Although some see Pope John Paul II’s message at a recent Vatican conference as closing the book on the question of whether nutrition and hydration may be withdrawn from patients in a persistent vegetative state, others in U.S. Catholic health care circles think resolution of the issue still remains elusive.
The administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act, the pope said during an address on March 20 to more than 350 physicians and medical ethicists from 42 countries.
Some U.S. ethicists and hospital administrators have called the papal talk a stunner, to say the least and a disaster with the potential to create a lot of chaos for both patients and Catholic institutions. The Rev. Michael D. Place, president and C.E.O. of the Catholic Health Association, responded more cautiously, saying in a statement that Pope John Paul’s speech affirms the church’s and the Catholic health ministry’s abiding commitment to the inviolable dignity of human persons no matter their physical or medical condition and reminds us of our responsibility never to abandon the sick or dying.
That being said, the guidance contained in his remarks has significant ethical, legal, clinical and pastoral implications that must be carefully considered, Father Place added. This will require dialogue among sponsors, bishops and providers, especially with regard to practical implications for those patients who are not in a persistent vegetative state.
Pope John Paul’s speech has significant implications for U.S. cases like that of Terri Schindler-Schiavo, the Florida woman whose parents have been fighting her husband’s attempts to withdraw her feeding tube. Schiavo, now 40, remains in a nursing home 14 years after her brain was deprived of oxygen for several minutes because of what doctors believe to have been a potassium imbalance. Some now characterize her condition as brain-damage, while others say she is in a coma or in a persistent vegetative state.
Richard Doerflinger, deputy director of the U.S. bishops’ Secretariat for Pro-Life Activities, attended the conference on Life-Sustaining Treatment and Vegetative State: Scientific Advances and Ethical Dilemmas, held on March 17-20 at the Vatican. Doerflinger said the position articulated by Pope John Pauland at a pre-conference news briefing by Bishop Elio Sgreccia, vice president of the Pontifical Academy for Lifeshould not have come as any surprise to those who have followed recent pronouncements on the issue by the Vatican and the U.S. bishops.
People reading the tea leaves should have seen this coming down the pike, he said. The trend has been there for a long, long time. According to Doerflinger, there has been a shift from a presumption against the continued use of artificial nutrition and hydration for a patient in a persistent vegetative state to a presumption for its use.
Before Pope John Paul spoke, Bishop Sgreccia’s comments at a Vatican news briefing on March 16 drew a strong protest in a statement written by Kevin O’Rourke, O.P., a professor of bioethics and health policy at Loyola University Chicago, which was circulated among U.S. health care ethicists for their endorsement. The magisterium has never maintained that prolonging the life of a patient in P.V.S. is beneficial to the patient,’ it said. According to excerpts published in some media reports, the statement said Catholic tradition holds that life support may be withdrawn if it does not offer hope of benefit or imposes an excessive burden.... The decision concerning hope of benefit is to be made by the patient or the patient’s proxy, it added. A representative of the church may offer guidance, but should not pre-empt the right of patient or proxy.
Father O’Rourke declined to discuss the statement or make it public. I did not respond to the statement of the Holy Father, nor do I intend to do so at this time, he said in an e-mail message to CNS on April 6.
The guiding principles for ethical decision making in Catholic health care in the United States remain the Ethical and Religious Directives for Catholic Health Care Services, as revised by the U.S. bishops in 1994. There should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient, the directives state. Unless they are revised again by the U.S. bishops, these directives still apply to U.S. Catholic health facilities, Doerflinger said, but some interpretations of the Ethical and Religious Directives should now be considered invalid.Bishops to Review 2004 Sexual Abuse Audit Plan
When they meet this spring, the U.S. bishops will review a plan for the 2004 audit of their dioceses’ policies and practices on sexual abuse and child protection. Kathleen McChesney, executive director of the U.S.C.C.B Office of Child and Youth Protection, said she hopes the new audit instrument will provide data for future annual reports to update yearly the data gathered separately last year on the nature and scope of sexual abuse of minors by members of the Catholic clergy in U.S. dioceses during the period 1950-2002. From that you’ll be able to show where progress has been made, she said.
The bishops’ Charter for the Protection of Children and Young People of June 2002 requires McChesney’s office to produce an annual public report on the progress made in implementing the standards in this charter in every diocese across the country.Catholic Voters Nearly Divided Between Bush and Kerry
An early poll shows Catholic voters are probably neither more likely nor less likely than the general population of Americans to vote for the first Catholic presidential candidate in 44 years.
In a national poll of Catholics conducted by telephone in March, the Center for Applied Research in the Apostolate at Georgetown University found that about 46 percent said they would vote for Senator John Kerry, Democrat of Massachusetts, in November, compared with 41 percent who would vote for President Bush, a Republican. A poll of voters nationwide taken by Zogby International the same week found the percentage voting for Bush and Kerry to be equal, at 46 percent each. Since the statistical margin of error for both polls is about plus or minus 3 percent, so far in this election year Catholic voters differ little from the general public in their presidential election choices.
The number of Catholics who said they would vote for Kerry nearly matches the figure of 47 percent, who said in a pre-election poll in 2000 that they would vote for the Democratic nominee, Vice President Al Gore. Mark Gray, a CARA researcher, said that among the more surprising findings of the March 15-21 poll of 1,001 Catholics was how few of them were undecided about who they will support in an election that at the time of the poll was still nearly eight months away. CARA’s poll found about 10 percent of voters were undecided. About 3 percent said they were likely to vote for the independent candidate Ralph Nader. Gray said that in spring 2000 many more voters were undecided between Gore and Bush, who by then had clinched their respective party’s nominations.
The Catholic vote, according to the CARA poll, seems to be less about religion and more about party identification, Gray said. About 40 percent of those Catholics polled who said they intend to vote in November said they were Democrats. About 33 percent consider themselves Republicans.
CARA found Kerry’s strongest support among Catholics to be from Democrats (81 percent would vote for Kerry) and Hispanics born in the United States (56 percent supported Kerry). Half of those born after 1982 said they would support Kerry.
Gray found that Catholics who attend church more often were more likely to support Bush than Kerry. Forty-five percent of weekly Massgoers said they would vote for Bush, compared with 41 percent who said they would vote for Kerry. More of those who go to church a few times a month were likely to support Kerry: 44 percent, to 42 percent for Bush. Fifty-one percent of Catholics who go to church a few times a year or never would vote for Kerry, compared with 36 percent who would vote for Bush.Sex Scandal Affects Attitudes Toward Religion
The scandal of sexual abuse of young people by members of the Catholic clergy has had a profound effect on the public’s attitude toward organized religion, said Albert Winseman, religion and values editor for The Gallup Organization in Atlanta. Since 1941 Gallup has quantified the religiosity of the American public with its index of leading religious indicatorsa compilation of responses to a series of questions on religious beliefs and practices, ranging from whether the respondent is a member of a church and attended church in the last seven days to his or her confidence in organized religion and opinion about the ethical standards of clergy. With a highest possible score of 1,000, the index reached an all-time high of 746 in 1956 and a historic low of 641 in 2002, but rebounded slightly to 648 in 2003, Winseman said.
He also reported polling data showing that 77 percent of Americans disapprove of the removal of the Ten Command-ments from government buildings, as has occurred in Alabama and other states, while 78 percent approve of nondenominational prayer at public school graduation ceremonies, which has been banned in some locations.
Asked about a display of the Koran, the Muslim holy book, in government buildings, 64 percent said they would disapprove. Fifty-six percent said they disapproved of the use of federal funds for social programs run by Islamic organizations.Boston College to Buy Archdiocesan Property
In a deal described as a win-win for both parties, the Archdiocese of Boston and Jesuit-run Boston College announced on April 20 that the university has agreed to purchase 43 acres of archdiocesan land for $99.4 million. The property includes the former archbishop’s residence and other buildings. The archdiocese put the Brighton property, just down the street from the Boston College campus, on the market last December to pay off $90 million in loans the archdiocese took out to pay off settlements in cases of sexual abuse by members of the clergy with more than 500 plaintiffs.
The two parties also agreed that the university will purchase the neighboring archdiocesan tribunal property in two years for $8 million. The building on that parcel houses the archdiocesan tribunal, or church court, and religious education offices. The agreement also commits Boston College to the purchase of the remaining chancery property for $20 million and the remaining St. John’s Seminary property for $40 million or more if the archdiocese should decide to sell either of those properties within the next 10 years.News Briefs
In 2003, 42 terminally ill Oregonians died using lethal prescriptions written by physicians, according to a report released earlier this year by the Oregon Office of Disease Prevention and Epidemiology. That compares with 38 who died in 2002, the previous high mark. Since the law went into effect in late 1997, 171 people have used it.
In a letter dated April 13, Bishop Wilton D. Gregory of Belleville, Ill., asked President George W. Bush to support bills that would give some foreign-born farmworkers and some undocumented high school students a chance to become legal permanent residents. Bishop Gregory also asked the president to modify his proposals for a guest worker program so that it would provide a path to legal permanent residency for illegal immigrants already in the United States.
In a letter on April 8, the New York-based Anti-Defamation League has urged Israel’s Interior Minister, Avram Poraz, to resolve the backlog of visa renewals for Christian clergy working or residing in Israel. During the first three months of 2004, for example, 52 Catholic religious were denied visas, bringing the total to 138 religious who are still trying to obtain permission to work in the Holy Land.
The wildly popular Left Behind series of Christian apocalyptic novels denies a number of Catholic teachings and is both subtly and overtly anti-Catholic, says an article in The Living Light, an official quarterly publication of the U.S. bishops’ Department of Education.
About 1,350 U.S. parishes say they support a poor parish in the United States or abroad, according to a report by the Center for Applied Research in the Apostolate. Of the parishes supported abroad, 83 percent are in Latin America.