How long must we preserve life?:

Shannon, Thomas A.

HOW LONG MUST WE THOMAS A. SHANNON PRESERVE LIFE? CATHOLIC ETHICS AT THE END OF LIFE ...

...Here the Pennsylvania bishops make an treatment is the point of departure for a determination of prointeresting observation...
...Nothing else, no matter how prized and precious, is of ultimate value...
...The totality of the cost of First is cost...
...Life is made an ultimate good he said, "you believe in immortality, otherwise you could not rather than remaining a finite good...
...Third, the stance assumes that the physician is the solely on the commonness and availability of the means them- major-or perhaps only-decision maker...
...But therapy or intervention distorts the evaluation of the actual then they go on to say "however, in the society in which we cost of the totality of the treatment, the appropriate locus of live this does not present a fully convincing argument...
...Such ultimateness is the ground of the command that we are not to have false gods before us...
...I can think of no surer way bladder and kidney and thrust down to encourage or even play right into the hands of those who are your uterus till you could feel it fall advocating euthanasia than to strongly imply that some therabetween your lips like a natural- pies cannot be forgone or stopped once started...
...as your huge tumor crushed gall A third issue is a pragmatic one...
...Thus, for example, some argue cuss ethical issues surrounding the removal that the demands of justice can require the taking of human life of life-prolonging therapies...
...Second, if one breaks A second issue is the traditional distinction between ordiCommonweal 3 December 1993: 13 nary and extraordinary means of treatment...
...in this quarter, any action that can be remotely construed as a compromise of life is to be rejected...
...I am talking about what impression people can take from stories about "There's a land that is fairer than day" the documents...
...One you sang me softly in the breath left you of the sanest and most profoundly Christian instincts of the "That's where I want to he Catholic medical ethics tradition has been its recognition of the where I won't ever have to do limits of medical intervention, grounded in a clear sense of human another goddam thing I don't want to...
...For indeed human life...
...Second, it ing routine-and what is morally ordinary-meaning a favorable proportion of benefits to burdens...
...but many modest virgins prefer to tolerate a disease or death rather than to be touched by men") Once the pain preyed unrelenting to Patuzzi's (d...
...any, pay for isolated items only...
...No, no," tance beyond its created status...
...To maintain biological processes for their own Mast Revered1dN 1Mg8% sake gives priority to the impersonal rather than the personal, wKneirwil is death-denying rather than death-accepting...
...Even though life is not a means to other od of twenty years...
...The ethical conclusion is that all values and practices must be seen as means to our journey to God, not ends...
...knowledges that built into the evaluation of whether a treatThe NCCB's Pro-Life Committee also acknowledges that ment or technology is extraordinary or disproportionate is a cost can be a valid factor in decisions about life support...
...I am seriously concerned about the strong tendency in ecclesial discussions of these questions to absolutize biological life or, at least, to make it the privileged factor in decision making...
...Resources the moral analysis...
...Designating biological survival in developing my perspective...
...The other salient moral positions asserting the priority of other values would not fact about this group is that it was Jewish...
...traordinary and should be used or not accordingly...
...my wife and I are be viable within Roman Catholicism...
...I was to give an overview and then as in war or self-defense...
...14.11 4 & 11IIITE II Q IlIIOIS on ra d "~ These two core beliefs of Christianity-the ultimacy of God Mast Rrnrs~i Umiel L 1Yw, AN INTER-ACTIVE IiearseeFSpiarReY . and the finiteness of human existence-seem to me to be given STATEWIDE CONFERENCE ON RACISM too little consideration in current episcopal teaching about for- FOR MORE Itisin nrk Iloirl I hir;u!o Illinois INFORMATION going or terminating therapies or technologies...
...What in human dignity is MAiddm $[Gkee NORerseid lavesP...
...dmeme lllim Ma F. Gffa ^ PhD Pro-Life Committee (Origins, April 9, 1992...
...The Penn- Dan M-", "a sylvania bishops, for example, say: "Supplying nourishment or...
...the total cost down, it may be the case-to follow the bishops' reasoning-that no one particular item considered in itn the context of this theological background, I want to self would be that expensive (though not if one has looked at examine several other critical issues, particularly in re- itemized hospital invoices lately...
...Catholic...
...These examples range from Lessius's How Sweet the Bye and Bye teaching in the 1600s ("women, especially virgins, are not bound to accept from men medical treatment of this type in (For JBH) the more secret parts...
...1769) observation that discussions of ordiyou could taste how bad nary means may be impractical because "people usually sin you wanted to go into that good night by being too solicitous of their lives rather than the other way you raged against the light around" (quoted in Daniel Cronin, doctoral dissertation, in prayed for it to go out Conserving Human Life, John XXIII Medical-Moral Research for you no false heroics Center, 1991...
...My reason for fearing such a loss is the growing influence Then you saw, being blind, the last dim light of the extreme versions of the prolife movement which see your opalescent pupil could permit euthanasia as the analogue of abortion...
...To say or suggest that anything else has the ultimate value or meaning that God has is to commit idolatry...
...For while life is valuable, it is neither the ulTHOMAS A. SHANNON is professor of religion and social ethics in the Department of Humanities at the Worcester Polytechnic Institute, Worcester, Massachusetts...
...The question grows out of my reading and reflec- KEYNOTE SPEAKERS tion on "Nutrition and Hydration: Moral Considerations" Ilralioa the I'atl...
...On the basis of such an analoutcome, not the patient's values or the implications of the prog- ysis we conclude that a particular treatment is ordinary or exnosis for the patient...
...As the discussion proceeded and a variety of points This perspective is particularly relevant when the only outwere pursued and different perspectives vigorously argued and come of a therapeutic or technical intervention is the presercounterargued, one man asked me what role my religion played vation of organic or biological life...
...But recognition of both the individual good and the common good...
...This includes human life...
...finitude...
...CATHOLIC ETHICS AT THE END OF LIFE year ago my wife and I spent an evening timate value nor the only value relevant to the issue at hand...
...Nothing and no one but God is to be adored or worshiped as God...
...Neither should we autodoes not in itself constitute the basis of the determination of matically assume an entitlement to them such that denial of acordinary or extraordinary...
...To argue for the determination of church has long held: when a family reaches the limits of its proportion or disproportion on the basis of one or the other resources, they have reached the limits of ordinary care...
...This position seems A treatment's routine or customary use in the practice of to be in contention with the prolife committee's approving ci- medicine or even its being lifesaving does not make such a treattation of the 1975 Declaration of Helsinki that medical proce- ment morally ordinary...
...Such a point has ethical significance in evaluating medical therapies and technologies...
...tain consoling perspective...
...Our apies-a context that gives a particular orientation to this belief and our hope is for life in the Kingdom, revealed in its discussion, indeed, gives it meaning and life, as well as a cer- fullness in the Resurrection of Jesus...
...with a group of couples who had been Nor does life's being a basic value give it a privileged position meeting for serious discussion over a peri- among other values...
...Thus for the sake of the value of biological life, we are to maintain individuals on life support systems until they die...
...Rather these a position is a type of medical indications policy that mandates terms refer to the conclusion of a moral analysis of the facts of treatment based on physician assessment of medical benefit or the case and the relevant values...
...For the patient in the persistent vegetative state, biological SPONSORS TIE CRTIUtK life certainly would be prolonged at length, but what confers [oiwrERBia of RIlIOIS Be" of Iieds,s on a created reality the ultimate significance that would lead these bishops to their conclusion...
...God is our ultimate reality...
...Their additional sigthe bile rising to your palate nificance is the acceptance of the patient's values and burned your taste buds out perspectives...
...Can one not argue (anfod*M *2-5 FEBRUARY 1994 312.467.4375 that life is sacred without conferring an ultimacy on it that borders on the idolatrous...
...Such an impression will be a total disaster...
...Such we determine whether or not they are to be used...
...limits of examples...
...if we are dust and unto dust we will return, why does bioAs Christians we may too easily assume belief in God as a given in ethical discussions, but without taking seriously what that actually means...
...This avoids Such a position first establishes what is ordinary by catego- an equivocation between what is medically ordinary-meanrizing the technology or procedure in the abstract...
...Were human life of ultimate value, discussion would follow-as indeed it did...
...12: 3 December 1993 Commonweal logical life have such a controlling role in ethical decision making...
...selves, although this is taken into account...
...Please note that ly aborted fetus...
...Nothing can compro14: 3 December 1993 Commonweal...
...I am not saying this is what the bishops actually say...
...My impression is that and cunningly left behind your agony...
...riper, protected by maintaining the biological processes when there Finarsref IelerRe is no reasonable basis for expecting any change in the person's Most k"rew Imo kR Ridaseefodt medical status...
...The terms ordinary and offer "hope of life, reestablishing health, or alleviating suffer- extraordinary do not refer to abstract classifications or categoing...
...Why does the use of cause of a desire "not to impose excessive expense on the family scarce funds and resources for prolonging biological life take or the community" (my emphasis...
...Starting to give the standard state- as the normative or controlling value in decision making in these ment on the ordinary-extraordinary distinction made within cases comes close to idolatry because life is given an imporCatholic moral thinking, my questioner interrupted...
...Assuming that on Euthanasia" (1980), which these two statements cite apsuch resources are available, why does the fact of their avail- provingly, holds that disproportionate means can be refused beability make them ethically mandatory...
...The congregation acpriority over other uses...
...As Christians we also believe in the life of the world to come...
...nteresting examples of this meaning of the terms show up in the history of moral theology and exemplify how attuned these moralists were to the culture, the state of medicine, the economic status of the person, and George Held personal values...
...Such wisdom is in danger of being lost...
...We were invited to dis- ends, it is not of ultimate value...
...Life would be preserved CONFERENCE COSTS at length and not merely temporarily prolonged while wait- R*tral1w is ing for an imminently terminal condition to complete its 545.00 Per PersM Regsterlyiare 14, 1944 course...
...I'll be free in the sweet bye and bye...
...My questioner was pointing to an important theological con- We have all taken comfort from the belief, expressed in the futext for discussions of forgoing or terminating life-support ther- neral liturgy, that life is not taken away, but transformed...
...As the Pennsylvania does not seek to determine the relation of benefit to burden for bishops correctly note, such a distinction is not to be "based the patient...
...This theological context has two di- This belief too provides strenuous challenge to those who mensions: belief in God and immortality, and the finiteness of would confer ultimate value on our present life...
...The ultimate or normative value is life, whether personal or biological...
...They acknowledge what the portion or disproportion...
...lama T. Phi 0P would not be an instance of simply prolonging the dying pro- 10 BAv J-0 hands cess without actually preserving life...
...speak as you do...
...These are only examples and they have the just the stoic's sort...
...are available from other sources, and these can often be tapped The Congregation for the Doctrine of the Faith's "Declaration before a family reaches dire financial straits...
...HOW LONG MUST WE THOMAS A. SHANNON PRESERVE LIFE...
...For while human life is sacred and valuable, it is created and finite and to suggest it has an ultimacy because of its sacredness is to commit idolatry...
...First, the actual cost of a therapy or treatment automatically makes its use ordinary...
...patient's values and overall prognosis...
...However, few, if indeed lation to medically assisted nutrition and hydration...
...this issue is needlessly complicated when the committee sep- While it may be the case that funds are available outside of the arates the cost of providing a particular modality-for example, family, either through insurance plans or other state or federal medically assisted nutrition and hydration-from the cost of monies, it does not follow that the availability of such funding the total care...
...Nonetheless, they point to a certain comYou could not taste at last mon-sense approach to the problem...
...The Helsinki statement implies that therapies or outcomes rizations of treatments or technologies on the basis of which are ordinary by virtue of the physician's determination...
...Rather, it is cost in relation to the cess ipso facto is an injustice...
...One must look to the benefits and burdures are appropriate if in the judgment of the physician they dens to see if there is a disproportion...
...Cer el West, Phd (Origins, January 30, 1992), by the Pennsylvania Bishops' Conference, and "Nutrition and Hydration: Moral and Pastoral (RAT fUiURE S Bdamees, PhD Reflections" by the National Conference of Catholic Bishops' I s...

Vol. 120 • December 1993 • No. 21


 
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