The prominence of the Terri Schiavo case has brought unprecedented media attention to the Catholic Church's teaching on end-of-life issues. But media portrayals of Church teaching are often inaccurate and misleading, according to two prominent Catholic ethicists.
Father Thomas Williams, dean of the theology department of Regina Apostolorum Pontifical University, and Richard Doerflinger, Deputy Director of the Secretariat for Pro-Life Activities at the United States Conference of Catholic Bishops, both said the Church makes a distinction between ordinary and extraordinary care. The first is always required while the second is not. "The Church teaches that we have a moral obligation to support life," Doerflinger said. "That obligation has limits. People talk about ordinary and extraordinary means. That just means that when the efforts to sustain life start doing more harm than good to the patient the moral obligation ceases to apply. Even then you should never abandon a patient and never deny them the basic care owed to everyone because of their human dignity."
Father Williams quotes from Pope John Paul II's 1995 encyclical, The Gospel of Life, when trying to define extraordinary means. "The Pope uses two sets of terms. For treatment to be considered extraordinary death must be 'imminent and inevitable' and the treatment would result in 'precarious and burdensome prolongation of life.'" An example might be a cancer victim who, after several rounds of treatment, has found chemotherapy to be ineffective and foregoes the treatment in order to avoid its side effects.
Father Williams and Doerflinger said that in some instances it can be extremely difficult to determine the difference between extraordinary and ordinary care and that in such instances people must follow their conscience. But both men said the Schiavo case is clear cut. "From a Catholic perspective, this is an open and shut case," Father Williams said. According to Doerflinger, "food and water should always be seen as basic care," a teaching made abundantly clear in an address by Pope John Paul II in March, 2004, he said.
A recent article in the Washington Post, "Catholic Stance on Tube-Feeding Is Evolving," tried to paint the papal pronouncement, that food and water are basic care, as contrary to the Catholic tradition. The article placed great stock in the teachings of two Spanish theologians of the 16th century, Francisco de Vitoria and Domingo Banez, as proof that the Pope has formulated a novel teaching. Banez "wrote that a sick man could refuse food without risk of committing a mortal sin if he had no hope of survival," the Post reported, and Vitora established "the guideline that 'ordinary' means of medical treatment were obligatory, but 'extraordinary' means - methods that would cause great pain or burdens - were not required."
Father Williams, says the two Spaniards are actually consistent with the teaching the Pope John Paul. "What they said does not mean that one can refuse to consume food for any length of time or refuse food that would save one's life. What they mean is that if you are dying and the food would make you sick to your stomach or you would die anyway, you can refuse the food." But even if Vitoria or Banez were at odds with the Pope, it would not mean that the Pope has made up a new teaching. "The fact is that you can find theologians on any point - even the most settled of moral doctrines like abortion, euthanasia, contraception - who disagree. That does not mean there is doubt or division or that there is not a Catholic position. The Church doesn't work that way. That's why we have a magisterium." Doerflinger, who was interviewed for the Post story, said the article failed to bring up the many statements calling food and water basic care that preceded the Pope's address. "Up until then it had not just been 'conservative' theologians versus 'liberal' theologians. There had been a number of Vatican documents. And there had been statements by the Pro-Life Committee of the US Bishops Conference that is chaired and run by cardinals and archbishops. "
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