Is pulling the plug on the dying a moral decision?

One of the most difficult moral issues a family has to deal with is whether to remove life-supporting machinery from someone who is dying. The death of Terri Schiavo followed by the autopsy report in 2005 helped to clear up some confusion that has arisen from cases like this. We should all have a written living will to instruct relatives and friends about the kind of medical treatment that we want or do not want if we find ourselves in an unconscious state.

A thorough autopsy found that Schiavo’s brain had withered to half the normal size since her downfall in 1990. No treatment could have remotely improved her condition. The report generally supported the contention of her husband, Michael, that she was incapable of recovering and had no possibility of having a normal life. This is the same conclusion that judges in six courts over a period of time embraced after five court-appointed doctors examined her.

The 5th Commandment forbids the intentional killing of a person or anything designed indirectly to cause another’s death. However, allowing nature to take its course is not considered “killing.” So, to what extent are we obliged to keep a person alive?

The Church’s teaching on this matter began with two 16th-century Dominican theologians, de Victoria and Banez.

Banez explained the distinction between “ordinary” and “extraordinary” means to avoid death. Today, “common practice” and can still be considered “extraordinary.” Using machines to keep a person alive is still considered “extraordinary.”

Over time, theologians and the teaching authority of the church fine-tuned this principle. On May 5, 1980, the Congregation for Doctrine and Faith issued this formal statement, “One cannot impose on anyone the obligation to have recourse to a technique that is already in use but carries a risk or is burdensome… When inevitable death is imminent… it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life.”

The Catechism of the Catholic Church reaffirms that position when is says, “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “overzealous” treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The patient should decide if he or she is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.” (2278). The Catechism carries significant importance because the worldwide college of bishops approved its contents.

On March 20, 2004, Pope John Paul II delivered an address to a visiting group of doctors in which he maintained that hydration and nutrition for patients in the persistent vegetative state is not a medical act and, therefore, is mandatory. The term “not a medical act” is confusing since only a medically trained person can insert tubes and needles, which bypass the natural digestive system. Besides, all countries are not able to do such procedures. Consequently, the pope’s statement merits a lower rung on the ladder of authority.

When the body is in a dying state, it wants to shut down. Often, by giving a person hydration and nutrition artificially, the treatment may do more harm and cause more pain than not dispensing it. Medical experts advise, “Giving patients small amounts of food or using mouth swabs, sips of water, ice chips and lubrication of lips, may be sufficient to alleviate hunger and thirst.”

What is the point of keeping someone alive when the person has no awareness and no hope of recovering? Do we really believe that death is the door to eternal life with God?