DEATH WITH DIGNITY

...But the "living-will-leads-to-euthanasia" argument has strong support within the church, particularly among those who see the euthanasia issue as a rerun of the abortion debate...

...Much of the Catholic rhetoric on death with dignity legislation seems to be dictated by right-to-life groups with a prohibitionist perspective that doesn't understand the Catholic approach to this issue...

...Miss Quinlan appeared to be in an irreversible coma...

...When the Quinlan case came along, most state legislatures did what'comes naturallymthey tried to legislate a solution...

...DEATH WITH DIGNITY JIM CASTELLI A controversy marked by both insight and distraction The Catholic Church seem~ ideally situated to enter the public debate on the "right to die" or "death with dignity...

...the disadvantaged because they are considered to be too great a financial burden on society and the state...

...But that decision was not popular with right-to-life groups, who accused the conference---and its executive director, Bishop John Cummins, now head of the Oakland diocese--of bringing euthanasia into the state...

...Hellegers says that the Quinlans would have been better off if, instead of asking the court permission .to remove life-support systems, they had charged their daughter's doctors with assanit for refusing to remove the treatment...

...State Catholic officials, including Msgr...

...Most Catholic commentators argue that living will laws are unnecessary...

...Andre Hellegers, director of the Kennedy Institute for the Study of Human Reproduction and Bioethics at Georgetown University, says a doctor will test a patient he takes off a respirator to see if heartbeat and breathing come back before declaring death on the basis of a flat brain wave...

...We are discussing here the question of allowing people to die...

...So far, "brain death" laws have been passed in 18 statesbAlabama, California, Georgia, Idaho, Iowa, Illinois, Kansas, Louisiana, Maryland, Michigan, Montana, New Mexico, Oklahoma, Oregon, North Carolina, Tennessee, Virginia and West Virginia...

...California led the way...

...in September...

...but, they argue, it is dangerous to write such wills into law...

...Opposition to the direct taking of the life of a terminal patient is, not surprisingly, at the heart of Catholic teaching...

...it should be alert every time the government deals with life and death issues...

...Definition of death laws use "brain death" as another criterion for determining death to go along with cessation of spontaneous heartbeat and respiration...

...The Diocese of Memphis remained neutral on a living will bill while the Diocese of Nashville:opposed it as unnecessary...

...she is now in a coma in a nursing home...

...Sometimes a bad offense is the worst defense...

...But .the Catholic contribution to the legislative debate over the right to die and the somewhat related question of a legal definition of death, has been mixed, marked by both insight and distraction...

...Supreme Court in its abortion decisions...

...one of the ironies of the debate is that many of the people who are upset because legislators won't write Catholic teaching on abortion into law are upset because some of those same legislators want to codify Catholic teaching On ordinary and extraordinary means...

...The court dismayed Catholic officials because it based its decision in part on the right to privacy discussed by the U.S...

...Dickie told a Catholic Hospital Association meeting that the conference had consulted the state's 19 bishops, theologians, attorneys and constitutional lawyers about the bill and had received recommendations ranging from strong opposition to strong support...

...McHugh warns that "much more consideration must be given to extending health care in an equitable way to all sick persons and to provide pastoral care to the dying~patient and his or her family.' . . . . . One bishop who sees living will legislation as a steppingstone to euthanasia worries privately that Catholic nursing homes are terrible places...

...the U.S...

...That teaching, as put forth by Pope Plus XII in an address to physicians in 1957, holds that each person has an obligation to use ordinary means to preserve his life, but has no similar obligation to use extraordinary means--defined in terms of the individual in a given time, place and culture--which would create a "grave burden" for himself or his family...

...In the long run, the church's response to the problems facing the terminally ill, like its response to women with problem pregnancies, will be measured not by its political rhetoric but by the quality of care it extends to those in need...

...They say laws like the one in CalifOrnia give a doctor more power than he already has and alter the existing doctor-patient relationship...

...When California first considered the Natural Death Act, the California Catholic Conference opposed the hilt, but it later withdrew its opposition after certain changes were made...

...They also say such laws could result in patients with living wills being under-resuscitated and patients without them being over-resuscitated...

...but the church does permit the use of powerful pain-killers which may indirectly hasten death...

...1976, it passed the Natural Death Act which allowed patients to write "living wills," directives to their doctors in advance of terminal illness requesting that extraordinary means not be used...

...her adoptive parents asked her doctors to remove artificial life supports--a request perfectly in line with Catholic hospital ethical directives--but the doctors refused because they feared lawsuits if Miss Quinlan died as a result...

...he also concedes that death with dignity legislation is not "inherently immoral...

...Hellegers and McCormick praised a statement by the Maryland Catholic Conference which echoed their own arguments and said that such legislation was well-intentioned but was neither "necessary, effective, or desirable...

...Sullivan says the church believes in death with dignity, but doesn't want to try to legislate it...

...This is a very delicate moral and ethical area...

...Hellegers and Jesuit Father Richard McCormick, a moral theologian at Georgetown, say there's nothing wrong with living wills in themselves...

...HeUegers argues---convincinglythat the church shouldn't even be concerned with such laws if they don't attempt to redefine death philosophically-by, for example, equating death with irreversible coma or attempting to define death differently for a patient with an organ wanted for transplant than for a patient without a desired organ...

...Others have been more restrained...

...Death with dignity" legislation i~often discussed together with definition of death legislation...

...The individual and his family have the right to refuse treatment and the doctor cannot stand in the way of that request...

...Press reports suggest that California's law has not been widely used...

...18 August 1978:526 Opposition to definition of death legisla, tion is, more often than not, a distraction...

...He says no doctor in the United States has ever been convicted for removing extraordinary means or for, administering a pain-killer that hastened death in a terminal patient...

...South Carolina, Virginia, Hawaii, Colorado, Florida, Georgia and New Hampshire have killed or delayed similar bills...

...At the same time, the church sometimes follows a familiar pattern of crying wolf: the legalization of abortion means that no other rights will be protected...

...Death with dignity" as a legal right became an issue with the Karen Quinlan case which, ironically, .began in a Catholic hospital...

...James McHugh, - direotor of the Bishop's Committee for Pro-Life Activities, says death with dignity bills represent an effort to "relieve society of its responsibilities to provide legal protection for human fife at every stage of its existence and in every circumstance, even if the enjoyment of life is limited or qualified...

...We must not be naive...

...HeUegers says doctors who do organ transplants also want a legal definition of death to protect them in cases in which a patient who has promised an organ has a fiat brain wave, but is kept on a respirator to peffuse the desired organ...

...The law received a great deal of publicity, but it appfies to only a narrow range of cases and would not have affected the Quinlan case because Miss Quinlan had not signed a living bill...

...and now the 21 states that have adopted either death with dignity or definition of death legislation have started irrevocably down the path to legal euthanasia...

...It's obvious that the church has a legitimate concern in following death with dignity and definition of death legislation...

...The Diocese of Boise opposed a Natural Death Act in Idaho, the first state to pass such a law after California, on the grounds that it would lead to euthanasia...

...The New Jersey Supreme Court eventually upheld the Quinlans' right to have the supports removed and, to everyone's surprise, Miss Quinlan did not die when they were...

...He and Curley said the bill was unnecessary and may even have been "imprudent," but it wasn't euthanasia or a wedge to euthanasia...

...It would be a terrible tragedy," he said, "if the euthanasia battle is lost as the abortion battle was lost because of a lack of accuracy...

...the Colorado Catholic Conference and Indiana Catholic Conference asked their respective legislatures to study whether such laws were really necessary...

...By linking the Natural Death Act to euthanasia the way we linked abortion to birth control," California's Jack Curley argues, "we run the risk of creating terrible confusion about what we stand for...

...Bishop Ernest Unterkoefler of Charleston, S.C., opposed both living will and definition of death legislation, charging "they are part of a callous new movement across the country seeking euthanasia for the elderly, the handicapped and...

...the private schools will be detroyed without tuition tax credits...

...Msgr...

...doctors do not wa~t to face lawsuits for removing the organ and causing "death...

...It also seems clear that the church has done a service in arguing that living will legislation is unnecessary and can have a negative impact on the doctor-patient relationship...

...California's law became the model for other states: Idaho, Arizona, New Mexico, Nevada, North Carolina, Oregon and Texas have adopted similar laws...

...But the church seems to be doing a disservice to the degree that it claims living will or definition of death legislation will lead to legal euthanasia...

...the New York Catholic Conference cited the American Medical Association in opposing a definition of death bill as unnecessary...

...Bishop Walter Sullivan of Richmond, for example, notes that patients already have the right Commonweal: 525 to refuse treatment...

...The debate over death-related legislation has also obscured a more pressing problem--the treatment of the sick and dying in Catholic institutions...

...Doctors argue that such a definition is needed in cases when a patient is on a respirator and a doctor can't tell whether or not spontaneous breathing and heartbeat have stopped...

...the Missouri Catholic Conference opposed a definition of death bill that would have equated death with irreversible coma and then supported a revised bill...

...bishops' Administrative Committee rejected a proposal by the pro-life committee that the b.~shops oppose all death with dignity and definition of death legislation as unnecessary...

...Bishop Sullivan said, "I am convinced the real issue is euthanasia...

...John Dickie, the conference's new executive director, and Jack Curley of the California Hospitals, have defended their position...

...its teaching on the use of ordinary and extraordinary means of treatment for the terminally ill is accepted outside the church, far more widely accepted, for example, than its teaching on abortion...

...Commonweal: 527...

...Given the same circumstances, we would make the same decision," Dickie said...

...it is not easily cast into legal absolutes...

...a patient with a flat brain wave and spontaneous heartbeat and respiration is still alive, Hellegers says...