End-of-Life Ethics

As anyone who has undergone major surgery might attest,

As anyone who has undergone major surgery might attest, medical technology available to keep the human body functioning through trauma, treatment, and healing - means that we often take for granted today - would have been viewed as little short of a miracle even a few decades ago.

But many of us also assert that we would not want to be "kept alive by tubes" if we were in the final days of a terminal illness or considered to be in a deep state of unconsciousness with no hope of recovery. A "living will" - a written declaration of the treatment one does or does not want to receive if circumstances leave one unable to communicate - is one way to make this desire known. In the absence of such an advance directive, the treatment decisions fall to the patient's next of kin.

What, however, is "treatment" and what is simply nonnegotiable, humane care? This spring Pope John Paul II, at a meeting focused on care of patients in a vegetative state, declared that "the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act," and is, as such, "morally obligatory."

These statements run counter to the teachings of many Catholic ethicists and current U.S. legal interpretation. The U.S. Supreme Court ruled in 1990 that feeding tubes that deliver nutrition and hydration to a person in a vegetative state are a medical treatment that can be withdrawn if there is "clear and convincing" evidence that the person would not want his or her life prolonged under such conditions.

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Sojourners Magazine August 2004
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