Priest states case for allowing life to end
With the grim countdown to Terri Schiavo's death on Thursday, the Rev. David O'Leary, chaplain of Tufts University, watched as the topic of his 1999 dissertation became the focus of global moral debate.
O'Leary, a Catholic priest, got his doctorate in medical ethics from Oxford University in England by arguing that Catholicism permits the cutoff of food and water to patients in a persistent vegetative state. The Vatican has said that Schiavo's feeding and hydration tubes should not have been removed; O'Leary disagrees. He points out that Catholic thinking traditionally has distinguished between extraordinary measures to sustain life, which may be refused, and ordinary medical care, which may not.
''Physical life is an important but limited value," O'Leary wrote in his dissertation, which the Catholic Center at Tufts published as a book. ''It serves to make possible the obtainment of a more important good: love of God and love of neighbor. When that good is, for physical reasons, not accessible, then medically dependent life may be permitted to end."
O'Leary, who also teaches medical ethics at Tufts, talked about the issue this week. Excerpts follow.
Q: Hasn't the pope said that it is ordinary care to feed and hydrate?
A: When you deal with someone in a persistent vegetative state, the lines start to get blurred of what is ordinary and extraordinary means. We have to take in medical opinion. If we're going to look at removing a feeding tube, there are questions about cost, undue burden. Is there any hope of improvement? When you factor in those issues, maybe food and water are extraordinary and might not have to be done.
It [varies] from country to country -- our medical technology in this country as opposed to Southern hemisphere countries. The case can [vary] by individual -- what's the hope of improvement? What's the burden on the family?
Q: To what degree does the consumption of medical resources that might be used for others factor in?
A: Family members themselves should weigh what they have the wherewithal of doing. They should not be burdened with undue guilt if they make a decision of just letting someone die. What's the ratio of benefit to risk, and what's the hope of improvement? And then you factor in the quality of life. In cases like persistent vegetative state, the majority of medical opinion says there's not going to be any change, and quality of life is just going to deteriorate.
Q: In your book, you say Catholic teaching calls for preserving life, but not at all costs. Which costs are unacceptable?
A: That's what the family has to weigh. What's their medical insurance? What's the emotional tie on the family? Are other family members going to be deprived of the love or care of parents or siblings if all attention is on this individual?
Q: Some pundits have said advocates of removing Schiavo's [feeding] tubes would be ''killing" her. Why do you distinguish between ''killing" and ''letting die?"
A: Killing is a direct action. You insert an air bubble. You hook someone up to the Kevorkian death machine. By removing a feeding tube or ending hydration, you are letting the human body take its course.
Q: You mentioned that families have to factor in their own views. I can see some religious believers saying your approach is relativism. There's no universal moral imperative against killing; we're on a slippery slope.
A: If you have sound medical opinion counseling family members that there is no hope, to let someone die is part of our human nature. We're finite beings. Families are always free to make their own decisions as long as they rely on medical opinion and, if they're Catholic, on the wisdom of the church.
Q: What would you say to those who are fearful that letting Terri Schiavo die would contribute to a ''culture of death?"
A: I think there are some questions about what the culture of life, versus the culture of death, is saying. The church's teaching is always that life should be respected as a gift from God. [But] we need to rely on the full wisdom of the church's teaching, and when we talk about life, it's usually an active life.
I've been present in many hospice [cases], families who are saying goodbye to a loved one, and it's a very prayerful moment. But we are just letting the person die and go to God.
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