A Jesuit bioethicist believes the religious right is exploiting Terri
Schiavo and that there is no moral or legal obligation to keep her alive.
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!