Schiavo: The Moral Dilemma

Was it wrong to pull Terri Schiavo's feeding tube?

The ethical question is not as clear cut as it may appear.

On the one hand, the Catechism teaches that euthanasia is murder:

“Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded” (No. 2277).

On the other, the Catechism would not condemn a family that avoided using extraordinary means to preserve the signs of life in a person:

“Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected” (No. 2278).

In the Catechism, one of the key concepts in such cases is “ordinary care”:

“Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted” (No.2279).

Dr. Daniel Sulmasy, a Franciscan Brother who is head of medical ethics at St. Vincent's Medical Centers in New York, said the Schiavo case is not simple.

He said that Catholic teaching does not demand that patients be kept alive as long as possible. Although some Catholic ethicists insist that medically assisted nutrition and hydration is always obligatory, he told the Register, “my view is that it falls under the category of ordinary or extraordinary care, and therefore is not always obligatory.”

Determining the difference would be a prudential judgment, according to Dr. Sulmasy, and would have to consider whether nutrition and hydration were doing the patient any good.

He could not make a judgment in the Schiavo case because he didn't know all the medical details, he said. At the heart of the case, he added, was a “bitter dispute” between family members who both claim to speak for the interests and intentions of Terri.

The Catholic Medical Association, with access to more information, was less unsure.

In an Oct. 17 resolution passed at its annual meeting and conference in Philadelphia, the Catholic doctors’ group condemned the court order that the feeding tube be removed. “The court decided to remove the feeding tube without first undertaking rehabilitation therapy to ascertain her ability to swallow and digest nourishment,” the resolution said. The court order amounted, therefore, to “depriving her of life without due process of law.”

Stephen Vincent