Catholic Bioethics

The Bond Of Love


Patrick Madrid's Grandson

Killian Patrick, born 3 months premature, is struggling for his life in neo-natal intensive care. In this poignant picture, his parents' wedding rings put everything into perspective.

In today's bulletin is an educational insert from the USCCB concerning the importance of keeping federal tax dollars from funding elective abortions as part of health care. At this time it looks as though an amendment to do just that has been attached to the Health Care Reform bill which passed the House of Representatives last night. Please stay alert and in touch with Congresspersons and Senators about your opposition to the inclusion of federal tax dollars for elective abortions.

What  a strange time in which we live: Killian  Patrick fights for his life, while other babies his age are freely aborted. Today say a prayer for Killian and all babies like him.


US Bishops to Discuss Artificial Nutrition and Hydration

Mon087149 Ethical and Religious Directives for Catholic Health Care Services

This month the bishops of the United States will vote whether to clarify when artificial nutrition and hydration (ANH) are morally obligatory.


Can food and drink ever be considered a medical treatment, and if so, are theyPEGs-2 equivalent to  other medical therapies such as chemotherapy, surgery, etc.?  Do artificial nutrition and hydration ever become “extraordinary” treatments?


If artificial nutrition and hydration are considered medical treatments, many argue they can be stopped or not started with the same moral and practical evaluation given to other medical treatments. They may be refused along with any or all medical measures if they offer little hope of benefit, or if the burdens outweigh the benefits.

If, however, nutrition and hydration can never be considered a medical treatment, they cannot be denied to the sick and dying if the technology is available to share. Even in extremis, instructions loosely spoken of as “do nothing,” do not mean eliminating the comforts owed someone who is sick: pain relief, clothing, warmth, human contact, prayer, cleanliness, etc.  Those who believe ANH never can be considered a medical treatment, include ANH among the never-to-be-denied components of compassionate care we owe each other.

What exactly are the benefits of ANH? What is the purpose for which ANH are begun? If the underlying disease for which they may be necessary is incurable, does that make ANH useless or irrelevant?  The Church has answered:  No, ANH are only useless when medically contraindicated or when death is imminent. Keeping someone alive with reasonably inexpensive, non-painful and easily managed care is not extraordinary and never useless, just as the life it supports cannot be seen as useless because it may not be productive.

Can nutrition and hydration be a compassionate comfort we owe each other under normal circumstances and become a medical treatment if and when it is provided with a tube? This is one of the sticking points.

Can  the meaning of food change depending on how it is delivered? Why is food special? Why don’t we have this difficulty with air and respirators? Just as Catholic teaching allows for discontinuing or not starting artificial ventilation under certain circumstances, why can’t the same rules apply to nutrition and hydration? I remember being challenged by an ethicist to explain the difference between food delivered by a feeding tube from air delivered by a respirator. He really didn’t wait for an answer, his point was that there is none.


It’s a great question - what is the difference between food and air? It got me thinking and praying and I think the answer has a lot to do with Eucharist.

We don’t gather at our family dining tables and pass around oxygen. We lavish care and attention on food preparation and its serving and we all know how important food becomes as a extension of care and love. We Catholics especially, gather each week to share a meal and a sacrifice, bread and wine which becomes the Body and Blood of Christ and though we worship and adore it at a distance, we also consume it. The Eucharist isn’t a symbol, it is the Body and Blood of Christ. We take seriously those who cannot join in the meal; we take communion to their homes, hospitals and nursing homes. And though while it is true we don’t as a matter of practice give Eucharist through feeding tubes or to the unconscious, we surely take seriously the physical and spiritual dimensions of food as an expression of God’s love and the community’s concern. It is I think, because we are a sacramental people that we puzzle over the meaning of food and water by tubes and fret about whether it can be discontinued.

Sacramental theology, medicine and moral theology can each contribute to an understanding of the pastoral care, including feeding of the sick, though not necessarily dying patient. Let us pray for our bishops and the guidance of the Holy Spirit as they discern God’s path for the church.


No Write-Offs Allowed When It Comes to People

Today's Lectionary Readings

Not a penny, not a single sheep is dispensable we hear in this morning's gospel, and surely neither is a person! Most of us under certain circumstances cut our losses; pursuit or retrieval of whatever it is we're after just turns out not to be worth it.

But we can never do that with a person, because Jesus never does that with us. This morning I  preached that Benedict XVI had recently given a speech defending the lives of those in the womb with Down's Syndrome. I was mistaken, I knew I read that one of my heroes had given the speech, but it wasn't the pope, it was Archbishop Chaput of Denver.

 Eighty percent of unborn babies with Down's Syndrome are now terminated in the womb, even though the non-invasive tests are not 100% accurate and amniocentesis, which is often done to clarify a falsely positive test, carries a risk of spontaneous abortion. I can't possibly do justice to Archbishop Chaput's article with a brief summary,so read it in First Things, here.  Do you know a "sniffer of souls?"

The US Bishops will vote this month whether to amend the Ethical and Religious Directives for Catholic Health Care Services to more strictly interpret the mandate to provide nutrition and hydration even using artificial means to those who cannot eat or drink on their own. Many ethicists have argued feeding should not be mandatory for those in a persistent vegetative state or other chronic conditions. Some have argued that if the prospects for recovery are dim or none, that artificial feeding merely prolongs a uselesss life - though they are careful not to use those words. The bishops may decide that nutrition and hydration are morally required nonetheless, since their purpose is not necessarily the recovery of the person's neurological or physical health, but prevention of starvation. The final document will no doubt be worded very carefully as the issue is complex and emotionally tender.




Catholic Bishops in the Public Square

Archbishop_DolanRead Archbishop Dolan's thought provoking article about anti-Catholicism in the American news media. The archbishop originally submitted his article which explicity criticizes The New York Times to The New York Times as an op-ed piece. Is anyone surprised it was rejected? You won't be after you read his article.


BishopThomasTobin In a separate matter, Rhode Island Representative Patrick Kennedy has agreed to meet with Bishop Thomas Tobin on health care after Kennedy's remarks some days ago which Bishop Tobin called "irresponsible" and for which he demanded an apology. Bishop Tobin's remarks are found on the Diocese of Providence's webpage. Kennedy had criticized Catholic opposition to health care coverage which does not include a ban on abortion funding as fanning "the flames of dissent and discord." Bishop Tobin remarked that Kennedy "contines to be a disappointment to the Catholic Church and to the citizens of the State of Rhode Island."


ArchbishopPicture I hope you follow Archbishop Chaput of Denver's remarks at least from time to time. From the Archdiocesan webpage his recent remarks :

If we stand up to evil, we may lose.  But if we don’t stand up we will lose.  Our God is a God of justice; a God who does not abandon his people and who rewards courage in the face of evil.  So have courage, serve the truth, love the Church, take confidence in the Lord, and stand up to witness for your faith.  We’ve got nothing to lose.  We have everything to gain. [Oct 8]

Catholic public officials who take God seriously cannot support laws that attack human dignity without lying to themselves, misleading others and abusing the faith of their fellow Catholics.  God will demand an accounting.  Catholic doctors who take God seriously cannot do procedures, prescribe drugs or support health policies that attack the sanctity of unborn children or the elderly; or that undermine the dignity of human sexuality and the family.  God will demand an accounting.  And Catholic citizens who take God seriously cannot claim to love their Church, and then ignore her counsel on vital public issues that shape our nation’s life.  God will demand an accounting.  As individuals, we can claim to be or believe whatever we want.  We can posture, and rationalize our choices, and make alibis with each other all day long -- but no excuse for our lack of honesty and zeal will work with the God who made us.  God knows our hearts better than we do.  If we don’t conform our hearts and actions to the faith we claim to believe, we’re only fooling ourselves. [Oct 16]


Stem Cell Research


The eight graders have asked to discuss stem cell research during my time with them this week. I will be distributing a copy of the brochure I wrote for the Diocese a few years ago and revised recently. It occured to me that others may find it useful as it contains a brief summary of the Catholic Church's teachings on stem cell research and several good references for further reading.

PDF file available:  Download StemCellBrochure2009