I know this won't resolve the debate, but

The Coffee Shop
1

FWIW, here is the text of a Catholic Living Will, which discusses the issue of artificial feeding vs. excessively burdensome or disproportionate means. Since the Schindlers are Catholic, and Terri was raised Catholic (I don’t know if she was practicing at the time of her brain injury), this at least explains where the Schindlers are coming from:

CATHOLIC DECLARATION ON LIFE AND DEATH
of (Name)_________________________________

This Declaration of Life and Death, made while I am of sound mind, is intended to convey my desires and directions regarding treatment or care for me in the event I become irreversibly and terminally ill.

Because of my Catholic belief in the dignity of the human person and my eternal destiny with God, I ask my family, physicians, lawyer, pastor, and friends to fully inform me of my condition and prognosis, if I should become irreversibly and terminally ill, so that I can prepare myself spiritually for death.

I have the right to make my own decisions concerning medical treatment that might unnecessarily prolong the dying process beyond the limits dictated by reason and good judgment. This Declaration applies in the event that I have an incurable injury, disease or illness from which I will inevitably soon die, as determined by two physicians who have examined me, one of whom shall be my attending physician; the physicians have determined that this condition will cause my death even with appropriate medical care; and that the use of life sustaining procedures would serve only to artificially prolong the dying process. In that event, if I am unable to make my own decisions and have no reasonable expectation of recovery, then I request and direct:

  1. that my pain be alleviated.

  2. that no excessively burdensome or disproportionate means be used to prolong my life

  3. that nothing should be done with the intention of causing my death.

I believe nutrition and hydration are generally not excessively burdensome or disproportionate, whether being administered orally or artificially. Therefore they are not to be withheld or withdrawn from me unless there is clear and convincing evidence, in the judgment of my physicians, that they would cause me harm, cannot effectively sustain life or are excessively burdensome to me.

There is another section that deals with appointing a surrogate to make the decisions for you in case you are incapacitated.

2

That last sentence is a mother huh?

I’ll have to read that a couple more times, I’m having a hard time with the last sentence and the meaning and hence interpretation of “nutrition and hydration” and: “cause me harm” or (and this is the biggie to me) “are excessively burdensome to me.”

3

I wonder when that Living Will was first published and even more importantly when that last bit was put into it. The way it hangs there at the end makes it look like it was added after the initial document was created.

My guess is that it’s not 15 years old.

4

First, you have to start with the concept that “generally, artificial nutrition and hydration are not considered excessively burdensome.” However, the “generally” part leaves open the possibility that artificial nutrition and hydration may be “excessively burdensome” in some cases. In this case, the Church definition of excessively burdensome follows:

“A treatment is judged excessively burdensome if it is too painful, too damaging to the patient’s bodily self and functioning, too psychologically repugnant to the patient, too suppressive of the patient’s mental life, or prohibitive in cost. Moral certainty of excessive burdensomeness is required to justify withdrawal of artificial hydration and nutrition.”–(my underline)

5

"A treatment is judged excessively burdensome if it is too painful, too damaging to the patient’s bodily self and functioning, too psychologically repugnant to the patient, too suppressive of the patient’s mental life, or prohibitive in cost

How could any treatment then be too burdensome for someone lacking higher brain function? Simply a cost issue?

6

Another excerpt:

“In 1980, the Vatican Declaration on Euthanasia stated: In the past, moralists replied that one is never obliged to use “extraordinary” means. This reply, which as a principle still holds good, is perhaps less clear today, by reason of the imprecision of the term and the rapid progress made in the treatment of sickness. Thus some people prefer to speak of “proportionate” and “disproportionate” means. In any case, it will be possible to make a correct judgment as to the means by studying the type of treatment to be used, its degree of complexity or risk, its cost and the possibilities of using it, and comparing these elements with the result that can be expected, taking into account the state of the sick person and his or her physical and moral resources.”

“The application of this principle becomes difficult in many cases and should be made by the patient in consultation with his or her family, physician, and priest or minister, whenever that is possible . . .”

In other words, there isn’t a clear cut answer in all cases. But, whatever is decided, there must be moral certainty.

The other thing to keep in mind is that, in Terri Schiavo’s case, she is (probably) “irreversably” ill, but not “terminally” ill, so regardless of burden or not, according to Catholic doctrine, withholding of nutrition and hydration is immoral.

7

Does Catholic doctrine specifically address persistent vegetative states?

There a big difference between PVS and some other “irreversible” illnesses…

8

This doesn’t use the words “permanent vegetative state” but I think “permanently comatose” is the same thing. This is from the 1989 Statement on the Life, Death, and Treatment of Dying Patients issued by the Florida Catholic Council which can be found in full at: http://www.flacathconf.org/Publications/BishopsStatements/Bpst1980/Lifedeathdying042789.htm* *

  • "The application of these principles to a patient who has been diagnosed with medical certainty to be permanently comatose, but whose death is not imminent, has aroused controversy. As stated, the strongest presumption must be given to continuing artificial sustenance. While the benefit is greatly reduced due to the lack of consciousness, human life itself is a good, and the life of comatose persons must be accorded respect. By the same token, the burdens of this treatment are limited, there being no, or very little, pain, discomfort or psychological repugnance. The cost of artificial nutrition and hydration is usually minimal, not much more than the cost of ordinary feeding. Thus we can say as a general rule that artificial sustenance should not be withheld or withdrawn from these patients."*

I am posting all this because I think the Schindler’s have been portrayed in a negative light by the press. However, in their belief system, to do anything less than they did to keep Terri alive would have been a sin.

9

not trying to further the debate but were they not offering her husband a lot of money to commit a moral sin by buying out his marriage?

10

This doesn’t use the words “permanent vegetative state” but I think “permanently comatose” is the same thing

Not the same thing form a medical standpoint, but I agree it would apply here. If anything, Terri had slighly more function than someone who is comatose.

While the benefit is greatly reduced due to the lack of consciousness, human life itself is a good…

Well, I’d personally disagree, but OK.I am posting all this because I think the Schindler’s have been portrayed in a negative light by the press. However, in their belief system, to do anything less than they did to keep Terri alive would have been a sin.

You make a good point, although I’m not sure the press has been portraying the Schindlers badly (maybe bloggers or forums like here). However I’ve never read a quote that says that they acted the way they did out of their Catholic beliefs, but rather based on a unreasonable assumption/hope that Terri could recover.

11

I don’t know the details of what they offered him so I really can’t say. Perhaps it was a sin, but in their view less of a sin than killing their daughter–but again, I don’t know so that’s just speculation on my part.

BTW–civil divorce is not, in and of itself, a sin in the Catholic Church. What is a sin is getting divorced and then remarrying or otherwise engaging in relations. A “Declaration of Nullity,” commonly called “annulment” must be issued prior to remarriage.