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| Two of the keynote presenters at the upcoming end-of-life issues conference Oct. 31 and Nov. 1 in San Antonio will be Dr. John Haas, left, and Father Tadeusz Pacholczyk, right, both of the National Catholic Bioethics Center in Philadelphia.
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Many Catholics still need to learn about the church’s teachings on end-of-life issues, such as when it might be morally acceptable to reject or terminate life-prolonging treatments. While euthanasia and assisted suicide are always wrong, in some situations the terminally ill or dying can withdraw or refuse treatment and still be in line with church teaching.
To help people make informed and ethical decisions, scholars, theologians, religious and health care professionals have been invited to the second annual end-of-life conference. The two-day gathering will take place Friday, Oct. 31, and Saturday, Nov. 1, at the University of the Incarnate Word. Official sponsors for the event are the Archdiocese of San Antonio, the University of the Incarnate Word, CHRISTUS Santa Rosa Health Care and the Texas Catholic Conference. The conference is being coordinated by the Basilica Press in conjunction with The National Catholic Bioethics Center.
“In today’s age of rapidly advancing technological and medical advancement, I believe it is very important that Catholics have a clear understanding of the many important issues that surround end-of-life decisions,” said Archbishop José H. Gomez in a letter of introduction to the event. “It is my hope that this conference will provide valuable information and resources for Catholic clergy and Catholic health and legal professionals who are involved with helping lay Catholics understand what the church teaches regarding this subject.
Presenters include Dr. John Haas, president of the National Catholic Bioethics Center (NCBC) in Philadelphia; Father Tadeusz Pacholczyk, Ph.D., director of Education, Neuroscientist and Staff Ethicist at the NCBC; Christina McClean, director of CHRISTUS VNA Hospice and Palliative Care; Andrew Rivas, executive director of the Texas Catholic Conference (TCC); Jennifer Carr-Allmon, associate director of the TCC; and Douglas Deffenbaugh and Lisette Lange, partners in the law firm of Deffenbaugh and Lange, P.L.L.C.
Topics to be discussed during the two days include end of life issues, Catholic health care and bioethical principles, pain management, palliative care, hospice, brain death and Catholic perspectives on living wills, health care proxies, advance directives and do not resuscitate orders. Overall, attendees will look at the scientific and ethical aspects of caring for the terminally ill and dying.
The gathering is especially important because the push for legalizing euthanasia and assisted suicide is taking root in many parts of the world.
In addition, even some Catholics might not be clear about what kind of decisions are morally licit, since ambiguities cloud many end-of-life issues.
One difficulty lies in the fact that moral theologians and some medical professionals may be attaching different meaning to terms such as “ordinary,” “extraordinary” and “futile” when describing a proposed treatment.
The Vatican’s Congregation for the Doctrine of the Faith tried to clear up this problem with its 1980 Declaration on Euthanasia. The Vatican assigned the terms “proportionate” and “disproportionate” to describe the probable effectiveness of possible treatments. Whenever a medical treatment is deemed disproportionate because it would cause the patient strain or suffering out of proportion with the benefits, then it is optional.
And the U.S. Conference of Catholic Bishops issued its “Ethical and Religious Directives for Catholic Health Care Services” in 2001 to help “articulate and apply magisterial teaching,” said Haas.
But some literature in moral theology has been ascribing new uses for the terms ordinary and proportionate — developments that he said do not seem rooted in the way the church traditionally has used those terms. He said the church must continue to refine the terms “to allow a greater precision in ethical judgment.”
Haas told CNS that in the world of high-tech medical advancements “the really big area of contention today is this area of assisted nutrition and hydration.”
This was made especially apparent during the legal battle over the fate of Terri Schindler Schiavo, a severely brain-damaged Florida woman who died in March 2005 after a court ordered that her husband could make her medical decisions for her. Michael Schiavo, the husband and legal guardian, said she would have wanted her feeding tube removed, while her parents said she would have wanted to remain alive based on her Catholic faith.
Pope John Paul II’s 2004 allocution said artificial feeding and nutrition of patients in a persistent vegetative state was not “a medical act,” but was proportionate and ordinary and therefore morally obligatory.
Haas stressed the concept that “excessive burden has to be applied to the treatment and not to the life” of the patient.
It would be immoral for a person with a chronic condition or a substitute decision-maker to decide the patient’s life has become “too burdensome” and to remove the necessary life support.
But, “if the person is dying and the continued use (of life-supporting measures) results in a prolonged and precarious existence, then clearly it can be withdrawn,” said Haas.
“The difficulty is people want black-and-white answers,” he said, “and when we are dealing with these end-of-life questions it’s a matter of prudential judgment as to what is going to constitute a reasonable hope of benefit and excessive burden.”
While market-driven medical technology applied at the end of life is a growing threat to human dignity, research involving embryonic stem cells ties in with end of life issues.
Father Pacholczyk said advocates for embryonic stem cells maintain that 100 million people could benefit in the United States alone. That claim is overstated, he said.
“There’s a good deal of overselling, overbilling, overcompromising and outright hyping that is occurring and have been occurring for so long that it is conditioning all of us whether we realize it or not,” he said. “We need to distinguish the truthful claims from the incredible hype that is going on all around us.”
Father Pacholczyk said it is a myth that Catholic teaching warms against stem-cell research. The church opposes research involving human embryonic stem cells but is not against using stem cells from adults, from umbilical cord blood and other sources.
“Of the different forms of stem-cell research, the church could support nine out of 10 under the right circumstances,” Father Pacholczyk said.
Catholic News Service contributed to this article.