Thanks to my religious brother, Daniel Sulmasy, for his article “Preserving Life?” (December 7, 2007). By providing the context for the August 1 Vatican document on hydration and nutrition for patients in a persistent vegetative state (PVS), Sulmasy helps us understand the direction taken by the Congregation for the Doctrine of the Faith (CDF).
Under the critical light of the maxim “Good ethics begins with good facts,” I would like to supplement Sulmasy’s article by zeroing in on the faulty reasons given by the CDF to support its arguments. First, hydration and nutrition differ significantly from each other, physiologically and medically. We die within a few days without hydration; we die within weeks without food. Invasive medical procedures can vary by partially or totally bypassing the digestive tract.
Second, the CDF seems to underplay the “burden” of maintaining a PVS patient. The “skilled care” required by a PVS patient does not come cheaply: from $63,000 upwards a year in the United States. This is a heavy burden even in societies that don’t suffer from the “extreme poverty” the CDF considers as an exception to providing such care. Third, the CDF states that if the invasive medical procedures for delivering hydration and nutrition are removed, the sole cause of death for a PVS patient is “starvation and dehydration.” In effect, the CDF denies that PVS is itself a cause of death. Medically, the CDF is wrong. If a PVS patient will die naturally unless invasive procedures are used, that means that the PVS is indeed the initial natural cause of death.
Finally, Jesus’ example offers us another viewpoint. In Eucharistic Prayer II, the priest begins the words of institution with: “Before he was given up to death, a death he freely accepted, he took bread...” Jesus, the very best of moral theologians, “freely accepted” death. Can’t we do the same?
JOHN L. OSTDIEK, OFM
NOT A THEOLOGICAL QUESTION
Daniel Sulmasy’s finely nuanced analysis boils down, for me at least, to this: the Vatican chose once more to be “politically” correct at the risk of being logically, and perhaps theologically, incorrect.
In catechism, we learn that our purpose in life is to know, love, and serve God, and thereby merit eternal life in heaven. But in a permanent vegetative state this is, by definition, impossible. True, the person remains a human, but his acts, while still those of a human, are no longer specifically human. Essentially, the person in PVS can no longer think or love in a human way; the person can neither sin nor gain merits for the life to come. Further maintenance of purely vegetative functions serves no theologically justifiable purpose; indeed it may be a form of injustice, since it delays the soul’s union with God.
Splitting hairs about ordinary-versus-extraordinary or natural-versus-artificial measures of survival seems completely beside the point. The real issue is: How certain can we be that the person is in a vegetative state and not merely unable to communicate? And even if his condition is truly vegetative, how certain is its irreversibility?
Such questions must be answered by human physiology and psychology, regardless of the inherent tentativeness of these sciences. Theological edicts or legislative fiats are as irrelevant here, and therefore as preposterous, as they were in the trial of Galileo. They only serve to give needless scruples to the conscientious and more fuel for ridicule to the scofflaws.
EDMUND F. KAL, MD
RESPONDING TO EXTREMES
Daniel Sulmasy’s article is helpful in setting out the European and American context for the response of the CDF to the American bishops. Troubling, however, is his note that the response should be understood as an “extreme position to counter extreme positions supporting euthanasia.” The question is, does responding to one extreme with another help resolve the issue? Will proponents of euthanasia be in any way persuaded of the problematic nature of their arguments by the Response’s extreme position? Will this statement even be meaningful to the extremists in the prolife movement who seem to hold biological life as an almost absolute value? If Sulmasy’s interpretation is correct, there is room to negotiate withdrawing a feeding tube from someone like Terri Schiavo—but would this statement be enough to hold off yet more attempted state and federal interventions, more misdiagnoses by those with only questionable medical knowledge of the case, and perhaps even another post-bedtime intervention by a president? Responding to extremes with extremes typically causes one to overlook the moral nuances of the tradition, the case, and the arguments that need to be made.
THOMAS A. SHANNON
Eagles Mere, Pa.
A MIXED BAG
Congratulations to Paul Stanosz for his courageous realism in addressing the crisis of health and morale among today’s Catholic priests (“The Other Health Crisis,” November 23, 2007). His analysis of the dire situation is accurate and unflinching. At the same time, I am disappointed that in rejecting “the progressives’ agenda” as a recipe for the revival of the local church, he sees fit to lump together “woman’s ordination, married clergy, same-sex unions, the easing of divorce restrictions, and the acceptance of abortion under certain circumstances.”
Each of these items needs to be assessed separately, and while some may have no direct bearing on restoring the health of the church, some might. The call for married clergy is sheer pragmatism. And the movement for women’s ordination is not fired by the progressive spirit, but by the cold, hard calculation that the so-called theological arguments against women’s ordination are just so much wind—as opposed to the breath of the Holy Spirit, which is also not the exclusive possession of progressives, but which seems to be calling quite a number of women forward for ministry. The progressives’ agenda may not be a quick fix, but items from that agenda might help just a little.
NO SILVER BULLET
Paul Stanosz offers an accurate and honest assessment of the morale crisis afflicting priests today. He also avoids pointing a finger at any alleged culprit. As he says, “large social, cultural, and economic forces ... have contributed to Catholicism’s decline.” We would do well to reckon honestly with this shift and, especially, to stop kidding ourselves about possible future improvement in vocations to the priesthood and religious life.
In fact, these kinds of prognostications serve to promote the kinds of problems in the seminaries and religious houses of formation that Stanosz describes.
I entered the Jesuits in 1984 and was ordained in 1996. I have little memory of the pre–Vatican II church and no nostalgia for it. I was blessed with a formation that taught me development of doctrine in a Catholicism that, as Stanosz says, is evolving. Thanks to Commonweal for continuing to allow these ideas expression.
TOM BRENNAN, SJ
PHILOSOPHER & TEACHER
I enjoyed E. J. Dionne’s description of Gene McCarthy as “a radical in defense of tradition” (“The Promise & Limits of Politics,” November 9, 2007). But I feel obliged to add that McCarthy was also a dedicated teacher and philosopher.
As a freshman at the University of St. Thomas in 1948 when Professor McCarthy made his first run for Congress, I was mainly a spectator in the exciting campaign as he was prodded to run against a three-term incumbent, Edward Devitt. Finally persuaded to run in the primary, McCarthy energized the student bodies of St. Thomas, Macalester, and Hamline to take over the precincts, wards, and finally the Ramsey County Democratic Convention in a preview of the 1968 “clean for Gene” presidential campaign. When McCarthy was elected to Congress, he inspired many of the students who led the campaign to become lifelong political activists and officeholders.
His role as a philosopher was evident whenever he revisited the St. Thomas campus to speak with students in large and small groups. His views on government were philosophical, fresh, and sometimes contrarian—something that didn’t always delight the Humphrey wing of the Minnesota Democratic-Farmer-Labor Party.
ANTHONY A. WIGGINS