Updated June 3, 2005

It is a rare person who has not heard of the recent cruel homicide of the Florida woman, Terri Schiavo. Everyone, it seemed, had a strong opinion on the subject. Yet, despite clear moral teachings on the evils of euthanasia, there are 'Catholics' who boast support for euthanasia and doctor-assisted suicide. [1]

Are these 'Catholics' badly formed and ignorant of their Church's infallible teachings on the dignity and sacredness of all human life? Is it the fault of Catholic clergy for not preaching the Church's teachings from the pulpit?

In view of the clarity and frequency of the Church's up-to-date teachings, which reflect modern medical advances on the subject, these Catholics dissenting opinions seem to be willful and conscious disregard of those infallible teachings. Let us look at one example.

Most recently, a devout Catholic contacted this writer. She bemoaned that she could not persuade members of her Catholic family to reject the evils of euthanasia, especially in light of Terri's Schiavo's plight. Her own Catholic mother, who begot fourteen children, recently instructed the family not to allow the ordinary means and palliative care of 'nutrition and hydration' if she should ever require it. The daughter provided a copy of the mother's specific written directive:

"I do not want to be kept alive by a feeding tube. I do not want to be a 'burden' to anyone. I do not want to be kept on 'life support.' If I become seriously ill, just 'pull' everything and let me go 'naturally.' If the 'quality of my life' is not good, I do not wish to remain alive."

The daughter next asked:

"My mother agreed with Michael Schiavo action to murder his wife, Terri, and Mom was very upset that I would suggest anything other than pulling Terri's feeding tube. She said she had no quality of life. What does the Catholic Church teach for people who are 'terminal' who choose starvation and dehydration and who actually put that in writing?"

Unfortunately, in most of these euthanasia cases, the families hotly disagree among themselves about whether 'nutrition and hydration' should be withdrawn. The family quarrel usually ends up in legal hassles and broken relationships.

Bishop Rene Henry Gracida, Bishop Emeritus of Corpus Christi, in an interview with this writer, offers the Church's teaching on this problem: [2]

"Some Catholics would argue that they are simply following their conscience and that the Church allows them to do so. They choose to forget that the Church says that one can only safely follow an INFORMED CONSCIENCE, i.e., a conscience that has been formed and illuminated by the teachings of the Church. The Church has given clear and explicit guidelines regarding the removal of a feeding tube through which 'nutrition and hydration' is supplied to a sick person.

"All persons who wish to remain in communion with the Catholic Church, to receive Holy Communion and the other Sacraments, must assent to the teachings of the Church in matters of faith and morals. [3]

"If a person supports euthanasia and assisted-suicide through the illicit rejection or removal of a feeding tube, they are not in communion with the Church. They have separated themselves from the Church."

A terminally ill or dying person does have the right to refuse 'extra-ordinary' medical means so long as nothing is done or omitted with the intention to hasten or cause the person's death. Compassionate family members, doctors and nurses will continue to provide the person with ordinary care and treatment, which include nutrition and hydration, comfort care, and effective pain management.

Julie Grimstad, Executive Director of 'Life is Worth Living, Inc.,' explained in an interview with this writer the very important differences between 'ordinary' and 'extra-ordinary' means:

"What constitutes "ordinary" (obligatory) and "extra-ordinary" (optional) medical means varies with the individual circumstances. The same means could be judged ordinary in one situation and extra-ordinary in another. For instance, a ventilator may be used temporarily to save the life of a critically injured person or it may be used to prolong the life of a dying person. In the first instance, a ventilator usually would be considered ordinary means. In the second, it usually would be considered extra-ordinary means, that is, means that could be refused. Refusal of extra-ordinary means is not a sin.

"It is the physician who makes the judgment that a particular treatment is extra-ordinary under the circumstances. It must always be the patient, if capable of making medical decisions, who decides whether or not to refuse the treatment. If the patient wishes to fight for every last moment of life, that is his/her right!" [4]

Depending on the individual patient's circumstances, the degree of pain and suffering caused by the treatment, the risk involved, or the burdensomeness to the patient, examples of extra-ordinary means could include:

• Kidney dialysis

• A ventilator

• Chemotherapy

• Experimental drugs and devices

• Debilitating surgeries or drugs

• Medical treatments that exploit the patient [enticements to participate in drug trials 'for the sake of mankind' that may add pain and suffering while hastening death]

• Medical treatments that push a patient beyond their physical and psychological capacity [this list is merely illustrative, not exhaustive].

However, it is imperative to understand that a sick, terminally ill, or dying person does not have the right to kill him or herself. Withholding or refusing 'ordinary means' or 'palliative care,' such as 'nutrition and hydration,' would be murder or suicide, and a grave mortal sin, [5] except in rare circumstances; e.g., kidney or stomach cancer, where the food and water cannot be assimilated by the body. [6]

'Nutrition and hydration' is not 'extra-ordinary' treatment nor is it 'life support.' It is not even a 'medical act.' 'Nutrition and hydration' is ordinary means, proportionate and moral palliative care, and something that must not be denied. Whether 'nutrition and hydration' is naturally taken by mouth by the patient, or fed to the patient by someone else, or artificially delivered to the patient by a feeding tube, it is still 'ordinary means,' and 'palliative care.' [7]

The subjective error of judgment into which one can fall in good faith does not change the objective nature of this murderous rejection of a required feeding tube. [8] One who plots suicide through premorbid wishes in a 'Living Will' or another written directive with the intention of setting an example for others also takes on the gravity of scandal. [9] Voluntary co-operation in suicide is contrary to the moral law.

A Catholic cannot prescind from the Church's mediation and canonical laws binding upon one's conscience. [10] We are not "free" to follow an erroneous or uninformed conscience. We are required to seek out the truth from the Church and her teachings. [11] We are not 'free' to believe one teaching of the Magisterium and not another.

The Church's clear moral teachings on Euthanasia are the same for all men, no matter their age, their 'quality of life,' whether they are sick, terminally ill, or dying. [12] To deprive ordinary, palliative care, such as simple 'food and water,' is not "allowing a person to die a naturally." Instead, it would be a grave and evil act of murder [or suicide]. [13]

The Sacred Congregation for the Doctrine of the Faith declared:

"It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly, nor can any authority legitimately recommend or permit such an action." [14]

The dangerous, ubiquitous phrase, 'quality of life' does not factor into what kind of treatment a person must receive. The late Pope John Paul II, who virtuously struggled with his own illness and who later received his nutrition and hydration through a 'feeding tube,' said specifically on Terri's behalf that a person's dignity does not depend on his "quality of life" which nowadays is sometimes interpreted as merely the ability to experience pain or pleasure, or to think rationally. [15]

As God's children, we must resist yielding to ephemeral cultural and moral trends — or cultural relativism. Pope Benedict warns that Christians must reject a conception of pluralism that reflects moral relativism. [16]

This is Christian ethics we speak of, but also the natural law of mankind, a principle of human civilization, infused upon every created person's heart, mind, and soul when God forms them in the womb.

Instead of Catholic leaders and laity promoting the Church's moral teachings, many are in fact the cause for much of the confusion. This writer has received more than a few communications from distraught readers who allege their pastors wrongly supported the withdrawal of Terri's 'nutrition and hydration' from their pulpits.

An April 8, 2005, a three-year Gallup Poll revealed that 32% of Catholics who consistently attend Sunday Mass morally accept doctor-assisted suicide or euthanasia. The number increases to 48% of Catholics who infrequently attend Sunday Mass. Is our Catholic pastors' silence from the pulpit to blame for this dissent from the Church's clear teachings on euthanasia?

Various news media sources reported Catholic clergy across the nation have made no secret of their support for the March 31, 2005 doctor-assisted murder of Terri Schiavo. What we have here is disobedience to magisterial teachings from Catholic priests, theological professors, ethics professors, [17] and laity. [18]

In a recent article, Catholic World News cited a survey revealing that almost 90% U.S. Catholic physicians supported medical treatments and ethical stances contrary to Church teachings. [19]

In March 2004, Pope JPII gave an address to a large group of physicians. Here is an excerpt:

"I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.

"The obligation to provide the 'normal care due to the sick in such cases' includes, in fact, the use of nutrition and hydration. The evaluation of probabilities, founded on waning hopes for recovery when the vegetative state is prolonged beyond a year, cannot ethically justify the cessation or interruption of minimal care for the patient, including nutrition and hydration. Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense, it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission.

"In this regard, I recall what I wrote in the Encyclical Evangelium Vitae making it clear that "by euthanasia in the true and proper sense must be understood an action or omission which by its very nature and intention brings about death, with the purpose of eliminating all pain"; such an act is always "a serious violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person" (n. 65). [Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004.)

What can you and I do? Print out the substantiating documents provided within this essay and distribute them to your bishops, pastors, family members, and friends. Educate and convince others to the saving truths of the Church's clear teachings on 'nutrition and hydration.'

NOTES: