Ethicists Do Battle Over Pope’s Comments on Euthanasia, Disabled

Bioethics   |   Steven Ertelt   |   Apr 10, 2004   |   9:00AM   |   WASHINGTON, DC

Ethicists Do Battle Over Pope’s Comments on Euthanasia, Disabled

by Paul Nowak Staff Writer
April 10, 2004

Washington, DC ( — In the wake Pope John Paul II’s proclamation that feeding tubes are necessary medical care for all who need them, Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, reacted writing an editorial for MSNBC entitled, "Must we all die with a feeding tube?" Caplan’s essay is sparking opposition from pro-life advocates.

"The Pope’s order spells trouble for your health care — not only because it threatens to undermine a powerful social consensus in the United States about your right to refuse medical treatment, but also because it means you can no longer be sure whether a hospital will respect your request or that of your loved ones making a decision for you," says Caplan."

Caplan cited the 1990 case of Nancy Cruzan, the Missouri woman who became brain damaged after a car crash.

John Ashcroft, then Attorney General of Missouri, insisted that a feeding tube remain to nourish her, despite her family’s wishes that she be left to die. The Supreme Court ruled that food and water tubes constitute medical treatment, and can be withdrawn if it can be shown that it is the patient’s wish.

Thus, Caplan argues that the Pope’s command on March 20 infringes on the "fundamental" right to control one’s medical care – even if it means one’s own destruction."

But Nancy Valko, a representative of Nurses for Life and a leading monitor of end-of-life issues, disagrees with Caplan’s assessment.

She said that the Patient Self-Determination Act (PSDA), which passed Congress as part of a budget reconciliation bill required health care providers to provide information on legal documents allowing for the withdrawal of medical treatments.

The first living wills, explains Valko, were drafted by an attorney with a euthanasia group to address the refusal of "heroic measures," restricted to when an individual was actually dying and required the patient’s own signature.

After that Cruzan decision, the documents deteriorated in a vague form were instead of only the patient, any "surrogate," such as friends or family, could refuse any medical treatment, even simple a simple IV as a "feeding tube" or antibiotic as "life support," even when the patient is not dying. Even worse, any vague statement by the patient can be taken as "clear and convincing" evidence that the individual wishes to die.

"It also should not be surprising that the Pope’s statement, the Schiavo case, and the now fairly frequent media stories about people waking up after even years in a ‘vegetative’ state are considered threats to the lethal evolution of the so-called "right to die" into what has become really medicalized, private killing with little or no legal or ethical protections for vulnerable people," said Valko.

"Unfortunately, the traditional common sense ethic of neither prolonging nor hastening/causing death is now being misrepresented as an attack on people’s rights," Valko concluded. "In Caplan’s world, the only ethical thing we have to fear is being ‘forced’ to live too long rather than a legal and ethical system that too often believes some people are a waste of health care dollars and really better off dead."

Expanding on the Catholic Church’s pro-life policies on assisted suicide and euthanasia, the Pope stated to the World Federation of Catholic Medical Associations that removing the feeding tube of a disabled patient is immoral and amounts to "euthanasia by omission."

Pope John Paul II also said that the lexicon used to describe such patients — as being in a "vegetative state" was degrading and inhuman.