Wednesday, February 27, 2008

Catholic Congress Studies End-of-Life Issues

On February 22, 2008, the Catholic News Agency issued a Press Release entitled "Vatican conference to examine ethics of end-of-life care" that announced an international congress named “Close by the Incurably Sick and the Dying: Scientific and Ethical Aspects,” sponsored by the Pontifical Council for Life, held February 25 & 26, 2008, at the Vatican.

Bishop Elio Sgreccia, president of the Pontifical Academy for Life, summarized the goal of the congress as an attempt to focus on the moment “in which human fragility is felt most deeply, a moment often intensified by solitude and suffering.”

This moment, he said, is very important in the Christian vision because “the physical body crumbles and the subject’s history comes to an end but they draw near the entrance to full life, eternal life.”

The bishop said the congress would examine the ethics of various medical therapies in response to “various doubts and continuing debate” about medical assistance.

“The main focus will be on treatments that respond to precise ethical questions,” he said. * * *

Monsignor Maurizio Calipari, a member of the Pontifical Academy for Life and a bioethics professor at the John Paul II Institute for Marriage and the Family, explained that new medical techniques ensure greater life possibilities and better health for many people. However, they can sometimes bring “a greater affront than personal suffering to the patient without there being, or even contrary to there being, a real perspective of benefit.”

Monsignor Calipari said the congress would consider the ethical and technical criteria for prolonging life. He proposed that the ethical standards of ordinary versus extraordinary treatment (a traditional category), and proportionate versus disproportionate treatment (a newer category), could be supplemented with a new ethical standard that joins the two.

Zbigniew Zylicz, a medical director at an English hospice, addressed the press conference on the topics of palliative care, hospices, and household assistance. "Death", he said, "should be seen as a part of life, a normal event. The death of a loved one can even be an important moment of personal growth.” * * *

That congress was convened on Monday & Tuesday of this week. This resulted in a further lengthy Press Release issued on February 25, 2008, by the CNA, entitled "Pope reaffirms Church’s stance against euthanasia", which reported that as Pope Benedict welcomed the participants, he reiterated that the Church is against all forms of euthanasia.
Reflecting on the moment of death, the Pope said that it “concludes the experience of earthly life, but through death there opens for each of us, beyond time, the full and definitive life. ... For the community of believers, this encounter between the dying person and the Source of Life and Love represents a gift that has a universal value, that enriches the communion of the faithful". * * *

Benedict XVI also spoke of the larger societal dimension of respecting those who are ill or dying.

All society "is called to respect the life and dignity of the seriously ill and the dying", he said. "Though aware of the fact that 'it is not science that redeems man', all society, and in particular the sectors associated with medical science, are duty bound to express the solidarity of love, and to safeguard and respect human life in every moment of its earthly development, especially when it is ill or in its terminal stages.

"In more concrete terms", he added, "this means ensuring that every person in need finds the necessary support through appropriate treatments and medical procedures - identified and administered using criteria of therapeutic proportionality - while bearing in mind the moral duty to administer (on the part of doctors) and to accept (on the part of patients) those means for preserving life which, in a particular situation, may be considered as 'ordinary'". * * *

Pope Benedict also pointed to how society can improve its support for the dying or seriously ill.

Society, said the Pontiff, must "ensure due support to families who undertake to care in the home, sometimes for long periods, sick members who are afflicted with degenerative conditions, ... or who need particularly costly assistance. ... It is above all in this field that synergy between the Church and the institutions can prove particularly important in ensuring the necessary help for human life in moments of frailty".

Catholics are one community of religious believers, among others, who study end-of-life decisionmaking, particularly in the context of advanced, life-prolonging, medical treatment. See: PA EE&F Law Blog postings (with links to resources) "UCC to Study Physician-Assisted Death" (06/29/07) and "Vatican Favors Living Wills" (11/28/06).

For a recent statement by the Catholic Bishops of Pennsylvania on one aspect of this end-of-life discussion, see "Statement on Nutrition and Hydration: Moral Considerations" (Revised 1999), posted by the Pennsylvania Catholic Conference.

These church discussions occur in the midst of continuing situations that question legal principles and medical ethics. See, for example, these recent articles:
  • Divorced parents contest life-sustaining feeding tube for brain-damaged adult daughter (02/08/08), posted by the Catholic News Agency.
    • Excerpt: In a case recalling the conflict over Terri Schiavo, two divorced parents in Delaware are fighting over whether to continue life-sustaining nutrition for their brain-damaged adult daughter, the News Journal reports. Lauren Richardson, 23, has been in a so-called persistent vegetative state since overdosing on heroin in August 2006. Pregnant at the time, she was kept alive at a hospital with feeding tubes and a breathing machine until she gave birth in February 2007 to a healthy baby girl. Her parents Randy Richardson and Edith Towers are currently disputing whether her feeding tube should be removed.Towers, who says her daughter did not wish to live in such a state and wants the feeding tube removed, was awarded guardianship of Lauren in January. Her father Randy Richardson disagrees, "She's committed no crime and doesn't deserve to have this death imposed on her," he told the News Journal. He is appealing the ruling awarding guardianship to Towers, his ex-wife. The appeal will take three months. Lauren lacked any living will or advance directive recording her wishes in writing. * * *
  • Families chafe at physicians' power to give up life support (02/08/08) published in The Atlanta Journal-Constitution.
    • Excerpt: From a legal standpoint, being brain-dead is the same as being dead. Before a patient can be declared brain-dead, two doctors must evaluate the patient on two occasions. Dr. Michael Hartman, a neurologist at Emory Eastside Medical Center, routinely removes patients from machines that support organ function after he declares brain death. Hartman said the physicians have to make the tough decisions when families can't. "If you let them take control, they will never let go," Hartman said. "I realize this lack of control families must feel when we go in, but it's part of the job." Hawkins' lawyer, Crongeyer, says that stance is "kind of a scary [thing]." * * *
For an extensive discussion about the pending case of Lauren Richardson, see: "Parents battle over life of brain-damaged daughter", published January 31, 2008, in The News Journal (Wilmington, DE), as reposted & updated with related reports by Delaware Online.

Update: 02/28/08:

On February 27, 2008,
Catholic World News published an article entitled
"Vatican concludes conference on end-of-life care".
The Pontifical Academy for Life has concluded a 2-day conference on ethical and pastoral questions involving care for those who are terminally ill.

The conference, held at the Vatican on February 25-26, explored the moral issues that arise in treatment of those who are approaching death. Participants discussed the moral principles involved in distinguishing between ordinary and extraordinary care, or proportionate and disproportionate efforts to preserve life.

The conference also addressed the issue of palliative care, and the reality that the alleviation of pain may indirectly cause an earlier death. * * *
Update: 03/03/08:

Professor Gerry Beyer noted this posting in his own, entitled "
Catholic Church Reiterates Its Position on End of Life Issues" (03/03/08) on the Wills, Trusts & Estates Prof Blog.

Update: 03/05/08:

On March 5, 2008, Michael D. Bonasera, Esq., who authors The Ohio Trust & Estate Blog, noted my posting and commented on it further as to Ohio law, in his entry entitled "Disability Planning and the Pope". He also provided a reference here in his closing comment:
"Thanks to Neil A Hendershot for this story on his always informative PA Elder, Estate & Fiduciary Law Blog."