A friend near the end

Jun 2-8. 05
VOL 124 NO. 21
A friend near the end
By Luke Eggleston/ SUN staff writer
SUN photo(s) Paul Finch
Terri Schiavo case highlights importance of end of life preparations.

The death of Terri Schiavo in March brought end-of-life issues to the fore for many American Catholics.

When she was 26 years old, Schiavo suffered a collapse and the oxygen flow to her brain was interrupted for five minutes. As a result, Schiavo needed to be nourished through a tube for the foreseeable future.

Schiavo’s death triggered reactions ranging from outrage to pity and to confusion in reference to the Church’s position on such matters.

Above all, the feud between Schiavo’s parents and her husband, who was her sole legal guardian and was seeking to have the tubes removed, showed that one must establish a strategy for executing one’s wishes in the event that one can either no longer communicate or is incapable of making decisions.

Syracuse Diocesan Director of the Respect Life Office Cindy Falise said that while she believes that sanctity of life must be honored, the actual Catholic Church doctrine remains murky.

“Moral theologians have not decided on the Church position on end-of-life issues,” she said.

The range of debate is emblematized in the disparity between the position most often interpreted to be Pope John Paul II’s and that of the Australian bishops.

In 2004, Pope John Paul II is quoted as saying, “I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.”

The pope’s language suggests that in the event that one’s life can be extended through hydration and nourishment, such means should be utilized. Yet the Holy Father himself rejected such means when he knew his life was near its end and he was at peace.

The Australian Catholic Bishops offer a different interpretation of the pope’s statement.

“In summary, the pope’s statement is an application of traditional Catholic teaching and says neither that nutrition and hydration must always be given, nor that they are never to be given, to unresponsive and/or incompetent patients,” the bishops’ statement reads. “Rather, the pope affirms the presumption in favor of giving nutrition and hydration to all patients, even by artificial means, while recognizing that in particular cases this presumption gives way to the recognition that the provision of nutrition and hydration would be futile or unduly burdensome.”

Two recent letters to the editor published by The Catholic Sun are indicative of the polarities in the debate. Falise herself contributed a letter to the editor.

In Schiavo’s case, Falise finds herself supporting the case for nourishing and hydrating the individual who is no longer able to think for him or herself.

In the letter, Falise argues that the “persistent vegetative state” description used in reference to Schiavo is not only a misnomer, it’s an offense.

“PVS is a loathsome term because it uses non-human terminology to describe a human physical condition,” she wrote. “The marvel of the human person is the presence of God in each and every one. God’s gift is the value of human people, not the wrapping in which it comes. Terri Schiavo represents the very population that God calls us to love and serve — the most vulnerable among us.”

Another letter coming from the same Central New York Diocese countered that the repeal of nutritive and hydrating feeding tubes from Schiavo was, in fact, wholly in keeping with the teachings of the Catholic faith.

“This is a common practice and this decision is reached tens of thousands of times annually to discontinue the medical treatment of artificial nutrition and hydration when it is not commensurate with the benefits involved,” wrote David Pasinski. “It is done legally, morally, ethically — and without distress to the patient. Secondly, this is perfectly compatible with Catholic teaching — not withstanding the allocution of the late John Paul II.”

Pasinski, who is the senior chaplain at the Hospice of Central New York, went on to note that Dr. John Harvey, a Catholic theologian and medical doctor, noted that the pope’s words on the subject, which are widely considered to support Falise’s thinking, are far more vague and suspect than many assume.

Pasinski was among three individuals from Central New York invited to participate in a panel discussion orchestrated by Father Joseph Champlin in an effort to show the complexities of end-of-life issues not only in the realm of ideas, but also in one’s personal life. Along with Pasinski, the panel discussion featured attorney Daniel Cantone and Dr. Joel Potash of Upstate Medical Center.

The discussion was prompted by the high profile of the Schiavo case.

“For the American people, the Terri Schiavo case opened up a window for about two months,” Father Champlin said. “People became very concerned about wills and health sponsors. That quickly passes and then we become concerned with the Yankees losing and now they’re winning again. I thought we’d seize on it and that’s when my idea was this [panel discussion].”

Father Champlin knew that such a forum would be necessary when he was waiting for an airplane home from Newark. While in transit to Newark, news of Schiavo’s death had hit the national networks. While waiting in the airport, Father Champlin was confronted with the image of outspoken right-to-life activist Father Frank Pavone announcing on the Larry King Live show that “We have killed this woman.”

According to Father Champlin, the actual Catholic response to end-of-life issues is more complicated than Father Pavone’s statement might claim. Father Champlin noted that many Catholics believe that Father Pavone’s statement and actions conform to the Church’s teachings.

“They [Catholics] do and that’s why I thought it wasn’t a wise thing to say,” Father Champlin said following the panel discussion. “It’s a complicated issue. I don’t think it was a clear statement of the issue and what I just did here this afternoon was give a summary of what I think is the Catholic teaching at the present time. It’s not quite as rigid as he would say.”

Father Champlin referenced the statement from the Australian bishops on several occasions both during the discussion and afterward during the interview. He considered it a more conventional insight into Catholic teachings on end-of-life issues.

“The presumption as the Australian bishops said is that it’s in favor of nutrition and hydration, but that could give way – and even the Holy Father alluded to that – that could give way to other decisions if it’s going to be futile or burdensome,” Father Champlin explained.

Although the Schiavo story created confusion in the reactions of many Catholics, it made one thing very clear: before one is no longer able to speak for oneself, one must make their wishes clear.

While many states recognize a “living will” as having legal authority, New York State gives legal primacy to a proxy.

A “healthcare proxy” gives an agent charged with executing one’s will broad control over one’s care in the event that the individual cannot act on one’s own behalf.

Falise believes that establishing advanced directives such as a living will or, even better, a proxy is absolutely crucial.

Daniel Cantone, a Camillus attorney, has known Father Champlin since he was pastor at St. Joseph’s Church. When Father Champlin moved to the Cathedral, Cantone and his family followed him.

At the panel discussion, Cantone offered an introduction to end-of-life issues from an attorney’s perspective. A handout given to attendees at the panel discussion presented overviews for legal recourses such as a last will and testament, power of attorney and a healthcare proxy.

In New York State, living wills are not specifically recognized as valid, making the selection of a proxy very important.

“The New York State bishops recognize proxies as morally acceptable,” said Kathleen Gallagher of the New York State Catholic Conference.

One can obtain a document for establishing a healthcare proxy from the New York State Catholic Conference website www.nyscatholic.org or by calling the Respect Life Office at (315) 470-1418.

Cantone presented several important elements of selecting and then utilizing a proxy. Father Champlin handed out a booklet before the presentation that included an overview of end-of-life issues from a lawyer’s perspective compiled by Cantone.

The agreement between the individual and his or her healthcare proxy must be in writing and must be independent of a power of attorney form, the summary notes, and there must be two witnesses for the signing of the form. The agent’s authority begins only when the principal cannot make his own health decisions. Unless wishes about artificial nutrition and hydration are specifically known, the agent does not have authority to make those decisions. The proxy remains in effect indefinitely, unless revoked or limited by the text. Absent a statement to the contrary, an agent has the power to seek a Do Not Resuscitate order limiting the use of CPR.

If a proxy had been clearly established for Schiavo, the entire debacle might have been averted altogether.

Along with Cantone, Dr. Joel Potash of Upstate Medical Center presented a medical perspective. Pasinski filled in the third spot and discussed the value of developing a healthcare proxy.

Pasinski said that it is important not only to develop a proper proxy but to discuss one’s wishes with the agent.

“These can lead to bigger discussions such as discussions of the values of life,” he said. “It goes beyond the legal and medical particulars and goes into the context of ‘What are my values.’”

If nothing else, the Schiavo case has made it emphatically clear that one must have some recourse should they be rendered incapable of communicating their wishes.

Gallagher notes that for a Catholic, the heart of the ambiguity lies in maintaining a life that honors the teachings of the Church, while living in a world ruled by secular law.

“Catholic teaching says that this is my body, but ultimately this is the Lord’s….I’m just a steward,” she said.

By contrast, secular law divests the human body from its niche in creation, giving primacy to the individual.

“The law says, this is my body, I can do what I want with it,” she said.

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