Give Life the Benefit of the Doubt

By Matt Bowman

The Catholic Hospital Association of the United States is again being criticized for promoting a position on a controversial sanctity of life issue that errs against life instead of for life. In October, I critiqued a CHA position paper on “emergency contraception” (chemical abortion) because, among other reasons, it adopted the pro-abortion euphemism “established pregnancy,” even though that phrase is used prominently to justify killing embryos after conception but before they implant in the womb. Shortly after my criticism was posted, CHA removed the problematic policy from their website; they did not repeal or fix the policy, they just made it harder for the public to know where they stand. (Fortunately, nothing is ever lost on the internet, and I have a saved version of the policy that I will try to post here later.)

Now CHA has posted a statement disagreeing with the Vatican’s position that food and water should not be withheld from disabled patients such as those in a “persistent vegetative state. The Vatican’s recent statement takes the side of life in resolving this contentious dispute, just as a different recent statement by the Pope chooses the side of life against chemical abortion. CHA’s newly posted paper, available here (unless they remove this one too), goes to great lengths to construe the Vatican’s position unreasonably narrowly, and even to reject it as being “at odds with the traditional teaching of moral theology”.

Thankfully, canon lawyer Dr. Ed Peters explained this week that the theologians in CHA’s magazine don’t seem to know canon law or the Church’s teaching documents. The theologians tried to use provisions 18 and 52 of the Code of Canon Law to construe the Vatican’s document so strictly that it would not protect many disabled patients. But Dr. Peters points out that Canons 18 and 52 only limit church law (“discipline”), whereas the Vatican’s statement on nutrition and hydration was a document on morality (“doctrine”), not law. Dr. Peters gives a history of the debate and describes several other basic errors in the theologians’ commentary (for example, the theologians say that the Vatican statement only applies in the US, as if morality is different in different countries, and despite the fact that the Vatican published the statement in eight languages).

The substantive moral issue at hand is this: if a person becomes cognitively disabled so that he or she can’t eat except through a tube, but that person is not dying, can you withhold feeding them by a tube? The Vatican said no, because food and water are ordinary care, like cleanliness and air. There are exceptions if you change the situation–such as if delivering the food itself causes harm or pain, or if the body rejects it, or if you’re in a third world country with no access to tube feeding. This view makes sense. My nine week old baby can’t feed herself, so if we “withhold” food from her we are not “letting her die”–we are killing her by starvation. If an adult can’t eat because of a disability, food and water are still ordinary care. [For further discussion, pick up A Will to Live: Clear Answers on End of Life Issues, by Most Reverend Jose H. Gomez, STD, Archbishop of San Antonio (Basilica Press 2006).]

Theologians on the wrong side of these debates are not satisfied with church clarifications. The theologians on CHA’s website claim that the mere “psychic burden” of being cognitively disabled, and the related “burden upon the loved ones giving care,” justifies withholding tube feeding and thereby causing death by starvation. This is exactly the conclusion that the Vatican statement rejected. A comatose person’s life, and our need to care for him, is not a burden that justifies starvation any more than it justifies suffocation. I fail to see how this line of reasoning does not in principle justify suicide. If a teenager suffering from depression decides not to eat because life is too much of a “psychic burden,” the compassionate response would be to care for her and feed her forcefully if necessary, not give her an air conditioned room to die in.

The theologians also emphasize that sometimes people “designat[e] in advanced directives or by oral communication” not to receive food and water in a tube if they become cognitively disabled, and this justifies withholding it. This view ignores the fact that many people who sign “living wills” don’t necessarily understand that it might mean that they are choosing to starve themselves to death when they are not dying. Even worse, however, is for these theologians to legitimize “oral communications” as a justification for withholding food and water. As seen in the Terri Schiavo situation, this loophole practically invites claims like “my wife, who I am no longer faithful to, once told me she would not want to live this way.”

In bioethical controversies at the beginning and end of life, it is important to err (if one must err) on the side of life, not against it. Some Catholic Bishops in Wisconsin recognize this, and they issued a letter this week opposing a law mandating that doctors dispense chemical abortion. Giving life the benefit of the doubt does not mean being uncompassionate or imposing excessive burdens on people. It means not relieving burdens by considering life itself a burden, and not killing the weak or inconvenient even when excuses can be made that you are not really killing.