Posted on 05/05/2005 6:31:54 AM PDT by AnthonyCekada
http://www.freerepublic.com/focus/f-religion/1393366/posts
Dear Dr. Gebel,
Someone forwarded to me your comments about my articles on the Schiavo case.
A number of other people involved in health care have written to me about the medical aspects of the case.
I not qualified to decide whether your medical opinion or other conflicting medical opinions about PVS, therapy, etc. are more in accord with the principles of medical science.
But common sense tells me that the method you used to arrive at your opinion -- reviewing CT images, watching a video and reviewing “summary/excerpts regarding testimony given in deposition transcripts” -- is no substitute for examining a live patient.
Unlike other doctors directly involved in the case, moreover, you have not been cross-examined on either your methods or your conclusions.
Be that as it may, I am qualified to speak about the moral issues in the case, and indeed, I am also obliged to do so.
If what you seem to be claiming is true and Terri Schiavo was somehow able to eat and drink by natural means, there is no dispute that those who cared for her would have been obliged to provide her with food and drink. To have withheld these would have been a mortal sin (unjust direct homicide) against the Fifth Commandment.
However, my writings on the Schiavo case centered on something else: the principles that Catholic moral theology would apply to removing a feeding tube.
I do not want my parishioners to be left with the impression -- due to the high emotions and bitter controversy fanned by the morally bankrupt media and by various lay and clerical grandstanders -- that something is a mortal sin when it is not.
Who knows when any one of my flock may be called upon to deal with the issue of a feeding tube for himself or a family member?
Here, put very bluntly, are the two essential questions in moral theology that I have sought to resolve:
(1) Does the Fifth Commandment under pain of mortal sin always require a sick person who is unable to eat or drink by natural means to have a doctor shove a tube into his nose or poke a hole into his stomach in order to provide food and water?
(2) Does the Fifth Commandment under pain of mortal sin then always forbid such a person to have these tubes removed, no matter what grave burdens -- pain, revulsion, depression, expense, etc. -- their continued use may impose on him or another?
The answer to both questions is no.
Having a hole poked in you, a tube shoved in and then having to eat and drink that way would be burdensome for any normal man.
Like the IV drip mentioned by the moral theologian McFadden (whom I quoted elsewhere), one could maintain this procedure would be morally compulsory “as a TEMPORARY means of carrying a person through a critical period.”
“Surely,” however, “any effort to sustain life PERMANENTLY in this fashion would constitute a grave hardship.” (Medical Ethics, 1958, p.269.)
(Perhaps some priest, layman or doctor who rejects this conclusion could get his own feeding tube inserted, live that way for fifteen years, and let us all know in 2020 whether the experience was a grave hardship or not. Any takers?)
Insisting (as some have done in the Schiavo case) that one is bound to this under pain of mortal sin (otherwise, euthanasia! murder!) contradicts Pius XII’s teaching that one is bound only to use “ordinary means,” which he defined as those “that do not involve any grave burdens for oneself or another.”
Imposing “a more strict obligation,” the pontiff warned, “would be too burdensome for most people and would render the attainment of a higher, more important good too difficult.”
So, even though as a doctor you may well consider poking holes into people and inserting permanent feeding tubes “by no logical measure extraordinary or unduly burdensome by any reasonable standard, moral, medical or economic" (as you say in your article), Catholics must nevertheless draw their understanding of extraordinary means from the Church’s moral teachings -- rather than from the practices and pronouncements of the medical-industrial complex.
In sum, by the standards of Catholic moral theology, the permanent use of a feeding tube constitutes extraordinary means and is therefore NOT obligatory. Like all such means, however, one is FREE to use it, “as long as one does not fail in some more serious duty.” (Pius XII)
But one cannot maintain that a Catholic is ALWAYS bound to use a feeding tube under pain of mortal sin — still less, that the refusal to do so constitutes “murder.”
Don’t try to invent a mortal sin where there is none.
In Christ,
The Rev. Anthony Cekada
I'm not taking sides here, but I'm just posting this info for those who don't know. Father Cekada is a sedevacantist.
I'm not taking sides here, but I'm just posting this info for those who don't know. Father Cekada is a sedevacantist.
You seem to be saying that unless a human can receive sustenance orally, any other method is "extraordinary", burdensome, and therefore not mandated.
In 1962--which is when time stopped for you--feeding tubes were considered extraordinary means of preserving life. So was open heart surgery and angioplasty. None of the three could realistically be classified as such today.
To say that a particular action may not be a mortal sin is beside the point. Christians are not called to simply avoid serious sin; we are called to give life the benefit of the doubt, especially when there are caretakers who are willing to assume the "burden" of attending to that life.
There is still considerable theological debate over end-of-life issues. But arbitrarily ending the life of an otherwise healthy woman without a clear and compelling indication that she would have chosen the same in an identical circumstance is morally problematic, to say the least.
If the casuistry of not crossing the line into mortal sin is your idea of moral courage, one is left to conclude that your standard for Christian witness to the world is very low.
Now that we've gotten that out of the way, deal with the principles.
Feeding tubes are no longer an extraordinary means of preserving life. This is not 1958.
Get over here.
ping
Thank you, sinkspur.
Normally one is held to use only ordinary means -- according to the circumstances of persons, places, times and culture -- that is to say, means that do not involve any grave burden for oneself or another. A stricter obligation would be too burdensome for most people and would render the attainment of the higher, more important good too difficult. Life, health, all temporal activities are in fact subordinated to spiritual ends.
Pius XII clearly notes here that ordinary means change "according to the circumstances of persons, places, times and culture". I think sinkspur's critique is penetrating: time hasn't stopped in 1958. As for the supposed "grave burden", in Terri Schiavo's case the "burden" was simply that she'd be alive. There's no reasonable way to construe that as a burden. Banez says, on whether a man has an obligation to be amputated to save himself, "Although a man is held to conserve his own life, he is not bound to extraordinary means but to common food and clothing, to common medicines, to a certain common and ordinary pain: not, however, to a certain extraordinary and horrible pain, nor to expenses which are extraordinary in proportion to the status of this man". Tube feeding is now common. Period.
Thus John Paul II:
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.
All right, I'll bite. What is a sedevacantist?
"Having a hole poked in you, a tube shoved in and then having to eat and drink that way would be burdensome for any normal man."
Burdensome schmurdensome!!! If that were the case then one could argue that the millions of people who use colostomy bags have a license to commit suicide as well, on the basis that they have to put up with holes being poked in them and tubes "shoved in".
Provision of nutrition and hydration, whatever the means, cannot be considered "extraordinary measures". These are basic requirements for life.
I fully agree with the comments made by sinkspur and gbcdoj on this one. If your approach to moral questions is reduced to "can I get away with this without committing a mortal sin?", then sinkspur is quite right - it is casuistry, and it stinks.
Even to ask the question "Is this 'mortally' sinful?" is an admission that the proposed course of action is wrong. To set out with the deliberate intent to commit a sin, particularly where the loss of a human life is the result of that sin, can itself be a mortal sin irrespective of the gravity of the specific action which is proposed.
If any Catholic, or other Christian for that matter, is serious about serving God, they do not ask "How far can I sin without losing my soul?", they ask "How can I do what is right and best and true?".
A sedevacantist is someone who claims that the See (Sede) of Peter is vacant i.e. that the Pope is not really the Pope. He is an invalid claimant to the office.
You aren't qualified to speak for the Catholic Church since you are in a schismatic church-and you SPEAK AGAINST THE HOLY FATHER!!
Again, the pope spoke in favor of feeding tubes as not being artificial life support and should be maintained. Most catholics agreed with him.
Since these are just the pope's opinion, how binding are either of them? Neither was spoken ex cathedra. The catechism deals with both issues, but in generalities and not tailored to the specific cases of the war and Terri Schiavo's unique situation. How binding is that? Where is the magisterium on this and just exactly what constitutes the magisterium?
Catholics are split on many critical issues of our times. The church would have much more influence if there weren't so many dissenters.
One pope says one thing; years later another pope says another thing that disagrees or partially agree with what a former pope said. At different times through history things were permitteddisallowed that are spoken against now, Jews, usury, torture, what constitutes a just war, do you just pick the pope that says what you want him to say?
AC: How do we know you are not an imposter or troll. That screen name is very unusual, and anybody could have chosen it. Whoever you are, I see you just joined up today.
Sinkspur: You are funny. You remind me of a cop calling for backup :-).
Okay - here's your mistake. The judgment on artificial nutrition and hydration was delivered in the course of a Papal Allocution to a conference. Such allocutions constitute an exercise of the Pope's teaching authority, and are routinely published in the Acta Apostolicae Sedis. Thus, what Pius XII says is fully applicable: "But if the Supreme Pontiffs in their official documents (Acta) purposely pass judgment on a matter up to that time under dispute, it is obvious that that matter, according to the mind and will of the Pontiffs, cannot be any longer considered a question open to discussion among theologians" (Humani generis §20).
On the other hand, in the case of the Iraq War, I'd note: I have never seen a quote by the Pope which condemned the war. Yes, the Vatican diplomatic policy was opposed to that, but that's not equivalent to official papal teaching published in the AAS which is clearly intended as binding.
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