The National Catholic Review
To the Editors

We are surprised and alarmed that America’s editors made numerous unauthorized changes to our article in the August 4-11 issue that explains the recent Response from the Congregation for the Doctrine of the Faith (CDF) on assisted feeding for patients diagnosed as being in a “vegetative state.” The changes are especially troubling because, as we said in our original text, we were writing to correct past articles in America that “have misinterpreted the Response itself, prior Church teaching on the obligation to sustain life, or both.” Even that statement about our purpose was changed by the editors without our consent.

Our title was changed to “Human Dignity and the End of Life,” although we hold that the so-called “vegetative state” is not “the end of life” and is not a terminal illness in the usual sense. Rather, patients in this state are wrongly seen by some as being at the end of a humanly meaningful life, even when they can survive a long time with continued feeding. With Pope John Paul II and the CDF, we reject use of this analogy to the dying state to justify withdrawing nourishment.

The editors also rewrote some paragraphs to produce a substantially different conclusion. For example, at one point we criticize the view that assisted feeding can be judged to be unduly financially “burdensome,” not because of the expense of the feeding itself (which is usually not great), but because of the expense of the total care of a patient who survives in a “vegetative state.” In response we write:

“By omitting food and fluids, what are we trying to achieve? What “burden” are we trying to ease? The CDF’s critics admit that assisted feeding is often not difficult or costly to provide in itself. They refer instead to the housing, nursing care, and other basic needs of a helpless patient who may never be able to care for himself or herself again. Rather, discontinuing assisted feeding frees us of these burdens only in the sense that it ensures that the patient dies, and hence is in no need of any care. Against this proposal the Church insists that we may not directly intend a patient’s death, as a good in itself or as a means to another end, whether we pursue this end by action or omission.”

The editors rewrote this as follows:

“By omitting food and fluids, what are we trying to achieve? Whose “burden” are we trying to ease? Assisted feeding is often not difficult or costly to provide in itself, but the housing, nursing care and other basic needs of a helpless patient can be significant. To discontinue assisted feeding in order to be freed from such burdens puts the caregiver’s interests ahead of the patient’s, even if we prefer not to recognize the reality of our choice.”

This changes our conclusion and misses the point. The moral problem here is not that of selfishness or willful ignorance, but that of intending the patient’s death (which is gravely wrong whether done for selfish or “altruistic” reasons).

Our message has been distorted in many other passages. Where we write that the Congregation affirms an obligation to provide assisted feeding except in rare cases, the editors suggest that the Congregation was affirming not the obligation but only the exception—and they delete our statement that this exception applies only in “rare cases.” Where we criticize the claim that a patient’s lack of cognitive ability exempts us from the obligation to sustain life, the editors erroneously say that such a claim rests on whether a patient is “capable of interaction with other persons”—and they remove phrases making it clear that we reject this view. Twice the editors gratuitously insert the word “difficult” when referring to the moral obligation to provide food and fluids.

While we could add many other examples, we believe the only adequate solution is to republish the article as we wrote it. Only in this way will our original text be clear and readable in context.

Sincerely,

Most Reverend William E. Lori

Bishop of Bridgeport

Chairman of the Committee on Doctrine

His Eminence Justin F. Rigali

Archbishop of Philadelphia

Chairman Pro-Life Activities

From the Editor in Chief

America sorely regrets the distorting changes noted by Cardinal Rigali and Bishop Lori in their article in the Aug. 4-11 issue. For that reason, we are publishing here the cardinal and bishop’s letter to us and the unedited text of their manuscript.

The copy editor made changes that altered the meaning of key passages in the original without consulting with the authors or alerting other editors handling the later stages of the article’s preparation. The alterations were all the more sensitive because the bishops were explaining their own teaching in response to two articles commenting on recent church teaching published earlier in this magazine.

As a Catholic journal of opinion, America remains committed to providing a forum for communication of the bishops’ teaching, pastoral programs and social policy advocacy as well as for commentary on them. This is essential to our mission of contributing to the education of an informed Catholic public and offers a service to our readers.

As in all publications, submissions are subject to routine copyediting following standard manuals of style and usage and to editorial revision of titles. The editors are again mindful, however, of their responsibility to check changes affecting substance and tone with authors.

Click here for the unedited text of “In Defense of Human Dignity: On Providing Food and Fluids to Helpless Patients.”

Drew Christiansen, S.J.

Editor in Chief

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