US Catholic hospitals to uphold living wills

Cathnews.com ^

[narses]

Catholic hospitals are reassuring patients they'll honour living wills in the wake of a papal pronouncement that hospitals should never remove feeding tubes from patients in persistent vegetative states.

Pope John Paul II said last month that feeding and hydrating such patients is "morally obligatory" - and that withdrawing feeding tubes constitutes "euthanasia by omission". Since then, US bishops, theologians and ethicists have been studying the issue closely to see what the pope's words will mean for hospital operations in the United States.

For now, many hospitals are deferring to the "Ethical and Religious Directives for Catholic Health Care Services" - commonly called ERDs - outlined by the U.S. Conference on Catholic Bishops.

According to those guidelines, feeding tubes for people in chronically vegetative states are "medical treatment" that can be continued or halted based on the benefits and burdens for patient and family.

Such guidelines call for following directives set out in advance by people who do not want life-prolonging medical treatments - as long as the person's wishes don't conflict with Catholic moral teachings, including the church's ban on euthanasia.

The pope's remarks came during a Vatican symposium on caring for people who are incapacitated. They are significant but do not carry the weight of an encyclical - the Vatican's most authoritative level of teaching, reserved for matters of extreme importance to the church.

"We have to figure out more specifically what he meant and the implications. I think it's too soon to tell; there are a lot of filters to go through," said Dan Dwyer, director of ethics for the St. John's Health System in Springfield, Missouri.

The pope has consistently opposed euthanasia, defined by the Vatican as "an action or omission that by its nature and intention" causes death to end pain.

Many public and private hospitals have honoured living wills - written declarations by people who say in advance they don't want life-prolonging treatments - since the US Supreme Court ruled in 1990 that vegetative patients could be allowed to die if there was "clear and convincing" evidence that was their wish.

[narses]

Pope John Paul II said on Saturday that the removal of feeding tubes from people in vegetative states is immoral, and that no judgment on their quality of life could justify such "euthanasia by omission".

The Holy Father made the comments to participants of a Vatican conference on the ethical dilemmas of dealing with incapacitated patients, entering into a debate that has sparked court battles in the US and elsewhere.

He said even the medical terminology used to describe people in so-called "persistent vegetative states" was degrading to them. He said no matter how sick a person was, "he is and will always be a man, never becoming a 'vegetable' or 'animal."'

[narses]

Catholic Hospitals REJECT the Pope. Schism? Or is this what Walter Cardinal Kasper calls "pluriformity within unity"?

[drstevej]

***"pluriformity within unity"***

sigh.... words fail me in the contemplation of the euphemistic chutzpah of this term.

[JulieRNR21]

FYI......PING

[narses]

The most learned Cardinal does have a way with words.

"After the first wave of enthusiasm, there is now much disenchantment at unfulfilled expectations Ecumenism seems to be in crisis. This state can either be positive or negative. A crisis situation is a situation in which old ways come to an end, but room for new possibilities open which points to the very heart of a healthy ecumenism: spiritual ecumenism and ecumenical spirituality. This means, first of all, prayer, for we cannot 'make' or organize church unity: unity is a gift of God's Spirit, which alone can open hearts to conversion and reconciliation. This kind of ecumenism is not restricted to the realm of selected experts; it is accessible and obligatory for all. When it comes to prayer, all are experts, or rather all should be experts."

Cardinal Kasper is President of the Pontifical Council for the Promotion of Christian Unity at the Vatican. Above is a very edited version of his address In England in May of 2003, as reported in the Church Times (May 23, 2003).

_____________________

Cardinal Kasper on Anglican/Roman Catholic Relations
(From the Church Times, May 23, 2003)

"[Cardinal Kasper said:] 'This concept of pluriformity within unity has consequences for our understanding of unity in faith. To confess the same faith does not necessarily mean to confess the same credal forumal'

Dr Kasper spoke of 'a new re-evaluation of Apostolicae Curae' After the conference he said, 'I think it should not be so difficult to come to almost a partial recognition of the episcopal ministry on both sides. We are no longer at the position of Leo XIII with his bull. A partial recognition is there. The Pope gave the Archbishop [of Canterbury] a gold [pectoral] cross-I have only a silver cross-and this is a symbol which is meaningful we are not in full communion, but we are in a high degree of profound communion.'"

From http://www.anglican-romancatholic.com/Ongoing_2004.htm

[TheBattman]

I have a question -

Is a feeding tube considered "extra-ordinary" means to maintain life?

After all, it's still the patient's body digesting and absorbing the nurishment.

My personal view on "extra-ordinary" means is using a resparator or a device to keep blood flowing because the body is no longer capable of doing this.

[narses]

According to whom? "Catholic" hospitals appear to think that food and water are "extra-ordinary". The Pope does not. Nor do I.

[cyn]

Thanks for the ping!

"...as long as the person's wishes don't conflict with Catholic moral teachings, including the church's ban on euthanasia." -- interesting . . .

Update on today's court hearing on Terri Schiavo -- floriduh voter got to meet and thank Ken Connor, who represented Gov. Bush & was speaking on Terri's behalf.

There is a need to keep up email/phone call pressure for Terri. Her parents have not seen her in 3 weeks! She is missing (at least) 2 (TWO) teeth and has a decubitus ulcer, either of which can result in a life-threatening infection.

[Drango]

The popemister rocks , but sometimes I wonder if the holy spirit is taking to him.

[cyn]

"My personal view on "extra-ordinary" means is using a resparator or a device to keep blood flowing because the body is no longer capable of doing this (. . .and that a feeding tube is not extraordinary)."

Right! and that's what most folks think, too. Which is why those living wills being touted as the answer are in fact part of the problem -- people do not understand what they might be allowing!

In fact, in FL, it wasn't until '97 or so that the FL legislature changed the statute so that a feeding tube was considered 'extraordinary' means. I did a literature search a while back; JAMA and other sources started [(more) openly] discussing this in the early 90's.

We are truly descending that slippery slope. It will have my claw marks in it.

[hocndoc]

Tubes and IV's require the insertion of foreign objects into the body of a person. People who are capable of informed consent have the inalienable right to refuse invasive procedures and manipulations.

The problem with Terri Schiavo is that, first, she's not in a vegetative state, and second, she never made a legal declaration as to her wishes.

[Clinging Bitterly]

They have been honoring so-called living wills at our local R.C. hospital for years. Indeed, on admission they will give you the advance directive paperwork and allow you to decide just how "heroic" you want them to be should the sad circumstance arise.

I'm not sure how this supposed new directive from the Pope would change that. Five or six years years ago the last nun to be in charge of the place retired, and they have an actual MBA type bean counter in the spot (although Sister Monica was a well educated professional business manager herself). But much to the chagrin of some of the local enemies of the hospital (a small crowd who have been very vocal opponents of the hospital's recent plan to expand and relocate), there is at least one "medical procedure" that is not likely to be performed on it's property anytime soon (but I digress).

To me, there's a difference between allowing a dead person to go in peace, and the more active practice of giving drugs to end life. I want to live my life and experience the whole thing, but when I leave consciousness that final time, I don't want people fighting to keep me breathing. I have the right to decline any form of treatment, and I think it's fair to expect any medical professional to honor that right.

[Ronaldus Magnus]

I have the right to decline any form of treatment, and I think it's fair to expect any medical professional to honor that right.

Fair enough, but don't expect this from a Catholic hospital for long. The Pope's statement was clear, as is his authority. It may take a few months or even years for this policy to be enforced upon the rebellious dioceses, but it surely will be. Those who disagree should simply avoid Catholic hospitals (and sadly perhaps, also the Eucharist).

[narses]

"Fair enough, but don't expect this from a Catholic hospital for long."

Interesting take. I hope you're right. Me, I sort of wonder if there are any Catholic institutions left in America. "Catholic" hospitals announce they'll defy the Pope and allow people to be starved to death in their once hallowed halls. How hideous.

[Ronaldus Magnus]

Me, I sort of wonder if there are any Catholic institutions left in America.

The gates of Hell will not prevail against Her, but that doesn't mean that it won't appear that they have from time to time.

[Future Useless Eater]

For now, many hospitals are deferring to the "Ethical and Religious Directives for Catholic Health Care Services" - commonly called ERDs - outlined by the U.S. Conference on Catholic Bishops.

Thanks for the post. I wonder what this same U.S. Conference on Catholic Bishops would say in a HYPOTHETICAL case, such as, lets say...

• if a HUSBAND takes on a NEW FIANCEE in 1996, and
• THEN he '(wink/wink) remembers' TWO YEARS LATER, in 1998, that his WIFE had 'wanted to die' if in a severely disabled condition,
• THEN he BUYS a HOUSE with the NEW FIANCEE,
• AND they live together out of wedlock,
• AND they have TWO CHILDREN together out of wedlock.

Would THAT be a simple enough 'hypothetical' case for these Bishops to go out on a limb, and take a stand????

For more info on this "HYPOTHETICAL" case, look HERE.

---

(the SILENCE of the U.S. Catholic Church is deafening!!! )

But hey wait... I thought a MAJOR difference between the Catholics and the LUTHERANS, was that the Catholics are 'supposedly' RULED by the POPE!
Was there a revolution, and I missed it?

[Future Useless Eater]

...a papal pronouncement that hospitals should never remove feeding tubes from patients in persistent vegetative states.

Hmmmm, I wonder what part of 'NEVER' the U.S. Bishops do NOT understand?

Or maybe it's the word 'PAPAL' they fail to understand...

---

But on conservative issues like NO GAYS as church ROLE-MODELS for children (like in the priesthood), they SURELY would understand that right?
...oops, no sorry, they don't 'get' that either.

I can't WAIT for my bishop to send around this year's Annual Appeal.

[AnimalLover]

Bump

[narses]

I'm curious as to the opinions of the "everyday" Catholic on this subject. Many of my friends feel that we OUGHT to be able to put in writing instructions that allow others to starve us to death if we cannot answer for ourselves. I have never fealt that, and in light of HH opinions I am more than ever certain it is wrong. Your thoughts?

[Clinging Bitterly]

"Catholic" hospitals announce they'll defy the Pope and allow people to be starved to death in their once hallowed halls. How hideous.

I dunno about that. At least in my locale, hospitals are certified by the state medical boards, it is sort of a controlled market and each one serves a specific geographic area. Sacred Heart Medical Center is the area's main regional hospital and has every intention of remaining in that top spot. One of the standards the market has made clear they expect is the right to refuse treatment, and that is a professional standard that a medical facility will uphold if it expects to remain licensed. Besides, the order that owns the hospital is conducting a specific mission, which is to relieve human suffering, and they seem bent on doing just that regardless of archaic religious doctrines.

The concept sort of pushes the envelope though, because some do argue that things like abortion should be classified as services that should be universally available, but the community hasn't mandated that - the argument is it is not an issue of suffering and I tend to agree - so it is an area that the professional facilities are left with their own convictions to decide. This hospital will not allow one to be performed in it's facilities, but non Catholic staff members may perform them in their own private facilities if they desire. But it seems they don't desire - in this town you can't get one. The last clinic to do them here shut down a couple years ago, saying the insurance to cover them was too expensive (which, of course, it wouldn't be if abortion were truly a "safe" procedure).

I predict the hospital's policy WRT advance directives will not change. I am not Catholic, but from the outside I think Pope John Paul II has had a long and successful tenure, he seems to have done very good service for the church and it's image on the world stage. Still, I don't think he has always been right, as no man could be, for surely the word of God would not dictate that a human suffer prolonged agony being kept alive artificially, when it would seem more proper to spend his or her final hours in a peaceful, natural death. I think the Sisters agree with me, and that they will wait this one out & see what the Pope's successor has to say on the issue.

Dave in Eugene