Sunday, March 19, 2006
Caring at the End
Paul Lauritzen in Commonweal on the Terri Schiavo case and Catholic teaching about end-of-life care
The Declaration is not much longer than Lauritzen's essay, if you want to read both for yourself. Lauritzen shifts the standard. He puts the judgment of intent in terms of "Do we inevitably intend death" by an act or omission. By contrast, the Declaration, in the context of the use of painkillers which have some risk of hastening death, says "In this case, of course, death is in no way intended or sought... ." ¶ 3/19/2006 01:27:00 PM
To see what assumptions are embedded in the claim that Schiavo was euthanized, it is useful to consider the definition of euthanasia set out in the Vatican's 1980 Declaration on Euthanasia. According to the declaration, euthanasia is "an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated. Euthanasia's terms of reference, therefore, are to be found in the intention of the will and in the methods used."Framed in this way, the Schiavo case throws into sharp relief a central moral question raised by the prospect of withdrawing a feeding tube from any patient in a persistent vegetative state (PVS). Do we inevitably intend death when we remove a feeding tube from a PVS patient?
The Declaration is not much longer than Lauritzen's essay, if you want to read both for yourself. Lauritzen shifts the standard. He puts the judgment of intent in terms of "Do we inevitably intend death" by an act or omission. By contrast, the Declaration, in the context of the use of painkillers which have some risk of hastening death, says "In this case, of course, death is in no way intended or sought... ." ¶ 3/19/2006 01:27:00 PM
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I cannot agree with the author in the rest of his article, though I do agree with the part that you excerpted. Having worked in a Catholic Hospital for more than the first half of my 33+ years as a nurse, at NO time can I say that his final two paragraphs were true. We never ceased offering food and fluids, in anyway we could get them into the patient regardless of the nature of the brain injury that caused someone to be in Terri's situation.
It was stressed both in my training AND in all inservices (further training) at the hospitals) that oral care, offering food and fluids as tolerated were as important as repositioning and skin care. Whether the pt was fed by hand or tube fed, it was NEVER considered to be any manner of extraordinary treatment. It was a basic necessity. I see no 'shift' in the attitudes until recently, and the 'shift' that I see is just the opposite of what this writer seems to be saying.
Tubes have been inserted and removed with no problem for as long as they have been around. The difference with Nancy Cruzan, et all up to Terri Schiavo and beyond is that they are removed without replacing the food and fluids they helped to provide. They are removed solely to facilitate death of the person, for no other reason.
I am not persuaded that there has been ANY shift in Catholic Tradition with JPII's words. Not in my experience.
In the normal dying process, there comes a point where the patient themselves is no longer interested in eating, because the body systems are shutting down. The same thing happens when someone is tube fed. The body can no longer assimilate (use, utlize) the nutrition.
During that process, however, we still OFFERED and attempted to give the patient fluids right up to the time when death was imminent.
Did I perhaps misunderstand what he was saying?
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It was stressed both in my training AND in all inservices (further training) at the hospitals) that oral care, offering food and fluids as tolerated were as important as repositioning and skin care. Whether the pt was fed by hand or tube fed, it was NEVER considered to be any manner of extraordinary treatment. It was a basic necessity. I see no 'shift' in the attitudes until recently, and the 'shift' that I see is just the opposite of what this writer seems to be saying.
Tubes have been inserted and removed with no problem for as long as they have been around. The difference with Nancy Cruzan, et all up to Terri Schiavo and beyond is that they are removed without replacing the food and fluids they helped to provide. They are removed solely to facilitate death of the person, for no other reason.
I am not persuaded that there has been ANY shift in Catholic Tradition with JPII's words. Not in my experience.
In the normal dying process, there comes a point where the patient themselves is no longer interested in eating, because the body systems are shutting down. The same thing happens when someone is tube fed. The body can no longer assimilate (use, utlize) the nutrition.
During that process, however, we still OFFERED and attempted to give the patient fluids right up to the time when death was imminent.
Did I perhaps misunderstand what he was saying?
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