One year ago...

Terri Schiavo died, after being denied food and water for 13 days.

Blogs for Terri is still up and running and offering information and analysis.

Prolife Blogs has many of the same posts, but more on other issues as well.

Fr. Rob Johansen has a piece in NRO today:

It is clear now that the battle to protect the lives of people like Terri is best won at the very outset — by amassing the best scientific and medical evidence to support the position that even lives that seem profoundly limited are nonetheless worthwhile and human. Ultimately, this is a battle for people's hearts and minds: Once people understand that there is hope in life, even when that life is limited or entails suffering, they will be unwilling to embrace death as a solution to problems. In the end, the struggle to protect the lives of people like Terri Schiavo is a battle of hope against despair.

Fr. Frank Pavone's open letter to Michael Schiavo, which many of you have already read, I'm sure.

Yesterday, NPR's Talk of the Nation featured (separate) interviews with Michael Schiavo and Jay Seklulow. I didn't listen, but I just read the transcript, and there is nothing surprising there - a total lack of hard questions beind directed Schiavo's way, which is what we've come to expect.

The most irritating thing about these discussions over the past week or so has been the absence of specificity about the issue at hand, which is not prolonging life or artificial life support. The issue was nutrition and hydration for a human being who was breathing on her own, and so on. No one made the distinction last year, and the issues are not being stated forthrightly this year, either.

I'll quote just a couple of interesting bits from Sekulow's part of the NPR interview:

CONAN: The autopsy after Terri Schiavo's death seemed to scientifically, medically supported Michael Schiavo's point that she was in a persistent vegetative state. There was no hope that any rehabilitation would've helped her. Has that changed anybody's mind do you think?

Mr. SEKULOW: I don't think it really has, because the really, the issue was not, was Terri, and I know there was all kinds, I call that the chatter on the side was the actual condition it was in. I would've, if I was litigating that case, I would've said look, there's nothing, David Boyce made the same, we were on the same side of this position. This was a disabilities case. She was, at a minimum, severely disabled, most severely disabled. And her brain function was either zero or minimal.

But she was breathing on her own, and in a sleep cycle, and that made all of us that are concerned about these kind of cases nervous that you start intervening in this way and I think that you have to, I find it interesting and I've seen some of the interviews that have taken place, of Terri's husband, and when he talks about that he held his wife, talking about Terri, and said goodbye to her, I don't know if he did that more for himself and his own, you know, well being, or whether he thought he was communicating with Terri. I thought that was an interesting thought, saw the interview with Matt Lauer the other day and I found that to be fascinating.

But look, without, I don't want to challenge anybody's motives. I think here's what you had at the end of the day. You had a situation that was unique in American jurisprudence, and that was you had a conflicted guardian who had another family. And I think what the court should have done in that case was deferred, on caution, on the side of life, regardless of the status of the medical situation at that point. And her parents were willing to take over the guardian and custody of their daughter, and I still to this day don't understand why he didn't let that happen. His answer is he knew Terri's wishes, but, you know, in a case like this, when you've got such an, to me, an apparent conflict, it would've been just much simpler and more civil to have gone the other way.

The disability-rights organization Not Dead Yet issued a statement on the anniversary:

Even though at least 26 national disability groups expressed concern over apparent violations of civil rights and guardianship laws in the withholding of food and fluids from Terri Schiavo, the 'culture war' framework imposed by others carried the day and still dominates the discussion," says research analyst Stephen Drake. "Players as diverse as Howard Dean, Randall Terry, Fox News and the New York Times all seem invested in making the public forget that the debate around Schiavo was never a simple right-left controversy." Drake pointed out that in addition to national disability groups, Reverend Jesse Jackson, Ralph Nader and Senator Tom Harkin all expressed concern about Schiavo's death and about people in similar situations.

"The media, pundits and demagogues have all but erased that complexity from the public consciousness," says Drake.

In the year since Ms. Schiavo"s death, even more disability organizations have joined in a Statement of Common Principles developed by the national disability groups that filed three amicus curiae briefs in the Schiavo case. The Statement (online at http://thechp.syr.edu/endorse/) sets out principles to guide a guardian's decisions with respect to life sustaining medical treatment. "We see many indications that managed care, government funded health care providers and overburdened courts have ignored constitutional principles that we used to take for granted, threatening millions of old, ill and disabled Americans who are endangered on many fronts," added Diane Coleman, president of Not Dead Yet.

Comments

[Rich Leonardi]

The issue was nutrition and hydration for a human being who was breathing on her own, and so on. No one made the distinction last year, and the issues are not being stated forthrightly this year, either.

Spot on. I've mentioned this conversation before, but it bears repeating. Last summer during a Dad's night out, I got into a lengthy exchange that quickly turned into an argument with a Catholic neighborhood physician. He kept saying over and over, "I deal with these issues every day and you don't."

"What issues?"

"People dying and what to do about life support."

"She wasn't dying."

"She was brain dead."

"No, she certainly had diminished capacity, but her brain functioned at least well enough to breathe."

"It was her choice."

"Aren't you skipping around here?"

"No one -- not you, not George Bush, not what you think the Catholic Church says -- has a right to make this decision for someone else. Besides where in the Bible does it talk about euthanasia?"

[Donald R. McClarey]

"It was her choice."

As relayed by "loving husband" after the personal injury lawsuit was won. After he was advised that his word alone would be insufficient, SHAZAM!, "loving husband's" bother and the brother's wife suddenly recalled similar statements. Contra statements were testified to by Terri's family and friends, but to no avail since the judge was hell-bent on euthanizing Terri, to allow her to "die with dignity", under the flimsy pretext that this was her wish. This case is an excellent reminder of why one of the salient facts about any case for any attorney is, "Which judge is this case in front of?".

[chris K]

Everyone should read Bobby Schindler's eloquent expression of his sister's and his family's years long suffering and persecution - by the legal system, the medical profession, the media's ignorance, the political system, but...esp. his own local Church during the time he needed them most to keep from losing his own faith. This last great disappointment is related in "Part IV".

We "slowing boiling frogs" have a lot to worry about within this culture if people are not moved to action by this most horrendous and public spectacle of cruelty. If anyone saw a helpless baby bird no longer with its mother, certainly the "unnatual" eye dropper would come out immediately to give some nourishment with hope. What have we become?? Where were you Bishop Lynch? If you had spoken out strongly with the Church's real teachings Terri might still be alive...and her brother knew this all the while he watched her helplessly and even your priests, by order, could not assist. God help us.

[Tony A]

When I entered the fray in the catholic blogosphere, one thing that shocked me was the zealous support for ther Schindler side in this story. This was a great surprise to me, quite familiar with the writings on bioethics of people like Fr. John Paris. It seemed clear to me then, and it seems clear to me still.

First, Terry Schiavo was in a PVS. She was not interacting with her family. I realize these people are suffering, but believing she was communicating with them is delusional. The post mortem showed this beyond a shadow of a doubt.

Second, the Church has taught that providing food and water could in these circumstances be seen as extraordinary and disproportionate measures, justifying removal. This would in no way be seen as euthania. I agree with you that nobody was making these kinds of distinctions. Before you all jump on me, I am well aware of John Paul's speech in 20044, where he said food and water were ordinary and proportionate. But this goes against much of the casuistry in the area. Even Richard Doerflinger (a proponant of the John Paul view) admitted that, before this statement, Catholics could come down on either side and be in line with the Church. Maybe it is better to keep provding food and water to people like this, maybe the development of technology makes this a preferable choice. But these were not the arguments made. The decision to remove the feeding tube was seen as tantamount to cold blooded murder. Given the history of the moral philosophy in this area, this venom makes me slightly uncomfortable.

Third, what really angered me was the use of this tragedy by various right-wing politicians with their own agenda. Sen. Martinez claimed this was as a great issue for Republicans. Delay threatened judges. Frist made a hugely embarrassing TV mis-diagnosis. Bush claimed he wanted to err on the side of life, which is laughable when you look at his record in the death penalty, torure, and unjust war. Also, while governor of Texas, Bush signed into law the Advance Directive Act which authorizes physicians to refuse to honor a patient's advance directive, or the wishes of a patient's guardian, and discontinue life-sustaining medical care, including feeding tubes. This was used against 6-month-old Sun Hudson lasy year, his parents' wishes to the contrary notwithstanding. Hudson died is his mother's arms moments later. The idea is that you can withdraw treatment from "futility cases". Is this euthanaia? No, but it is not "erring on the side of life" either, especially when the plug is pulled when the parents can't pay for the care.

[Rich Leonardi]

Second, the Church has taught that providing food and water could in these circumstances be seen as extraordinary and disproportionate measures, justifying removal. This would in no way be seen as euthania.

That is simply a lie. As section 2278 of the CCC instructs, those decisions may only be contemplated when the patient is dying or death is imminent:

Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

[Ken]

Has anybody noticed that Terri's husband and her parents showed all the symptoms of being involved in a family blood feud, with Terri the maguffin in the middle?

I've been in one family feud (an inheritance feud -- remember even Jesus wouldn't step into the midst of one of those), and know the dynamics: "I'm Right! You're Wrong! And I don't care how much it costs, YOU'RE GOING TO LOSE!" Put Terri's husband on one side, her parents on the other, and Terri as the maguffin in the middle, and it all falls into place. Terri became just a prize to be claimed and a weapon to stick it to the other side, with both sides calling in as many allies as possible (like the media, government, and activists on both sides) to stick it to the other.

[Tony A]

Rich,

No, you are not correct in your interpretation.

The develoment of the casuistry in this area is well laid out in "The Catholic Tradition and the Use of Nutrition and Fluids" by John J. Paris, S.J., in Birth, Suffering, and Death, edited by Kevin Wildes, 1992, Kluwer Academic Publishers.

There used to be a dispute as to whether providing nutrition (food) and hydration (water) could ever be disproportionate. This dispute was resolved decades ago as follows: if a person is unconscious with no hope of recovery so that nutrition and hydration are provided by tubes, or other technology (the person simply cannot eat or drink even with assistance), then the means of providing nutrition and hydration may be judged disproportionate and discontinued. It must be determined that the person is in such a state of unconsciousness that he/she cannot feel pain. If these conditions are not present, we are obliged to provide nutrition and hydration. If these conditions are present, we may withdraw the disproportionate means of providing nutrition and hydration and allow the person’s body to expire.

That was pretty much the consensus view, at least until 2004.

[Tony A]

Follow up: here is some of the arguments from Paris's book:

Daniel Cronin's doctorate from the Gregorian in 1958 (he was later archbishop of Hartford, Mass.): after a thorough review of over 50 moralists from Aquinas to the 1950s, he concluded "even natural means, such as taking of food and drink, can become optional if taking them requires great effort or if the hope of beneficial results (spes salutis) is not present".

Gerald Kelly S.J. stated in 1950 that "no remedy is obligatory unless it offers a reasonable hope of checking or cusing a disease".

Moralist Albert Moraczewski, O.P. "There appears to be no strict ethical obligation to provide nourishment by such technological interventions as intubation."

Fr. Robert McManus, asked to advise Biship Gelineau (Providence, Rhode Island) on a case involving a catholic in a persistent vegetative state for 2 years on the morality of removing life-sustaining nutrition and fluids: "The medical treatments which are being provided the patient, even those which are supplying nutrition and hydration artificially, offer no reasonable hope of benefit to her. This lack of reasonable hope or benefit renders the artificially invasive medical treatments futile and thus extraordinary, and disproportionate and unduly burdensome. Moreover, the continuation of such medical treatments is causing a significant and precarious economic burden to [the patient's] family. It must be unambiguously clear that the primary intention of removing what has been competently judged to be extraordinary means of artificially prolonging the patient's natural life is to alleviate the burden and suffering of the patient and not to cause her death."

In 1987, the pro-lfe committee of the U.S. Catholic Conference declared that "laws dealing with medical treatment may have to take account of exceptional circumstances where even means of providing nourishment may be too ineffective of burdensome to be obligatory." (The Right of the Terminally Ill, 1987).

Take what the Texas bishops adopted in their official guidelines on the use of nutriton and fluids in Catholic hospitals in 1990: patients in a persistent vegetative state can have such treatment withdrawn. They claim this is "not abandoning the person. Rather, it is accepting the fact that the person has come to the end of his or her pilprimage and should not be impeded from taking the final step".

[Christine]

Well Tony A., my mother is now in a nursing home in the initial stages of Alzheimers. Hopefully, intervention via appropriate drugs will prevent her from becoming full-blown as she's already 85 years old. But she is still in surprising good physical health. Theoretically, the time may come when she will no longer be able to feed herself or might need a feeding tube. At that point she probably won't have the least idea of who her family are. Should we pull the tube even though her physical person is still functioning quite normally?

Terri was still breathing and maintaining other bodily functions. The human person is not technically "dead" until the soul no longer animates the body.

I don't know Michael Schiavo. But to me his pettiness came through loud and clear when he denied Terri the right to have a Catholic funeral. It would not have cost him one ounce of integrity to permit her ashes to be brought into Church for a funeral Mass. Schiavo was not Catholic, and he may have been her husband but he had absolutely no right to deny her her religious identity and rights.

[Rich Leonardi]

No, you are not correct in your interpretation.

It's not an interpretation; it's what the Church teaches. But it's rather generous of you to make plain your dissent and then explain it for us.

[Tony A]

Rich,

So you are saying everybody I quoted is a dissenter? Interesting. In future, I suggest you do some research before blasting us which such definitives.

[chris K]

It's a wonder that after years of receiving nutrition in this simple manner and which Terri had adjusted to so well that all of a sudden it became labeled "extraordinary". Well, if that is considered such an overwhelming burden then spoon feeding, (without even the equal result in some cases of good nutritional health), those in extended nursing care...btw, who also may not be able to communicate, should be considered even more so. The only difference is that the nutrition gets to the same place and for the same purpose in different mannners; the one being just more efficient to get the job done. And...the simplicity of giving food directly is not considered in any way complicated "technology". Many toddlers are fed that way and then they are off to participate in life's other activities. Terri's case was similar BEFORE the order came down by the "controlling authority". She was fed and then taken to the mall or some other place of diversion and stimulation. To repeat the lie that "Terri was hooked up to machines" or that the Church teaches anything other than calling her purposeful dehydration murder shows only a willful display of the shell game. The commenter above who repeats the PC label of PVS, considered an ongoing debate within the medical profession, proves Bobby Schindler's point...label a group who cannot communicate and perhaps one can rubber stamp as well the national conscience. Will the spoon fed be next? But then, Bobby and family walked the walk. The others couldn't be bothered to get involved. They can only pontificate...even over and above the one who actually has the authority to do so and who actually did so by his own actions - not just talk.

Rather, it is accepting the fact that the person has come to the end of his or her pilprimage and should not be impeded from taking the final step".

Well, Terri wasn't nearly at the "end of her pilgrimage". In fact, when hustled illegally into the hospice she had a prognosis of another 20 years. Like Mr. Felos, Tony A. seems to enjoy distorting reality. Hopefully, he didn't also picture such a gruesome intentional killing as "peaceful and serence". But then again, all those "spirits" that communicate to Mr. Felos, wishing death, seem to emanate solely from those who CAN'T speak for themselves. What models of courage that bunch of conflicts of interest displayed.

[Celine]

Tony A.:

You are correct in your assessment of the prevailing Catholic moral theology in this area -- a dirty little secret that doesn't stop loud mouths like Fr. Pavonne from calling Michael a "murderer" and a lots of people from struting around in outrage over what has been going on almost entirely unquestioned in orthodox Catholic health care settings for over 50 years as "letting people go home."

However, this is a fault of "traditional" moral theology in this area -- without more, this business about proportionate/disproportionate or ordinary/extraordinary means is inherently vague, almost entirely subjective, and open to gross abuse. Quite literally, one person's extraordinary means is another person's murder, depending on factors like wealth of family and psychological repugnance.

But no one seems willing to face up to this. At least until there was some magisterial clarification in the pope's 2004 statement. Hopefully, this statement will fuel a reexamination of the criteria traditionally used to rationalize withholding/withdrawing treatment beyond tube feeding/hydration -- hardly a unique from of medical intervention that cannot easily be distinguished from other forms of treatment or care (like ventilator theraphy) or even antibiotics that everyone thinks can be and often are withheld or withdrawn virtually at will as "extraordinary."

[chris K]

You are correct in your assessment of the prevailing Catholic moral theology in this area -- a dirty little secret that doesn't stop loud mouths like Fr. Pavonne from calling Michael a "murderer" and a lots of people from struting around in outrage over what has been going on almost entirely unquestioned in orthodox Catholic health care settings for over 50 years as "letting people go home."

We're still speaking of the case of Terri Schiavo here...what is it about "not dying" that you don't understand? They HAD to willfully hold back her normal means of nutrition and hydration, for many days, in order to IMPOSE DYING upon her. So what you say about this being the Church's or Catholic health care's "dark little secret" of "letting people go home" is just ridiculous. If they were just "letting her", she'd still be here today!! If the body is maintaining its own with such regular and normal care, then the case of death being imminent and the body's own refusal of nourishment does not even enter into the equation. And that was the case with Terri.

Please, if you're going to argue on the side of evil, try to do so with the actual facts. Then again, facts of truth are anathema to evil.

You DO know that Fr. Pavonne was a witness to the suffering hours of the court ordered - not God ordered - demise of Terri?? You were there too then?

[kat]

My husband wrote the following article in New Oxford Review about 9 months ago about this very issue.

http://www.newoxfordreview.org/article.jsp?did=0705-collins
Here is a little snippet:

The Catholic Church does not teach now, and has never taught, that every heroic and extraordinary measure must be taken to preserve life for as long as humanly possible. Pope John Paul II did not teach that in his March 2004 address, "On Life-Sustaining Treatments and the Vegetative State." The Catechism does not teach it; in paragraph 2278, the Catechism states, "Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate…. One does not will to cause death; one's ability to impede it is merely accepted." In 1981 the Congregation for the Doctrine of the Faith promulgated its Declaration on Euthanasia, which reaffirmed the traditional Church teaching distinguishing between "ordinary" and "extraordinary" means of prolonging life. This can at times be a difficult distinction, and evaluating different treatments with different risks, hazards, pains, costs, and so forth, can be a fairly technical task, requiring the help of physicians.

[Fr. Rob Johansen]

Kat wrote:

The Catholic Church does not teach now, and has never taught, that every heroic and extraordinary measure must be taken to preserve life for as long as humanly possible.

That is true. However, food and water are not, and cannot (at least in orthodox Catholic moral theology) be considered "heroic" measures.

Furthermore, Pope JPII, in his 1992 address "Address to An International Congress on the Care of the Dying", interprets the CDF Declaration on Euthanasia, quoting from it in part:

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.

So, the question of whether treatment can be refused only comes into play "when inevitable death is imminent". Terri wasn't dying. Her death was caused by the removal of food and water.

JPII clarified further the nature of "normal care" in 2004, saying:

I should like particularly, to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.
(emphases mine)

The words about food and water attaining their "proper finality" here are important. Fr. Paris and other advocates of starvation and dehydration base their claims that the Pope departed from "mainstream" Catholic medical ethics on a sleight-of-hand that hinges on redefining the "finality" of food and water. This redefinition is described by Cindy Province, RN, MSN in her article "Hungering and Thirsting After Righteousness: Providing Nutrition and Hydration to Patients in the Persistent Vegetative State". In short, they argue (or usually its just an unstated assumption) that because food and water don't provide sufficient benefit, in the sense of promoting a cure, it is "futile" and can be withdrawn. In other words, it is the so-called bioethicists that have moved, not the Church.

The reliance of Frs. Paris, et al. on authorities like Kelly and Cronin, from the 1950's, is very problematic, as their assessment of what constitutes ordinary or extraordinary means is based on the state of medicine then. We all know that measures considered experimental or risky then are frequently regarded as commonplace now.

I would argue that the 1980 Decaration on Euthansia, the 1992 Address, and the 2004 Speech, when read together, show a refinement and development of Church teaching which rules out the position of Paris, et al.

I address some of these issues in a post on my blog from July 2004, titled "The Pope As Ignorant Schoolboy", that is a response to an article by Fr. John Tuohey that appeared in Commonweal Magazine.

[Celine]

chris k:

You write, "What part of 'not dying' do you not understand." What you fail to understand is that whether Terri was dying or not is not relevant to the extraordinary/ordinary calculus. If the treatment is "extraordinary" or "disproportionate," it may be withheld regardless whether a patient is terminal. Furthermore, Terri was "terminal" in the same sense as, say, someone on a ventilator who cannot breathe on her own. She could not eat or drink on her own and would die without emulsified fluids being pumped into her stomach, any more than a person who cannot breathe on her own can survive without a respirator. So why would it be moral to ever withdraw someone on a respirator, while it is not permissible to withdraw tube feeding from someone? This is the sort of incoherence that results from the "traditional" moral analysis at issue.

You seem to think that I defend withdrawing tube feeding from Terri. I certainly do not. My point is that objecting to withdrawing tube feeding/hydration from her is somehow murder, while withdrawing air from someone on a ventilator who will die of asphixiation without or withholding antibiotics from an elderly woman or cancer patient with a treatable infection from which they would otherwise die is also objectionable. But it happens all the time without objection.

Yes, I know Fr. Pavone was at Terri's bedside. So what? So was Michael Schaivo. This provides no excuse for such self-righteous overkill, unless he is willing to call the likes of Msgr. Kelly a murderer too.

[cheyan]

If a feeding tube is not actually feeding the person - because they can't digest the food, because they've developed an infection, because the incision isn't healing, or so forth - then it's not worth it. But if the person is digesting the food, then whether or not they appear to be "there" (and since when do Catholics believe we're spirits that animate fleshly shells?) the person must be fed - that's just the ordinary means of being kept alive, since if they could swallow, they could eat.
If someone can't breathe because their throat's swollen, then bypassing their swollen throat so that they can still breathe isn't extraordinary.
If someone can't breathe because their brainstem isn't sending the impulses to inhale and exhale... then forcing air in and out of their lungs is extraordinary.
This doesn't seem that complicated to me. What am I missing?

[Celine]

Fr. Rob:

I agree that the "1980 Declaration on Euthansia, the 1992 Address, and the 2004 Speech, when read together, show a refinement and development of Church teaching which rules out the position of Paris, et al."

However, the distinction that you draw between "normal care" and "treatment," placing tube feeding into one category and, I suppose, everything else into the other cannot be sustained. To say "Terri wasn't dying. Her death was caused by the removal of food and water" simply begs the question. By your criterion, a person on a ventilator who cannot otherwise breathe, but will live indefinately with ventilator also is not dying, and air provided by respirator is easily as "normal" as the emulisfied, chemicalized food/fluids that is pumped through a tube into a stomach involved in tube feeding. Similar analogies can be drawn to the use of antibiotics and even chemotherapy. So why is it forbidden to withdraw the tube feeding, but not the ventilator, etc.?

The point is that the papal statements require reexamination of the whole laxist "tradition" permitting withholding/withdrawing forms of life-sustaining medical interventions, not simply the rather minor and subsidiary matter of tube feeding.

Finally, the opinions of Kelly and Cronin, et al., were not simply based on the fact that some of the treatments they discussed then were "experimental." Rather, Kelly, for example, invoked St. Alphonsius Ligouri's opinion that one need not eat "rich foods" even if doctors say one should do so to survive as grounds for refusing tube feeding/hydration. Further, are you suggesting that anything, like tube feeding, that is now medically "ordinary" must be used? If so, then all manner of high-tech stuff must now be deemed morally mandatory and may never be refused for oneself without commiting suicide or for another without committing murder. Fine with me, but I don't think you mean it.

[Celine]

cheyan:

People who really need tube-feeding are just like people who really need respirators. Their brains don't permit them to swallow properly (or at all), just like the person you describe whose brainstem isn't working won't let them breathe properly (or at all). So I ask you: If "forcing air in and out of lungs is extraordinary" in one case, then why isn't forcing food in (and if necessary) out of the digestive tract extraordinary in the other case?

[chris K]

Yes, I know Fr. Pavone was at Terri's bedside. So what? So was Michael Schaivo.

There ya go. No differentiation? - no qualification? Therefore no ability to discern good from evil. And feeding Terri is extraordinary? For whom in THIS situation?

So why would it be moral to ever withdraw someone on a respirator, while it is not permissible to withdraw tube feeding from someone?

From that elusive "someone" again? I thought we were speaking to Terri's case. Simple feeding and hydrating is considered normal care for any human being. And in Terri's situation it was quite simple. But, are you also saying that there would be no case where deliberate removal of a respirator as well would not involve evil intent and also not be immoral? There was no barrier to this being done for Terri without it being PURPOSEFULLY ordered by the court. When a live human being is ordered to be killed (no, not "let go" - here, there was human purposeful activity determined to a specific end) who otherwise had the basics of life offered to her, yes, that is murder. And it is not done in most civilized cultures. Oh, and the other real evil in this case was that she was also purposefully put in this position of dependency due to lack of basic care and continued attempts at feeding. Is the husband also let off the hook for this purposeful neglect of care and conscious positioning of his wife for the next step in his planned scenario for the ultimate terror? And how convenient for his plans were the late in the game "recollections" also required for the intention of her premature demise. Now, do you see the difference between Mr. Schiavo and Fr. Pavone?

And many people will have to answer not only for their sins of what they did, but also for "what they had failed to do". Quite a few religious, as reported and mentioned before.

[cheyan]

Celine: putting food in a stomach that can digest it just bypasses the swallow reflex, just like putting a tracheotomy tube bypasses a swollen or damaged trachea.
Now, if the stomach can't digest it, or the body rejects the feeding tube for whatever reason, *then* it's like a respirator forcing air in and out of lungs.
Right?

[James Kabala]

The Fr. Robert McManus mentioned by Tony is now bishop of Worcester, Mass., my home diocese. I wonder if his opinions have changed in the intervening years.

[Margaret]

Keep in mind that Terry's feeding tube was initially put in for the convenience of the nursing staff. I believe it was at Michael's request. Previously, she had been successfully spoon-fed for a period of time. I would assume that when a person with traumatic brain injury spends extended periods of time on a feeding tube, however, that that ability to take food by mouth would be lost.

[Tony A]

Celine-- you are making some excellent points.

I also appreciate the input of Fr. Rob Johansen. It's amazing how many Schiavo supporters have simply erased history, in terms of how the church has historically dealt with these cases. And this is the first time I've seen an attempt to explain how doctrine might legitimately develop from this to John Paul's 2004 statement. But I remain unconvinced. Many of these cases do indeed go back to the 1950s, but Paris also deals with the 1970s and the 1980s, making it hard to base the argument on the "state of medicine" in the earlier period. What exactly has changed? After all, these arguments go back to theologians like Francisco de Vitoria, Juan de Lugo, and St. Alphonsus Liguori, and their arguments seem equally valid today.

[Laura(southernxyl)]

My mother-in-law became ill suddenly last year. She had a feeding tube for about three weeks. Apparently you forget how to swallow pretty quickly when you are in your 80's and tube-fed. Even when she was fully conscious and agitating to go home they had limited success getting her to swallow ice chips and applesauce. Then, on Good Friday last year, they brought her breakfast tray and left her alone with it. She ate everything. I went to see her in the afternoon and she told me about the catfish she had for lunch. "Laura, whoever they have cooking in this hospital knows how to fry catfish! That was the BEST CATFISH I ever had!" I thought, "yeah, and you were hungry as a dog, too." Shortly thereafter the feeding tube came out and she left the hospital. She's been just fine ever since.

Tube feedings are appropriately stopped when a person is end-stage and is no longer processing nourishment. Period. This did not describe Terri Schiavo, which is why it took her two long weeks to die. God have mercy on us.