of the person's life itself. We can never justify the withdrawal of sustenance on the basis of the quality of life of the patient."
The withdrawal of nutrition and hydration from Mrs. Terri Schiavo will result in her death. The tube feeding itself does not impose an excessive burden on the patient. Discontinuing nutrition and hydration in this circumstance violates in its intention the distinction between "causing death" and "allowing death." (Catholic Medical Assoc. Bioethical Principles of Medical Practice #9) Therefore, in view of these teachings and directives, we must conclude that at this time the withdrawal of nutrition and hydration from Mrs. Terry Schiavo cannot be justified by currently promulgated Catholic moral principles.
Robert J. Saxer, M.D.
President, Catholic Medical Association
Steven White, M.D. President, Florida Catholic Medical
601 N. Clyde Morris Blvd.
Daytona Beach, FL 32114
Catholic Medical Association National Headquarters
1241 Highland Avenue
P.O. Box 920480
Needham, Massachusetts 02492
Tel: (781) 455-0259
FAX: (781) 455-0357
E-Mail: [email protected]
Copyright © 2005 Catholic Medical Association. All rights reserved.
To see how you can help please go to Terri Schiavo's website.
For more information please see these other articles in Catholic Culture's Library:
1. Bishop Vasa's Statement on Terri Schiavo
2. Statement Concerning the Case of Theresa Schiavo
This item 6356 digitally provided courtesy of CatholicCulture.org
