March 23
- Despite congressional intervention, a three-judge panel of the
United States Court of Appeals for the 11th Circuit refused to order
the brain-damaged Terri Schiavo’s feeding tube reinserted,
intensifying the fight over the fate of a woman who has become a
symbol—some say pawn—for both the right-to-life and the right-to-die
movements. Schiavo’s parents, Robert and Mary Schindler, said
Wednesday that they plan to appeal one last time to the U.S. Supreme
Court.
Meanwhile, peripheral players and pundits weighed in on a case that
is drawing wall-to-wall cable coverage. From Washington to Rome,
leaders of the religious right have repeatedly called for American
courts to protect Schiavo—a Roman Catholic woman whom medical
experts say is in a persistent vegetative state with no hope of
recovery—from certain death if her feeding tube is not replaced. The
Vatican’s leading bioethicist called such a death a “pitiless way to
kill” someone.
But
much like in the United States, where consensus is a rare commodity,
even the Roman Catholic Church is not unified in its stance on
Schiavo. The Rev. John J. Paris, a bioethics professor at Boston
College and an expert on the intersection of law, medicine, and
ethics, believes that past statements made by the pope have been
taken out of context, misrepresented as church doctrine and applied
to the Schiavo case. He says Schiavo, who has a moral right to die,
has been exploited by the religious right to further its agenda—and
if the pope himself,
who has
no known living will, were in a similar situation, it would
be “an invitation to open chaos” at the Vatican. Paris spoke to
NEWSWEEK’s Brian Braiker about euthanasia, high-tech life support
and moral obligations. Excerpts:
NEWSWEEK: The church has said that providing food and water does not
constitute an extraordinary way of sustaining life.
John J. Paris: What you’re quoting is a statement that was
issued by the pope at a meeting of [an] international association of
doctors last year in Rome. This was really a meeting of very
right-to-life-oriented physicians. It was an occasion speech. The
pope meets 150 groups a week—a group comes in and the pope gives a
speech. If the pope tells the Italian Bicycle Riders Association
that bicycle riding is the greatest sport that we have, that doesn’t
mean that’s the church’s teaching, that the skiers and tennis
players and golfers are out. It wasn’t a doctrinal speech.
So
it’s been taken out of context?
It has to be seen in the context. This has to be seen in the
context of the pope’s 1980 Declaration on Euthanasia, which says
that one need not use disproportionately burdensome measures to
sustain life. Even if the treatment is in place, if it proves
burdensome it can be removed. The terms you’ll hear them talk about
all the time are “ordinary” and “extraordinary.” Well, those words
are so confused in the minds of the public that they no longer serve
any useful purpose. People think of extraordinary as respirators or
heart transplants. Extraordinary never referred to technique or to
hardware—it referred to moral obligation. What are we obliged to do?
What is the church doctrine?
The church doctrine, and it’s been consistent for 400 years, is that
one is not morally obliged to undergo any intervention. And, of
course, 400 years ago they weren’t talking about high technology.
Here’s the example one of the moralists of the 16th century gave: if
you could sustain your life with partridge eggs, which were very
expensive and exotic, would you be obliged to do so? The answer is
no, they’re too expensive. They’re too rare. You can’t get them.
They would be too heavy an obligation to put on people.
Would the pope’s recent tracheotomy qualify as a partridge egg?
No. This was best put together in a statement by the chief justice
in the Brophy [v. New England Sinai Hospital Inc.
right-to-die] case. He said even such things as artificial nutrition
and fluid can become extraordinary if they become burdensome when
you have to sustain somebody for 15 years on it. That’s surely
burdensome. It has nothing to do with the technique itself.
Antibiotics could be extraordinary if a patient is dying and
it’s not going to offer many benefits. The bishops of Florida
themselves have addressed this issue of the papal statement.
Right-to-lifers aren’t attacking this Jesuit priest, me; they’re now
attacking all the bishops of Florida saying they are deviating from
the pope. What the right-to-lifers want to say is the pope said you
must always use artificial nutrition and fluids for patients in
persistent vegetative state—and there’s no exception. The Florida
bishops say that’s not what the church has taught and that’s surely
not what this means.
But at the Vatican Monsignor Elio Sgreccia, a bioethicist like
yourself, said "starving" Schiavo to death would be a "pitiless way
to kill" someone.
The people in the Vatican are the same as the people in the United
States: they run the gamut. He represents the radical right-to-life
segment of thinking. But he’s not the only voice in the Catholic
Church. He undoubtedly wrote that speech the pope gave. And now he
says, “See? The pope said it!”
So
you’re saying providing Schiavo with food and water is not morally
obligatory?
For 400 years the Roman Catholic moral tradition has said that one
is not obliged to use disproportionately burdensome measures to
sustain life.
And in this case, you view this as disproportionately burdensome?
Fifteen years of maintaining a woman [on a feeding tube] I’d say is
disproportionately burdensome, yes.
The editorial page of The New York Times said she has been
"exploited" by the religious right in this country.
I agree with that. First of all, this is not a fight about a
feeding tube in a woman in Florida. This is a fight about the
political power of the Christian right. The argument from Bishop
Sgreccia is like saying, “Tom DeLay just said, ‘In America we never
stop feeding tubes'.” That doesn’t make it true. The fact of the
matter is that feeding tubes are removed every day in hospitals
around this country. We solved this question medically in the United
States in 1984 when the American Medical Association said that
patients who are terminally ill and/or in a persistent vegetative
state, it is ethically acceptable to remove all medical
interventions, including artificial nutrition and fluids. That’s the
official statement of the American Medical Association.
The pope, himself a sick man, has yet to make known a living will.
What do you suppose would happen if he were in a similar situation?
This is the open invitation to chaos. There are no rules in the
Vatican on this sort of thing because, up through 1950, really, it
wouldn’t happen. Doctors tended to kill people more than save them.
Unless there’s some secret document that the pope has written, he
becomes a pawn in the hands of bureaucrats. This organization is no
different than any others.
How does the stance of Schiavo supporters in the church reflect
religious teaching about death?
Here’s the question I ask of these right-to-lifers, including
Vatican bishops: as we enter into Holy Week and we proclaim that
death is not triumphant and that with the power of resurrection and
the glory of Easter we have the triumph of Christ over death, what
are they talking about by presenting death as an unmitigated evil?
It doesn’t fit Christian context. Richard McCormick, who was the
great Catholic moral theologian of the last 25 years, wrote a
brilliant article in the Journal of the American Medical Association
in 1974 called “To Save or Let Die.” He said there are two great
heresies in our age (and heresy is a strong word in theology—these
are false doctrines). One is that life is an absolute good and the
other is that death is an absolute evil. We believe that life was
created and is a good, but a limited good. Therefore the obligation
to sustain it is a limited one. The parameters that mark off those
limits are your capacities to function as a human.
But is anyone arguing that for Schiavo to die would be an
“unmitigated evil”? They just don’t want her death to happen
unnecessarily.
It’s not happening unnecessarily. It’s happening because her heart
attack has rendered her utterly incapable of any future human
relationships. The Republican riposte to this is astonishing:
interest in states’ rights disappearing, interest in privacy of the
individual to be free of government intrusion disappearing. If we
implemented the policy articulated by the Congress and the
president, we’d have everyone going forever!
And Social Security would really be in trouble.
[Laughs.] It just makes no moral sense.
MSNBC.com