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Arkansas Catholic
Little Rock, Arkansas
July 15, 1990     Arkansas Catholic
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July 15, 1990

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PAGE 8 ARKANSAS CATHOLIC JULY 1 5, "Bishops," from page 1 and health falls especially upon those per- sons and institutions directly involved in the healing ministry. Catholic health facilities have a special duty to reflect Roman Catho- lic teaching while carrying our the compas- sionate healing ministry of Jesus Christ. In particular, this commitment to rele- vant church teaching is exemplified in the treatment of all patients, including those who require life-sustaining procedures. Specifically, the highly controversial issue of the provision of artificial nutrition and hydration is of particular concern today because of the current anti-life ambiance in the U.S. The Texas Conference of Catholic Health Facilities, to ensure consonance with the teachings of the Catholic Church in all of its activities, consulted the bishops of Texas on the subject of forgoing, and withdrawing of artificial nutrition and hydration. This consultation contributed to this statement, which addresses the moral aspects of this issue. Moral Values to be promoted and pro- tected 1. Human personhood: Each human per- son is of incalculable worth because all humans are made in the image of God, redeemed by Christ and called to share the life of the triune God. 2. A holistic integration: This value includes the spiritual, mental, emotional and physi- cal health in the unity of the person and communion of persons. The life and health of the total person and communion of persons are important in order for each person to hear and respond effectively under the influence of grace to God's call. 3. The inherent sacredness and digm'ty of the human person: The life of each person has an inherent dignity, which is to be respected by all other humans. So each person, re- gardless of age or condition, has exactly the same basic right to life, which deserves equal 2801 KAVANAUGH BLVD. LITTLE ROCK 683- 4131 Free Oelivery Church Insurance Specialist of Ark. We have competitive premiums on most churches. Give us a call for a free quote. ROY JAMES 225-4760 protection by society and its laws. Basic Moral Principles 1. Although life always is a good, there are wnditions which, if present, lessen or remove one's obligation to sustain life. While every reason- able effort should be made to maintain life and restore health, Pope Pius XII noted that there comes a time when these efforts may become excessively burdensome for the patient or others. 2. If the reasonable foreseen benefits to the patient in the use of any means outweigh the burdens to the patient or others, then those means are morally obligatory. Examples of benefits include cure, pain reduction, restoration of consciousness, restoration of function and maintenance of life and reasonable hope of recovery. Even without any hope of recov- ery it is an expression of love and respect for the person to keep the patient clean, The moral issue, then, is what conditions make it morally obligatory to inter- vene with artificial nutrition and hydration. warm and comfortable. There is no moral distinction to be made between the forgo- ing and withdrawing of fife-sustaining pro- cedures. 3. If the means used to prolong life are dispro- portionately burdensome compared with the bene- fits to the patient, then those means need not be used, they are morally optional This principle, taught in the Vatican Declaration on Euthanasia (1980), was built on the teaching of Pope Plus XII and the church's moral traditiofi. Burdens are th6se undesirable aspects and consequences of the use of the means themselves which fall upon the patient or others - family, care provider or community. Examples of disproportion- ate burdens include excessive suffering for the patient; excessive expense for the fam- ily or the community; investment in medi- cal technology and personnel disproportion- ate to the expected results; inequitable resource allocation. The National Conference of Catholic Bishops' Committee for Pro-Life Activities came to the same conclusion regarding the situation when the burden is disproportion- ate to the benefits in their statement on the proposed Uniform Rights of the Terminally Ill Act. The statement (July 2, 1986) allowed that "laws dealing with medical treatments may have to take account of exceptional circumstances, where even means for pro- viding nourishment may become too inef- fective or burdensome to be obligatory." The Declaration on Euthanasia, as well as the teaching of Pius XII, explicitly states that such forgoing or withdrawing are not sui- cide; rather they should be considered as the acceptance of the human condition and simply letting nature take its course. The omission of life-sustaining means (whether it be a mechanical respirator, a cardiac pace- maker, a renal dialysis machine or artificial nutrition and hydration) can be acceptable under conditions which render those means morally non-obligatory. In those appropri- ate cases the decision maker is not guilty of murder, suicide or assisted suicide, since there is no moral obligation under these circumstances to impede the normal conse- quences of the underlying pathology. The physical cause of death is ultimately the pa- thology which required the use of those means in the first place. The proximate physical means are either the absence of the substance necessary for life (oxygen, water, nutrients) or the presence of toxic substances resulting from metabolic activi- ties of the body. Application to Persistent Vegetative State Patients, competently diagnosed to be in a persistent vegetative state or in an irre- versible coma, remain human persons. Nonetheless, those individuals are stricken with a lethal pathology which, without arti- ficial nutrition and hydration, will lead to death. The moral issue, then, is what conditions make it morally obligatory to intervene with artificial nutrition and hydration to prevent death; which would otherwise occur as a consequence of the underlying pathology? While each case has to be judged on its own merits, the final decision should be based upon the application of the principles previously described regarding the burden/ benefit analysis relative to the use of Life- sustaining procedures. Decisions about treat- ment for unconscious or incompetent pa- tients are to be made by an appropriate proxy (e.g., spouse, parent, adult children) in light of what the patient would have de- cided. This judgment should be based on the expressed withes of the patient. The final decision, however, for patients with a fatal pathology, but who are conscious and competent and in the judgment of physi- cians have no reasonable hope of recovery from it, is to be made by thepatients them- selves and by no one else. Patients, even those persons who are in a permanent vegetative state or irreversibly unconscious, should never be abandoned. They should be cared for lovingly - kept clean, warm and treated with dignity. The morally appropriate forgoing or withdraw- ing of artificial nutrition and hydration from a permanently unconscious person is not abandoning that person. Rather, it is accept- ing the fact that the person has come to the end of his or her pilgrimage and should not be impeded from taking the final step. The forgoing or withdrawing of artificial nutrition and hydration should only occur after there has been sufficient deliberation based upon the best medical and personal information available. Conclusion The principles are applicable to threatening situation where a person" regardless of age or condition - requires some intervention, especially administered nutrition and hydration, order to impede the threat to life. In a medical context, the decision needs to be made in each particular case as i~o whether the normal consequences of a disease or injury should be impeded by human inter" vention. All care and treatment should be directed toward the total well-being of the person i~ need. Because of the high value of tempO" ral health and life, and presumption is made that the necessary steps will be taken to restore health or at least avert death, However, the temporal concerns must al- ways be subordinated to the patient's spiri" tual needs and obligation. Catholic health facilities should be par~ ticularly sensitive to the pastoral needs 0~ both patients and care givers (family, friends, staff), especially in the context of death and dying. In the event of doubt about meaning of application of church teaching, the dioce" san bishop or his delegate shall be co~" suited. (Reprinted from "Origins: CTVS Documentaf~ Service," VoL 20, # 4, June 7, 1990.) , This document was signed by 16 out of Texas 18 bishops. One bishop who refused his signatua is Bishop Rene Gracida of Corpus Christi, who recently notified an abortion clinic director and an obstetrician who performs abortions that thO had incurred automatic excommunication. Tht identity of the other non-signing bishop remainS a mystery. Neither Catholic News Service nor an~ dio~san newspaper in Texas has been able to determine the identity of the bishop. According one Texas editor, all of the bishops except Gr~ dda have refused to comment. -- Ed. " Managed by ] OOTHII g JK APARTMENT -'~ O Spacious 1 & 2 Bedroom Garden Apartment 171 Convenient Location O Bay Windows, I vate Patios O Washer/Dryer Connections O Beautiful Community Center O Exercise Room,Swimming, Call or Come by Today. 2401 Lakeview Rd., North Little Rock ( Near McC.ain Mall ) Industrial Fasteners and Supplies 500 North Olive Street North Little Rock, 72114 @72-7127 ARK WATTS 1-800-482-902@ Brenda Kent $ Gaff Clayton Terry Kent $ Lauraetta Edgar Raymond Clayton