Judge rejects right-to-die delay

[Boris Godunov]

Originally posted by Mrs. Tuberski
First how do you let the woman die? Starvation isnt the answer. This is a hard one While I have agreed she hasnt been a whole person for a long time there needs to be an alternative to starvation.

She won't die of starvation, actually, but kidney failure.

My grandmother died in 1994. She was diagnosed simultaneously with advanced lung cancer and Alzheimer's disease. The docs explained all kinds of treatment procedures, or they could "make her comfortable." She chose the latter without hesitation.

Anyway, as the end neared, they removed the feeding tube, IV, everything...and my grandfather went ballistic, worried she was going to suffer. Not at all, said the docs, and she was lucid enough until the last days as her kidneys failed to let them know if she were in discomfort. It was a very peaceful way to die, devoid of any suffering on her part.

Now Schiavo isn't even lucid--she's in PVS. So I don't think there will be any suffering. They should sedate heavily to make sure, but otherwise she will die very peacefully.

[Mrs. Tuberski]

Boris you are right. I know that. Hell i lived through that with my father. If the family wants to take care of her and self deluding themselves she will get better why doesnt this guy just walk away. Sure because he loved the person she was but he doesnt love the person she is now. I dont get it. I know Its not for me to get because im not involved but still.

[Gamecube64]

Oh boy, congress is rushing a bill. This will mean another entire trial before anything can be done. Maybe the supreme court will declare the law unconstitutional, since there have already been two other trials.

[Mrs. Tuberski]

[QUOTE] Originally posted by Gamecube64
Oh boy, congress is rushing a bill. This will mean another entire trial before anything can be done. Maybe the supreme court will declare the law unconstitutional, since there have already been two other trials. [/QUOTE
] What Bill?

[GePap]

Originally posted by Mrs. Tuberski
What Bill?

The repugs in Congress got together and are close to passing a bill that will give the parents the right to move their court claims up to Federal court, and out of the state courts. Bush has said he will even cut his little trip back to the ranch short to sign it.

This would probably mean that a Fed judge would re-instate the tube while waiting to decide, and gives the parents a whole nother round.

Which they will probably lose, just like they have lost in Florida.

Some, please, put tom delay in a permanent vegitative state.

[Mrs. Tuberski]

while all of you guys put up a great argument why cant the family just take control over this woman and end all of the media hype.

[GePap]

Originally posted by Mrs. Tuberski
while all of you guys put up a great argument why cant the family just take control over this woman and end all of the media hype.

Because parenst do not OWN children. This is specially true of adult, married children. Its Terry Schiavo, not whatever her maiden name is. There is a right of spouses not testifying against each other in court- no such right for parents and kids.

The law recognizes marriage as a union. Ties to siblings and to parents after you are an adult have no similar legal protection. Hence the parents have no legal ground to "take her over". This is why the husband keeps winning, and probably will keep winning.

So unless the husband decides to give control over, which iks purely his decision and I am incapable of speculating about, the parents only recourse is more suits, that will probably fail.

[DinoDoc]

Out of curiosity has Congress ever intervened on such a microscale before?

[Mr. Harley]

First of all, even the Catholic Church lets the feeding tubes be removed in cases like this. They essentially leave it up to God. What a concept! If you really believe in a Theistic God - i.e. he keeps sticking his divine finger into your business - then at least be consistent like the Christian Scientists. They do not permit any medical intervention. I may think they are nuts, but they have a consistancy and belief in an activiely Theistic God that make me respect them. I may still think they are crazy, but damn they are truly willing to die for their convictions.

Dying via starvation is actually not that bad after the first couple of days, by most accounts. FYI. My own choice, if my wife and sister (the burned one who lost her husband in Iraq) can make it work, if I have Alzheimers, once I can no longer recognize who I am, let me wander outside in subzero weather. As long as some nutcase prosecutor doesn't go after them, it's quick and relatively painless.

The problem with the cases against assisted suicide are that, typically as long as I am capable of it I DONT'T NEED IT.. But once my mental faculties are gone, i.e. I am dead, my body just needs to catch on to the fact, then I cannot do it for myself. Catch-22 if I ever heard one.

[Drake Tungsten]

First of all, even the Catholic Church lets the feeding tubes be removed in cases like this. They essentially leave it up to God. What a concept! If you really believe in a Theistic God - i.e. he keeps sticking his divine finger into your business - then at least be consistent like the Christian Scientists. They do not permit any medical intervention. I may think they are nuts, but they have a consistancy and belief in an activiely Theistic God that make me respect them. I may still think they are crazy, but damn they are truly willing to die for their convictions.

[Imran Siddiqui]

Originally posted by DinoDoc
Out of curiosity has Congress ever intervened on such a microscale before?

I dunno, but I wouldn't put it past the ********* in Congress. This is dangerously coming close to pissing all over the seperation of powers (not like Congress cares).

[DanS]

First of all, even the Catholic Church lets the feeding tubes be removed in cases like this.

No it doesn't. What are you talking about? A breathing machine is OK to remove though.

[Mr. Harley]

Since I've been out of the Church for over a decade, I had missed Pope John Paul II most recent pronouncement. This article for the most part includes part of the context that was current at the time I left. The fact that Pope JP2 had to make a pronouncement meant that he felt many Catholics had fallen into error. I won't even get into the fact that he needs a Council (i.e. Vatican Council II was one such, the Council of Trent, etc.), cannot make binding pronouncements of faith or Church Law unless his statement is Ex Cathedra, and that has only existed since the 1800's.

Upholding the teachings of the Catholic Church
Vol. XIX No. 3 Michaelmas 2004
Celebrating 20 Years - 1984-2004



Bioethics Watch
The Pope's Address on Feeding and the "Vegetative" State



by Nancy Valko, RN

"When someone suffers an illness or injury that puts them in a persistent vegetative state, they have put their first foot on the path to eternal life. When we remove artificial nutrition and hydration, we open the door and say, 'Have a wonderful journey'".

Sister Jean deBlois, ethicist, Aquinas Institute,
Spring, 2004

"The sick person in a 'vegetative state', awaiting recovery or a natural end, still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention of complications related to his confinement to bed. He also has the right to appropriate rehabilitative care and to be monitored for clinical signs of eventual recovery".

Pope John Paul II, March 20, 2004



Before 1972, when influential neurologists Drs. Fred Plum and Bryan Jennett coined the term "persistent vegetative state" (PVS) to describe a condition in which a person was presumed awake but unaware because of an injury or illness involving the brain, the idea of removing a feeding tube from a brain-injured person was simply unthinkable. The experience of the Nazi euthanasia program -- which used medical personnel to end the lives of the disabled, mentally ill and others characterized as "useless eaters" -- was considered the ultimate betrayal of medical ethics and still fresh in many minds.

But around this same time, the euthanasia movement was finally gaining traction with its "living will" document, where a person could request no heroic measures when he or she was dying. Because traditional ethics held that medical treatment could be withheld or withdrawn if it was futile or excessively burdensome, there were few objections to such a document and state legislatures started passing laws giving legal status to such documents.

However, it wasn't long before "right to die" court cases involving people considered in PVS started to result in feeding tubes being withdrawn with the support and court testimony of some doctors and ethicists who maintained that PVS patients would never recover and that such patients would refuse medically assisted food and water. As a result, PVS began to be added to state "living will" laws and eventually such laws expanded to include documents allowing the withdrawal of virtually any kind of medical treatment or care by a designated surrogate when a patient was mentally unable to make decisions.

Some influential Catholic ethicists developed theological justifications for withdrawing food and water in the special case of PVS by arguing that there was no moral obligation to maintain the lives of such people who could supposedly no longer achieve the spiritual and cognitive purpose of life. Terms like "futile" and "burdensome" -- the traditional ethical standard for withdrawing treatment or care -- were redefined . "Futility" was now to mean little or no chance of mental not physical improvement, and "burdensome" to the patient, was extended to include family distress, medical costs and even social fairness in distributing "scarce health care resources".

Despite myriad Church statements supporting the basic right to food and water (see sidebar page 34), some of these Catholic ethicists even testified in "right to die" court cases that their view was consistent with Church teaching, insisting that there was no intention to cause death by starvation and dehydration but rather merely withdrawing unwanted and useless treatment.

Unfortunately, some Catholic ethicists have moved even beyond PVS, and now include conditions such as Alzheimer's and the newly named "minimally conscious state" (in which patients are mentally impaired but not unconscious) as additional circumstances in which giving a person medically assisted food and water, antibiotics, etc., is no longer obligatory.

Pope's Address on "Vegetative State" Surprises Many
Against such a backdrop, Pope John Paul II's March 20 address to the International Congress "Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas", affirming the obligation to feed and care for patients considered in PVS, was, in the words of one Catholic ethicist, a "stunner". Not surprisingly, reactions to the pope's statement varied widely and some were scathing.

For example, ethicists Arthur Caplan and Dominic Sisti described the pope's statement as "flawed", "at odds with the way medicine has been practiced in the United States for well over a decade" and "fundamentally at odds with the American values of self-determination, freedom and autonomy".2

Sister Jean deBlois, C.S.J., director of a master's degree program for health care executives at Aquinas Institute in St. Louis, said that the pope's statement places "an unnecessary and unfounded burden on family members faced with treatment decisions on behalf of their loved ones" and that "artificial nutrition and hydration... holds no comparison to a meal".3

Father John F. Tuohey, who holds the endowed chair in applied health-care ethics at Providence St. Vincent Medical Center in Portland, Oregon, wrote an article in the June issue of Commonweal magazine treating the pope's statement as a poorly argued thesis proposal by a misinformed student.4

Peggy Wilkers, president of Fitzgerald Mercy Hospital Nurses Association of Pennsylvania was quoted as saying the pope's statement "will change very, very little" and that she and other nurses would base their patient care "not on what the pope says but on what the family wants". She defended families "who would love to keep their loved one alive knowing full well that they will never be who they were before" but can't take care of them at home and can't find affordable long-term care.5

However, many others applauded the pope and at least one ethicist changed his opinion about withdrawing feedings as a result of the pope's statement.6

Pro-life groups like The National Right to Life Committee and the American Life League welcomed the pope's statement, especially in view of the ongoing Terri Schiavo "right to die" case in Florida. Women for Faith & Family posted the statement on its web site as soon as it appeared.

The World Federation of Catholic Medical Associations and The Pontifical Academy for Life issued a joint statement calling the pope's words "deeply inspiring".7

The National Catholic Bioethics Center described the pope's statement as "a welcome clarification of Catholic thinking on one of the most vexing and controversial issues in health care".8

Richard Doerflinger, Deputy Director of the Secretariat for Pro-Life Activities, US Conference of Catholic Bishops, wrote that the pope's statement was not only an affirmation of human dignity but also "a recognition of the latest medical and scientific findings on the 'vegetative' state, reviewed at length during the congress itself. Misdiagnosis of the 'vegetative' state is common, prognoses (including predictions that patients can never recover) are far from reliable, and the assumption that this state of unresponsiveness entails complete absence of internal sensation or awareness is being seriously questioned".9

However, the Catholic Health Association (CHA), a national group of more than 2000 hospitals and health organizations, was less enthusiastic.

As USA Today reported, "Until now, the 565 hospitals in the Catholic Health Association considered feeding tubes for people in a persistent vegetative state 'medical treatment', which could be provided or discontinued, based on evaluating the benefits and burdens on patient and family".10

Thus, the pope's words could have a profound impact on practices and policies in Catholic health institutions, many of which had relied on ethicists like Dominican Father Kevin O'Rourke of St. Louis University, who have long maintained that there is no benefit possible in maintaining the mere physical existence of PVS patients.

Father Michael Place, president of the CHA, said that the pope's statement "has significant ethical, legal, clinical, and pastoral implications" that might even affect "those patients who are not in a persistent vegetative state" and will continue to be studied by CHA.11

In the meantime, CHA is advising its members that "Until such time as we have a greater understanding of the meaning and intent of the pope's allocution, Catholic hospitals and long-term care facilities should continue to follow the United States Conference of Catholic Bishops' Ethical and Religious Directives for Catholic Health Care Services as interpreted by the diocesan bishop".12

Ironically, just a few weeks ago, a reporter from a national secular newspaper called me about Pope John Paul II's statement. A self-described "cafeteria Catholic", he was perplexed after talking to several Catholic health experts who maintained that the pope's statement needed months of intensive study to understand its intent and meaning. Even this reporter said that he found the pope's statement very clear and explicit and he could not understand the apparent evasiveness of these Catholic experts.

Challenge - and Opportunity
While the average person might assume that the pope's eloquent defense of the most severely disabled in our society would finally resolve the controversy over PVS and feeding tubes in at least Catholic health facilities, the battle is far from over.

Not only do we need consistent, unambiguous policies in Catholic health facilities that protect the lives of the severely brain-injured but, as the pope points out, we also need better support for such patients and their families. This is an area where the Catholic health system has a real opportunity to take a powerful leadership role in health care. Patients and their families cannot help but benefit from new opportunities for appropriate rehabilitative care as well as spiritual, physical and emotional assistance.

And whether we are clergy, health care providers, ethicists or laypeople, we do well to heed the words of Jesus that the pope included in his statement: "Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me". (Mt 25:40)





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FOOD AND WATER:
Some excerpts from Catholic sources

"Ultimately, the word euthanasia is used in a more particular sense to mean 'mercy killing', for the purpose of putting an end to extreme suffering, or having abnormal babies, the mentally ill or the incurably sick from the prolongation, perhaps for many years of a miserable life, which could impose too heavy a burden on their families or on society".13 Declaration on Euthanasia, May 1980

"Nutrition and hydration (whether orally administered or medically assisted) are sometimes withdrawn not because a patient is dying, but precisely because a patient is not dying (or not dying quickly enough) and someone believes it would be better if he or she did, generally because the patient is perceived as having an unacceptably low 'quality of life' or as imposing burdens on others".14 NCCB Committee for Pro-Life Activities, 1992.

"The administration of food and liquids, even artificially, is part of the normal treatment always due to the patient when this is not burdensome for him: their undue suspension could be real and properly so-called euthanasia".15 The Charter for Health Care Workers, 1995.

" the presumption should be in favor of providing medically assisted nutrition and hydration to all patients who need them".16 Pope John Paul II, 1998


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NOTES
1 "Prolonging Life or Interrupting Dying? Opinions differ on Artificial Nutrition and Hydration", Aquinas Institute, Spring 2004 newsletter. Available online at Aquinas Institute website at www.ai.edu

2 "Do Not Resuscitate" by Arthur Caplan and Dominic Sisti, Philadelphia Inquirer, April, 1, 2004. Available online at: https://www.philly.com/mld/inquirer/...8324997.htm?1c (registration required)

3 "Prolonging Life or Interrupting Dying?"

4 "The Pope on PVS -- Does JPII's statement make the grade?" by Fr. John F. Tuohey, Commonweal, June 18, 2004.

5 "Pope's feeding-tube declaration pits religion, medicine" by Virginia A. Smith, Philadelphia Inquirer, April 16, 2004. Available online at: www.philly.com/mld/inquirer/news/ nation/8442625.htm

6 "Australian ethicist Rethinks Position on 'Vegetative State'", Catholic News. Available online at: www.cathnews.com/news/ 407/57.php

7 "Considerations on the Scientific and Ethical Problems Related to Vegetative State", Joint statement by the Pontifical Academy for Life and the World Federation of Catholic Medical Associations. Available online at: www.vegetativestate.org/documento_FIAMC.htm

8 Statement of the NCBC on Pope John Paul II's Address on Nutrition and Hydration for Comatose Patients. Available online at: https://www.ncbcenter.org/press/04-0...CBCStatementon NutritionandHydration.html

9 "John Paul II on the 'Vegetative State'" by Richard M. Doerflinger, Ethics and Medics, June 2004, Vol. 29 No. 6. Available online at: www.ethicsandmedics.com/0406-2.html

10 "Pope declares feeding tubes a 'moral obligation'" by Cathy Lynn Grossman, USA Today, 4/1/04. Available online at: https://www.usatoday.com/news/religi...ope-usat_x.htm

11 Ibid.

12 "Persistent Vegetative State and Artificial Nutrition and Hydration: Questions and Answers", Resources for Understanding the Pope's Allocution on Persons in a Persistent Vegetative State. Online for CHA members on website www.chausa.org

13 Declaration on Euthanasia, Sacred Congregation for the Doctrine of the Faith, May 5, 1980. Available on the WFF web site at: www.wf-f.org/declarationoneuthanasia.html

14 "Nutrition and Hydration: Moral and Pastoral Reflections", NCCB Committee for Pro-Life Activities, 1992. Available online at: https://www.usccb.org/prolife/issues...s/nutindex.htm

15 Charter for Health Care Workers by the Pontifical Council for Pastoral Assistance to Health Care Workers, 1995. Available online at: www.wf-f.org/healthcarecharter.html

16 Ad limina address of the Holy Father to US Bishops of California, Nevada and Hawaii, October 2, 1998. Available online at: www.wf-f.org/JPII-Bishops-Life-Issues.html

[Mr. Harley]

It is the critical differences that let a Catholic Doctor terminate a fallopian tube pregnancy (inevitably fatal for both mother and child). The Doctor is saving the mother's life, and if they could they would save the child, but medical technology does not permit that.

Many theologians have argued that terminating heroic measures is not euthanasia, it is instead letting God decide where man has chosen to intervene, perhaps mistakenly. If you believe in a theistic God, then you believe that he can intervene any time he so chooses.

The fact that this can actually cause a substantially more painful death then painkillers - look at Mrs. Tuberski's reaction to death from asperation, though usually that leads to pneumonia - does not get in the way that theologically it can be considered sound. It can also be considered the other way, as the article amptly describes, which you will note actually supports the Terry Schiavo's parents. I posted it because it seems to largely cover both sides of the argument, even if biased against mine.

[Boris Godunov]

What is a "theistic God?" Is there such a thing as an "atheistic God?"

Anyway, I'm curious to what theologians would say is the current state of Terri Schiavo's soul. Is her soul trapped inside this body, or when her brain damage occured, was her soul whisked away? If the former, I'm curious as to why any theists would want to maintain a soul in that manner as opposed to allowing it to be freed and (presumably) join the afterlife. Is there any ultimately non-selfish reason to keep a person's soul suspended in such a state?