Let's be honest. We belong to a Church that is deeply prejudiced, biased, in fact. Irredeemably, unequivocally, unabashedly prejudiced on behalf of life. This is, of course, as it should be. The pope gave a good example of this "bias for bios" in a recent allocution given on March 20, 2004.1 How was his important message received?2
I ask this question because about a month after the pope spoke, in a Zenit news article dated April 27, 2004, "Why Vatican Teachings Face a Tough Reception," Archbishop Angelo Amato of the Congregation for the Doctrine of the Faith was interviewed on the occasion of the recent Vatican document Redemptionis sacramentum. Writes the author: "He [Amato] also recalled that John Paul II warned the doctrinal congregation in February that the publication of magisterial documents 'often confuses the faithful more than it informs them because of the reactions and interpretations' of the media."
I believe it will prove instructive to apply this insight, mutatis mutandis, to the recent allocution of the Holy Father. As of this writing, few, if any, scholarly articles have been written about the allocution.3 What we do have at our disposal, however, are accounts in the popular press, both secular and Catholic. We will focus on these.
As I read the reports coming out of the vegetative-state conference, as well as the reactions to the Holy Father's talk, I am struck by the fact that most reports contained no quotes from the pope's speech but rather summations in the reporter's or interviewer's own words of what it was thought the pope said or what someone else said the pope said, or, in some instances, perhaps, what a hasty reading of the original Italian text happened to be. Headline writers had a field day. Catholics around the world, for the most part, got their important first impressions of the allocution from little more than headlines.4
Our task will be made easier by several resources readily available. The organizers of the vegetative-state conference have established a website which contains not only many of the addresses given during the conference but also clips from the world press which chronicle the immediate reactions to the conference in general and to the pope's allocution in particular.5 The Catholic Health Association of the U.S.A. (CHA) has performed a similar service in making accessible on its website a listing of various news articles available for review.6 We will deal mainly, though not exclusively, with the materials from these two sources.
Though the pope spoke to the assembly on Saturday, March 20, 2004, some news about the vegetative-state conference was making the rounds before then. The website of the organizers contains quite a few accounts, many of them from Italian newspapers. Bishop Elio Sgreccia's news conference of March 16 is featured prominently in John Allen's National Catholic Reporter column, "The Word from Rome," for March 19.7 Allen comments on the animated and at times heated exchanges that took place during the unfolding of what he labels a "fascinating conference." As Allen tells it, unanimity of opinion did not reign at the conference; opposing viewpoints were presented.8 In many ways, Bishop Sgreccia and Fr. Norman Ford of Australia served as lightning rods for the debates that went on during the conference -- Sgreccia for the view that food and water should be provided to vegetative-state patients,9 Ford for the view that food and water may be withdrawn.10
While it is true that the Holy Father spoke to a group composed mainly of Catholic health-care professionals, he does, of course, have a worldwide audience, a fact we see clearly illustrated at the beginning of the fourth paragraph of his talk.
As a teacher and as a firm believer in the Christian intellectual heritage of joining faith and reason, the pope is speaking not only to Catholics, but to all men and women engaged in the healing professions. To one and all, the pontiff states this truth: The human being in the vegetative state is our brother, our sister. This insight is not exclusive to Catholics. To see its truth is not the exclusive bailiwick of Roman Catholic theology. This is a truth of human solidarity that stands to reason.
Available at first only in Italian, the English text of the pope's speech did not appear officially until about a week after it was delivered. In hindsight, this lag may have proved somewhat unfortunate. Headline writers had a field day ("Pope Rips Docs Who 'Pull the Plug"'), and many who could not read the original Italian were left to imagine the worst.
What the pope said did receive some favorable mention, of course. A Vatican Information Service press release was issued on the same day as the pope's talk. Its title: "Patients in the Vegetative State Are Always Human." A LifeSite News Bulletin, also released on the day of allocution, had a most optimistic headline: "Pope Ends Debate over Nutrition and Hydration for Patients in the Vegetative State." By far the most effective American spokesman for the importance of the pope's allocution was Richard Doerflinger, deputy director of the Secretariat for Pro-Life Activities of the USCCB and adjunct fellow in Bioethics and Public Policy at The National Catholic Bioethics Center. In addition to writing articles,11 Doerflinger was interviewed for many newspaper stories.12
Several days later (officially, April 1), Fr. Michael Place, president of the Catholic Health Association of the United States, issued a brief but important statement on the pope's allocution. In it, after reminding one and all of Catholic teaching on the dignity of the human person, "no matter their physical or medical condition," Fr. Place went on to sound a cautionary note. The pope's allocution contains "implications" (a word he uses twice) that will have to be sorted out, especially "practical implications for those patients who are not in a persistent vegetative state." While issuing a call for "dialogue" (he uses this word three times), the CHA president assumes that the current edition of the Ethical and Religious Directives for Catholic Health Care Services (ERDs), as interpreted by the diocesan bishop, will remain in effect.13 Many accounts about the repercussions of the pope's speech will make the same assumption, namely, that the ERDs will remain in effect while the "dialogue" goes on.14
At approximately the same time, additional CHA materials were made available in order to encourage study and dialogue.15 One is especially eye-opening, namely, the "Comparative Analysis of Past Church Teaching on Nutrition and Hydration and an Initial Reading of What Is in the Papal Allocution."16
Writing in The Tablet soon after the pope spoke, Michael Hirst gives a fairly comprehensive overview of the goings-on in Rome at the vegetative-state conference. After making allusions to the debates and contretemps that took place, Hirst gives the last word to Eugene Diamond, M.D., past president of the Catholic Medical Association, who sums up the matter of vegetative patients in succinct fashion: "Our choice is really between caring for such persons or abandoning them."17
On the website of the World Federation of Catholic Medical Associations, one finds "FIAMC's Final Statement on Vegetative State," a text (undated, as far as I could tell, but certainly posted after March 20, 2004) which is open for electronic signatures. Its author is Gian Luigi Gigli, M.D., president of FIAMC. Of the fourteen points listed in the FIAMC "Final Statement," eight make scientific points, six deal with ethical considerations. Point fourteen says:
Vegetative-state patients cannot be considered as "burdens" for society; rather, they should be viewed as a "challenge" to implement new and more effective models of health care and of social solidarity.18
The pope's words, while well-received, no doubt, by most of the conference's participants, were not music to everyone's ears. Indeed, John Paul II's critics soon lined up, both Catholics as well as non-Catholics.
Of the non-Catholics weighing in on the matter, Arthur Caplan, as usual, was outraged.19 The pope's reasoning was seriously flawed, and the pontiff was guilty of undermining patients' rights and going against well-established clinical practice in the United States.20 Barbara Coombs Lee, president of the Compassion in Dying Federation, appearing on National Public Radio's Morning Edition, claimed that a cabal of conservative Catholic bishops benefit from what she considered the pope's ambiguous remarks.21 The pope's speech merited some "observations" ("criticism" is not the right word here) from other well-known authorities, such as neurologist James Bernat of Dartmouth College, who opined that the American bishops will not put the pope's words into practice verbatim because what the pope says goes against the status quo of end-of-life care in America.22
Not all non-Catholics were critical of the pope's allocution, a fact that rarely appears in the press accounts. I, for one, know they are out there.23 It seems to me that much of what the pope said in March 2004 was adumbrated in a 1993 Lutheran document, Christian Care at Life's End:
In these circumstances continued feeding [of PVS patients] is wise because it effectively blocks the temptation society may have solely to aim at the death of patients whose "biological tenacity" [the phrase belongs to Daniel Callahan] has become inconvenient and troublesome.24
Some Catholics who take issue with what the pope says are content to voice their objections in the course of interviews.25 Others confront the allocution head on. Of these, several presume to lecture the pope on the precise meaning of the Catholic ethical tradition, attempting to label John Paul II, for all intents and purposes, a "vitalist."26 Others lament the "narrowing" of traditional Catholic teaching on end-of-life issues that has, according to them, taken place on this pontiff's watch.27 All of these critics concur that the pope's approach, though admittedly well-intentioned, could end up fostering a push for physician-assisted suicide and euthanasia "by engendering a fear of having one's dying or vegetative state prolonged."28
There is a common theme sounded in many press accounts of the Catholic reaction to the pope's allocution, to wit, no action will be taken, no changes to current practices will take place until those who administer Catholic health-care facilities receive instructions on how to interpret the allocution.29 For example, Benefis Healthcare of Great Falls, Montana, envisions no changes in its life-support practices as a result of the pope's remarks, but "Benefis will take another look if changes are recommended by the Catholic Health Association, to which the hospital belongs, or Providence Services, the hospital's Catholic Sponsor."30
By the beginning of April, word of the significance of the pope's speech had certainly made the rounds, occasioning lengthy comment at both ends of the American Catholic spectrum.31 Nationally, the allocution made the big time when USA Today carried an article by Cathy Lynn Grossman, "Pope Declares Feeding Tubes a 'Moral Obligation,'" in which we read that the 565 Catholic hospitals comprising the CHA have for Years been routinely considering feeding tubes for PVS Patients as "medical treatment."32 Grossman also picked up on Fr. Michael Place's remark that the pope's speech may have repercussions for patients who are not in a PVS.33
Newspaper accounts throughout the month of April continue to stress the fact that the status quo will remain, Catholic hospitals will continue to honor living wills, and the ERDs will continue to remain in place. Interestingly, one columnist, Abram Katz, science editor for The New Haven Register, perceptively pointed out in an April 26 column, "Pope Seems to Limit Choices," that the allocution "seems to contradict health-care directives to Catholic hospitals by the U.S. Conference of Catholic Bishops" (i.e. the ERDs).
We read over and over again of the roles to be played by the CHA and the American bishops in interpreting for the American Catholic health-care community the meaning of the allocution in light of the ERDs. The same reports also bring to light a serious misunderstanding of what is contained in the ERDs. Notes Columnist Bill Tammeus:
The pope's position has yet to work itself into the written directives [i.e., the ERDs] from American bishops that guide Catholic health-care workers. Those directives now are in conflict with the pope's statement because they consider feeding tubes to be medical treatment, not basic care.34
While discussions are taking place, the ERDs remain the core of Catholic end-of-life care, notes another report, which adds: "According to those guidelines [i.e., the ERDs], feeding tubes for people in chronically vegetative states are considered 'medical treatment' that can be continued or halted based on the benefits and burdens for patient and family."35
And yet another: "At the moment, Catholic hospitals consider feeding tubes for people in a persistent vegetative state as 'medical treatment.' That treatment can be discontinued when its burdens outweigh its benefits."36 In an Associated Press article which appeared in many newspapers, Columnist Jim Suhr makes note of the fact that many Catholic hospitals continue to defer to the ERDs and, in his words, "according to those guidelines, feeding tubes for people in chronically vegetative states are 'medical treatment' that can be continued or halted based on the benefits and burdens for patient and family."37
My point is not to take issue with these reports. On the contrary. It is to note that in my copy of the ERDs, I come across no text that says or implies that feeding tubes are "medical treatments" for vegetative-state patients or, for that matter, for any others. Where has this interpretation come from, an interpretation that, if we can believe the reports, apparently permeates American Catholic health-care delivery?
While no such statement is found in the Ethical and Religious Directives for Catholic Health Care Services, it does appear in some commentaries written about the ERDs. Some approach the matter gingerly.38 Others come right out and say it:
Weighing the benefits and burdens will depend on an accurate diagnosis of the patient's condition which, as in the case of the persistent vegetative state, occurs only over time. Once a person is diagnosed to be in a persistent vegetative state, however, the ERD do not preclude the removal of nutrition and hydration from the patient.39
Though artificial nutrition and hydration as medical treatment is not found anywhere in the ERDs, it nevertheless seems to be the case that many who work in Catholic health care think that this is what the ERDs can be made to say. What does all this mean? Richard Doerflinger gets right to the point: "Some interpretations of the Ethical and Religious Directives should now be considered invalid."40
As we have seen, many regard what the pope said as upsetting the status quo of American health care. While that may be true, that ought not to be taken necessarily as a criticism. If the pope's allocution is regarded as a course correction for the Catholic tradition and if the initial reactions to it are any indication, there would appear to be much hard work that has to done, much honest dialogue that needs to occur, much teaching, or perhaps better, reteaching that will have to take place.
On one point, Catholics of whatever ideological persuasion do indeed agree: the pope's allocution, valuable though it is, left many questions unanswered.41 As we reflect on the questions and try to come up with faith-filled, reasonable answers, may it not be the case that what the pope is telling us in the allocution about our care for the most dependent human beings is ultimately epistemological? On this point, perhaps the pope is agreeing, in the final analysis, with the daughter of a Protestant minister who wrote:
I fear the power of choice over life and death at human hands. I see no human being whom I could ever trust with such power -- neither myself not any other. Human wisdom, human integrity are not great enough.42
1 The pope's allocution appears with the title "Care for Patients in a 'Permanent Vegetative State" in Origins 33.43 (April 8,2004): 737, 739-740; see also the verbatim in this issue, 573-576; and http://www.vatican.va/holy_father/john_paul_ii/speeches/2004/march/documents/hf_jp-ii_spe_20040320_congress-fiamc_en.html. The pontiff was addressing the participants who were assembled in Rome for an international congress titled "Life-Sustaining Treatments and the Vegetative State: Scientific Advances and Ethical Dilemmas." The gathering was co-sponsored by the World Federation of Catholic Medical Associations (FIAMC) and the Pontifical Academy for Life. [Back]
2 On the "weight" of papal allocutions, see Fr. Joseph Clifford Fenton, "The Doctrinal Authority of Papal Allocutions," American Ecclesiastical Review 134 (February 1956): 109-117; J.T. Catoir, s.v. "Documents, Papal," The New Catholic Encyclopedia, vol. IV (Palatine, IL: Jack Heraty & Associates, Inc., 1967): 946-947; Rev. Bevil Bramwell, O.M.I., "The Authority of Church Statements," Ethics & Medics 28.2 (February 2003). [Back]
3 Father John Strynkowski, current executive director of the Secretariat for Doctrine and Pastoral Practices, estimates that it will take a least a year for scholars to do their work. He is quoted in a newspaper article by Lisa Greene, "At Pope's Word, New Schiavo Cases?" St Petershurg Times Online, May 1, 2004, 1B. [Back]
4 I know this firsthand from several of the consult calls that came to The National Catholic Bioethics Center (NCBC) soon after the pope spoke. One doctor, for example, was hopping mad because of a headline he had read in the March 21 edition of the New York Post, to wit, "Pope Rips Docs Who 'Pull the Plug.'" This doctor had not read the pope's allocution. This was true of others as well. [Back]
5 Check the conference "Press & Comments" section, http://www.vegetativestate.org/commenti.htm. [Back]
6 See the CHA members-only section titled "Resources for Understanding Pope's Allocution on Persons in a Persistent Vegetative State," http://www.chausa.org/$MEMB/MISSSVCS/ETHICS/anh.ASP. [Back]
7 0nline version, http://www.nationalcatholicreporter.org/word/wordO31904.htm. [Back]
8 Several of these may be found in the same issue of Origins which contains the Holy Father's allocution. Among them are Norman Ford, S.D.B., "Determining What Is Best for Patients," Origins 33.43 (April 8, 2004): 751-752; and John Harvey and Ronald Hamel, "On Withdrawing Medically Administered Nutrition and Hydration," Origins 33.43 (April 8, 2004): 748-751. [Back]
9 0n Sgreccia as lightning rod, see Arthur Jones, "U.S. Ethicists Counter Vatican View: Artificial Hydration, Feeding: Normal or Extraordinary Care?" National Catholic Reporter, March 26, 2004, 5. James J. Walter and Kevin O'Rourke, O.P., voice their disagreement with Bishop Sgreccia's remarks at the March 16 press conference. [Back]
10 After hearing what the pope said on March 20, Fr. Ford let it be known that he accepts the Holy Father's teaching on nutrition and hydration. See his article, "The Debate Goes On," Tablet (London) (May 1, 2004): 8-9. [Back]
11 See for example, Richard Doerflinger, "Pope's Euthanasia Speech Is about Human Dignity," LifeNews.com, April 19, 2004; and idem, "John Paul II on the 'Vegetative State,'" Ethics & Medics 29.6 (June 2004): 2-4. [Back]
12 See Frank Langfitt, "Pope's Stand on Life Support Unclear for Church Hospitals: Giving Food, Water Moral Obligation, Pontiff Says," Baltimore Sun, April 3, 2004, 1A. [Back]
13 CHA, "The Catholic Health Association of the United States Statement on the March 20, 2004, Papal Allocution, "April 1, 2004; see also United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, 4th ed. (Washington, D.C.: United States Conference of Catholic Bishops, 2001). [Back]
14 See for example, Roseann Keegan, "Queen of the Valley to Continue Honoring Living Wills: Pope's Statement on Forced Feeding [sic] Doesn't Alter Status Quo for Catholic Hospitals," Napa Valley Register, April 26, 2004, http://www.napanews.com/templates/index.cfm?template=story_full&id=182A4B9F-C698-4DDB-9ECF-7E3D62BE3A1B; and Jonathan Maze, "2 Area Hospitals Weigh Pope's Stance," Post and Courier (Charleston, SC), April 7, 2004. [Back]
15 See the CHA website and the materials assembled as "Resources for Understanding Pope's Allocution on Persons in a Persistent Vegetative State." [Back]
16 The authors seem to be saying that the pope is making a radical break with the Catholic tradition on end-of-life care. I believe that John Paul II is making a radical break with some interpretations of that tradition. Suggestive in this regard are comments made by columnist Carl Hiaasen, "Pope's Comments Have Jarring Effect," Miami Herald, April 11, 2004, 5L. [Back]
17 See Michael Hirst, "Failure to Feed 'vegetative' patients Immoral, Says Pope," Tablet (London) (March 27, 2004): 27, http://www.thetablet.co.uk/cgi-bin/citw.cgi/past-00172. For an article that seems most prescient in light of the Holy Father's allocution, see Eugene Diamond, "Medical Issues When Discontinuing AHN," Ethics & Medics 24.9 (September 1999): 1-2. [Back]
18 The one scriptural citation used by the pope comes to mind: "Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me" (Mt 25: 40). On the notion of "solidarity," see William E. May, Ph.D., "Tube Feeding and the 'Vegetative State,'" Ethics & Medics 24.1 (January 1999): 2-4. [Back]
19 Caplan is the unofficial leader of the secular bioethics establishment in America. From that perch, he has of late been firing broadsides at those who espouse what he considers "right-wing views." Caplan, always quick with a phrase, rails against these "contemporary conservative caterwaulers" and "new would-be mullahs." Leon Kass is a special target. See Caplan's "Revulsion Is Simply Not Enough: The Impending Culture War over Advances in Genetics," American Philosophical Association Newsletters 2.1 (Fall 2002): 206-209. [Back]
20 For yet another instance of what we might call the "How Dare the Pope Go against the Status Quo?" argument, see especially Caplan's "Must We All Die with a Feeding Tube? Pope's Directive Undermines Patients' Medical Rights," MSNBC, April 6, 2004, http://msnbc.msn.com/ID/4669899/. Well before the 2004 vegetative-state conference, Caplan and a Catholic ethicist used the pope's Parkinsonism as the basis for an article. See Dominic A. Sisti and Arthur L. Caplan, "Would the Pope Get a Feeding Tube?" Chicago Tribune, December 26, 2003, 21. (My thanks to Nancy Valko, R.N., for locating this article and for her suggestion that the allocution may be regarded as a reply to Sisti and Caplan.) The duo took on the pope once again, this time after his allocution, in an editorial "Do Not Resuscitate," Philadelphia Inquirer Online, April 1, 2004, http://www.philly.com/mld/inquirer/news/editorial/8324997.htm?1c. Here the pope is excoriated because he is at odds with the American values of self-determination, freedom, and autonomy. When interviewed for an article by Lisa Greene, "At Pope's Word, New Schiavo Cases?" Caplan opined that the pope's talk will cause "an earthquake" in end-of-life care. Interestingly, in this interview, while several Catholic theologians downplay as much as possible the scope of the pope's remarks -- Fr. John Paris is quoted as saying: "I think the best thing to do is ignore it, and it will go away. It's not an authoritative teaching" -- Caplan, while not agreeing with the pope, nevertheless insists on the allocution's importance. [Back]
21 The segment aired on April 29, 2004. Lee was not the only person interviewed, but she was, I believe, the only non-Catholic. [Back]
22 That the pope is upsetting the "status quo" is a mantra of sorts, mentioned by both secular and Catholic commentators. Bernat is interviewed by Dean Olsen, "Pope's Speech Stirs Health Groups," State Journal Register (Springfield, IL), April 19, 2004. [Back]
23 I received an e-mail several days after the pope's speech. The author, Wesley Smith, a Lutheran, wrote: "I was so pleased that the pope did the right thing -- as he always does." [Back]
24 Commission on Theology and Church Relations of the Lutheran Church -- Missouri Synod, Christian Care at Life's End (St. Louis: Concordia Publishing House, 1993), 14. [Back]
25 For some of them, see the articles by Greene, "At Pope's Word, New Schiavo Cases?"; and Bill Tammous, "Pope's Stance Puts Pressure on Hospitals," Kansas City Star, April 3, 2004, A1. [Back]
26 See Thomas A. Shannon and James J. Walter. "Artificial Nutrition, Hydration: Assessing Papal Statement," National Catholic Reporter, April 16, 2004, 9-10. Readers can judge for themselves whether the authors are setting up a straw man. These two authors have collaborated before. See Thomas A. Shannon and James J. Walter, "The PVS Patient and the Forgoing/Withdrawing of Medical Nutrition and Hydration," Theological Studies 49.4 (December 1988): 623-647. For a treatment of how to distinguish "vitalism" from an authentic sanctity-of-life viewpoint, see John Keown, "The Legal Revolution: From 'Sanctity of Life' to 'Quality of Life' and 'Autonomy,'" Journal of Contemporary Health Law and Policy 14.2 (Spring 1998): 253-285. [Back]
27 See, in this regard, Ronald Hamel and Michael Panicola, "Must We Preserve Life? The Narrowing of Traditional Catholic Teaching," America 190.14 (April 19-26, 2004): 6-13. The editor of America magazine, Jesuit Thomas Reese, interviewed for a newspaper article, also voices his concern that the pope is breaking with an unbroken tradition. See Steven G Vegh, "Three Local Hospitals Weigh Pope's Words on Feeding Tubes." Virginian-Pilot. May 4, 2004, online. [Back]
28 This possibility also appears in the CHA's packet of materials of the pope's allocution. See the "Persistent Vegetative State and Artificial Nutrition and Hydration: Questions for Study and Discussion." It is possible that the authors of the articles were part of the group of ethicists that raised the questions in the first place. This argument is not new. See, for example, Rev. Kevin D. O'Rourke, O.P., J.C.D., and Sr. Jean DeBlois, C.S.J., R.N., Ph.D., "Removing Life Support: Motivations, Obligations," Health Progress 73.6 (July-August 1992): 20-27, 38. [Back]
29 See for example, Matt Leingang, "Hospitals Stand Pat on Living Wills," Cincinnati Enquirer. April 3, 2004. http://www.enquirer.com/editions/2004/04/03/loc_loc1alife.html; and Maze. "2 Area Hospitals." [Back]
30 See Richard Ecke, "Life-Support Policy Will Not Change for Now, Benefis Says: End-of-Life Care Will Remain Patients' Decision despite Papal Proclamation," Great Falls Tribune Online, April 7, 2004, http://www.greatfallstribune.com/news/stories/20040407/localnews/184325.html. [Back]
31 See Fr. John T. Zuhlsdorf, "Holy Father Outlines Care of Persons in 'Persistent Vegetative State,'" Wanderer, April 1, 2004, 1, 8; and Shannon and Walter, "Artificial Nutrition and Hydration." [Back]
32 When Grossman's article appeared in the Chicago Sun-Times on April 2, it was titled "Pope's Edict on Life Support Stuns Catholic Caregivers." The headline is based, it would seem, on Laurence O'Connell's statement that the Holy Father's stance is a "stunner, to say the least." O'Connell is the president and CEO of the Chicago-based Park Ridge Center for the Study of Health, Faith, and Ethics. [Back]
33 The National Catholic Bioethics Center agrees: "This statement [i.e., Pope John Paul II's allocution] has implications not only for comatose patients but for all patients who receive or may receive food and water." See NCBC, "Statement of the NCBC on Pope John Paul II's Address on Nutrition and Hydration for Comatose Patients," press release, April 23, 2004, http://www.ncbcenter.org/press/04-04-23-NCBCStatementonNutritionandHydration.html. [Back]
34 Bill Tammeus, "Catholic Hospitals and Rome Not on Universal Footing," Kansas City Star, May 8, 2004, 2. [Back]
35 "Papal Pronouncement Reviewed by Hospitals," Belleville News-Democrat, April 16, 2004, 1A. [Back]
36 Maze, "2 Area Hospitals Weigh Pope's Stance." [Back]
37 Jim Suhr, "Pope Decries Euthanasia -- Hospitals to Honor Living Wllls," Boston Globe, April 16, 2004, A4. [Back]
38 See Michael R. Panicola, Ph.D., "Withdrawing Nutrition and Hydration," Health Progress 82.6 (November-December 2001), 28-33; Kevin O'Rourke, O.P., and Patrick Norris, O.P., "Care of PVS Patients: Catholic Opinion in the United States," Linacre Quarterly 68.3 (August 2001): 201-217; and Gerald D. Coleman, S.S., "Take and Eat: Morality and Medically Assisted Feeding," America 190.12 (April 5, 2004): 16-20. [Back]
39 Rev. Thomas R. Kopfensteiner, S.T.D., "Developing Directive 58," Health Progress 81.3 (May-June 2000): 27. These are the last words of the article. Citing Kopfensteiner's article as helping to form the basis for his own view, admittedly cautious, but favoring ultimately the withdrawal of artificial nutrition and hydration from PVS patients, is John Collins Harvey, M.D. "Ordinary or extraordinary Care et the End of Life," Priest 60.1 (January 2004): 8-11. [Back]
40 Doerflinger is quoted in Nancy Frazier O'Brien and John Thavis, "Sorting Out Feeding-Tube Policies," Compass (Diocese of Green Bay, WI), April 23, 2004. [Back]
41 0n this point, Fr. Norman Ford ("The Debate Goes On") and Richard Doerflinger ("Pope John Paul II Affirms Obligation to Feed Patients in the 'Vegetative' State,'" National Right to Life News, April 2004, 1, 28-29) certainly agree. For some of the questions that remain, see the CHA and the NCBC websites. [Back]
42 Pearl S. Buck, foreword, in The Terrible Choice: The Abortion Dilemma, eds. Robert E. Cooke et al. (New York: Bantam Books, 1968), x. [Back]