Here, I will not discuss the question of parental vs. state authority in life-or-death decisions. I only want to talk about the life-or-death decisions themselves, and I want to challenge the brutally simplistic narrative that there are two sides: People who want to treat Charlie further, who are good, and people who want to withdraw Charlie’s life support, who are bad.
It’s not so simple.
Remember the scene in Monsters, Inc. where all the various monsters are getting ready to be scary? They each have their own style: One is a blob with many eyes, one has retractable spikes; some are sneaky, some are creepy. And then there is the one who makes his point by flailing his orange tentacles around and rushing forward with a hysterical shriek.
This is the approach taken by a blogger for the Register a few days ago, in a post called “The Advent of the Artificial Womb: Suddenly, it’s a braver, newer world.”
Currently, preemies must adapt prematurely to breathing air and receiving nutrition orally — an ordeal which sometimes saves lives, but still often leaves survivors with profound, lifelong disabilities. Rather than being intubated in an incubator, sedated and on a respirator, premature babies in an artificial womb would grow in a pouch filled with lab-made amniotic fluid, which would be gentler on their tiny bodies, and would allow their lungs and brains to develop more normally.
But this blogger calls the artificial womb a “travesty.” In nearly 3,000 words, he devotes only a few brief paragraphs to the idea that the invention, if successful, will keep premature babies alive, and he allows half a sentence for the idea that it’s a good thing to keep premature babies alive.
And the rest of his post is flailing tentacles, as he drags in everyone from Descartes to Dune to homeless schizophrenics to Simone de Beauvoir to Octomom, to the right to spank and homeschool, to (of course) the gays, and finally to – shudder – “feminists,” saying, “The artificial uterus is fraught with danger to the point of moral disaster on the par with abortion.”
He looks into his crystal ball and sees nothing but horrors:
Now that artificial uteri are to soon be a possibility, how many more made-to-order pedophile sex slaves are we to expect? How many of more will a liberal media refuse to shed a spotlight on?
Also, can a woman who has used an artificial womb truly bond with her child? Can the child develop normal feelings for the person who purchased its birth in a plastic Ziploc baggie?
Does he have a leg to stand on?
Well, it’s true that some folks will immediately scheme how to use this medical advance in ways that are harmful and contrary to human dignity — like incubating a child entirely and electively in an artificial environment, so that women no longer have to give birth, or so people can design and purchase a child to their specifications, with motives ranging from selfish to monstrous. I’m no fool: I know that there are people who desire these things. (It’s already being done, only we use poor Indian women rather than a plastic bag.)
But it’s also true, once artificial wombs are functional, that some of the tens of millions of babies born prematurely may live instead of die, and may be born closer to full term, with less trauma and more of a chance of avoiding life-long health problems. This is not nothing. This is not some negligible perk that we can easily decline for fear of potential abuse.
Artificial wombs are not intrinsically evil. They may someday be used for evil, but so may every other medical advance you can name. The medical syringe, for example, was invented to inject painkillers; now it’s also used to heal the sick, to administer vaccines, and to save lives. Syringes are also used for delivering heroin, and consequently are responsible for the spread of HIV and hepatitis, which is transmissible to unborn children of the infected. Bad, bad stuff. Things that make the world undeniably worse.
But that doesn’t mean that syringes are a travesty on par with abortion. It means that human beings are prey to original sin, and will immediately set to work perverting the use of everything they can lay their hands on.
The outraged blogger fails to draw a vital distinction between two kind of scientific advances:
IVF and abortion fall into the second category. The artificial womb falls into the first category. But he seeks to blend the two categories, essentially arguing, “Just think how very wrong this could go!”
And what if God the Father had made this very persuasive argument when He made our first parents? Lots of potential for abuse there. Should He have scrapped the whole project?
There should always be special caution when we see medical advances related to the conception and gestation of humans. Because human life is sacred, it is especially heinous when it is treated as a commodity, as a means to an end, or even, God forbid, as a trinket.
Because human life is sacred, it is wrong to use technology to create a human life in a petri dish, even if the parents of the child love him. It is wrong to use technology to deliberately end human life through euthanasia, even if the patient is suffering.
And there are some murky areas about which, as far as I can tell, Catholic bioethicists have still not made a definitive pronouncement. For instance, it’s possible that a theoretical womb transplant might be moral or immoral, depending on the object, the end, and circumstances surrounding the procedure. It’s uncertain whether it’s ethical to “adopt” a frozen embryo which would otherwise be destroyed.
So I have some grudging sympathy for the blogger. Medical advances and human gestation make uneasy bedfellows, and modern folks are not especially particular about which bedfellows they choose. It’s no use pretending that there are no dangerous possibilities when medical technology makes another leap ahead. It’s no use pretending that everyone who might use new technology will be pure and noble. Horror are all around us, and technology is advancing faster and more recklessly than we can keep up with.
But nothing will be gained — nothing but more horrors– by shrieking hysterically and wishing for the good old days when people just went ahead and died. “It’s a braver, newer world suddenly,” says the blogger. “It’s moments like this that make me long for simpler days.”
I was at a cemetery yesterday. One large grave plot included one man, his first wife with a string of child’s headstones, and his second wife with her own string of dead children.
Those were simpler days.
Babies died, women died, over and over and over again, because the medical technology available was a bowl of hot water, a poultice, and a prayer. Things were simpler then, and children flickered in and out of life like stars, too tiny ever to send their light all the way to earth.
Was it simpler? Yes, it was. Was it better? No, it was not. Evil ebbs and flows. It adapts to whatever the current age can offer. There was evil, and carelessness, and the devaluation of human life back in the old days, and there is evil, carelessness, and the devaluation of human life now. An artificial womb may look scary and dystopian to us. For perspective, maybe browse baby coffins.
I won’t lie: I’m horrified when I look into the future (or even the present) and see that science is separating us more and more from our humanity. But I’m equally horrified when I see Catholics retreating into a sort of sentimental brutality that sighs heavily, dons a cloak of false nobility, and grandly chooses death for others over hard choices for us all.
“Death with dignity” laws are both sensible and compassionate; religious prohibitions of suicide are both emotional and cruel.
Too often, that’s how the narrative goes when we discuss end-of-life issues and the laws surrounding them. Secular folks claim that, when people of faith protest against legalized suicide and euthanasia, our arguments are based in emotion, passion, or even a sadistic appetite for pain and suffering.
On the contrary, the Catholic Church’s teachings are both consistent and compassionate.
In light of recent discussions of Supreme Court nominee Neil Gorsuch and his views on assisted suicide and euthanasia, and in light of the story of a Dutch doctor who directed family members to hold down a struggling old woman so he could carry out her “assisted suicide,” I’m sharing again this article from 2013. The research I did for it corrected many of my own misconceptions about what it means to be pro-life at the end of life.
***
“Technology runs amok without ethics,” says Tammy Ruiz, a Catholic nurse who provides end-of-life care for newborns. “Making sure ethics keeps up with technology is one of the major focuses of my world.”
How do Catholics like Ruiz honor the life and dignity of patients, without playing God—either by giving too much care, or not enough?
Cathy Adamkiewicz had to find that balance when she signed the papers to remove her four-month-old daughter from life support. The child’s bodily systems were failing, and she would not have survived the heart transplant she needed. She had been sedated and on a respirator for most of her life. Off the machines, Adamkiewicz says, “She died peacefully in my husband’s arms. It was a joyful day.”
“To be pro-life,” Adamkiewicz explains, “does not mean you have to extend life forever, push it, or give every type of treatment.”
Many believe that the Church teaches we must prolong human life by any means available, but this is not so. According to the Catechism of the Catholic Church, “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment” (CCC, 2278).
Does this mean that the Church accepts euthanasia or physician-assisted suicide—that we may end a life to relieve suffering or because we think someone’s “quality of life” is too poor? No. The Catechism continues: “One does not will to cause death; one’s inability to impede it is merely accepted” (CCC, 2278).
Richard Doerflinger, associate director of Pro-Life Activities at the USCCB, explains that caregivers must ask, “What good can this treatment do for this person I love? What harm can it do to him or her? This is what Catholic theology calls ‘weighing the benefits and burdens of a treatment.’ If the benefit outweighs the burden, in your judgment, you should request the treatment; otherwise, it would be seen as morally optional.”
Palliative care is also legitimate, even if it may hasten death—as long as the goal is to alleviate suffering.
But how are we to judge when the burdens outweigh the benefits?
Some decisions are black and white: We must not do anything, or fail to do anything, with the goal of bringing about or hastening death. “An act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator (CCC, 2277).
The dehydration death of Terry Schiavo in 2005 was murder, because Schiavo was not dying. Withdrawing food and water had the direct goal of killing her.
But if a man is dying of inoperable cancer and no longer wishes to eat or drink, or his body can no longer process nutrition, withdrawing food and water from him might be ethical and merciful. He is already moving toward death, and there is no reason to prolong his suffering.
Moral Obligations
Our moral obligations are not always obvious. Laura Malnight struggled with doubt and fear as she contemplated the future of her tiny newborn quadruplets. Two of them had pneumonia.
“It was horrible to watch them go through what they had to go through to live, being resuscitated over and over again,” Malnight says.
One baby was especially sick and had suffered brain damage. The doctors who had pushed her to do “selective reduction” while she was pregnant now urged her to stop trying to keep her son alive. “They said we were making a horrible mistake, and they painted a terrible picture of what his life would be like in an institution,” Malnight says.
Exhausted and overwhelmed, Malnight was not able to get a clear answer about the most ethical choice for her children.
Everyone told her, “The baby will declare himself,” signaling whether he’s meant to live or die. “But,” says Malnight, “my only experience with motherhood was with these babies, in their isolettes. The thing was, we would put our hands over our son and he would open his eyes, his breathing would calm.”
“We just kind of muddled through,” she says. Her quadruplets are now 13 years old, and her son, while blind and brain-damaged, is a delightful and irreplaceable child.
Doerflinger acknowledges Malnight’s struggle: “Often there is no one right or wrong answer, but just an answer you think is best for your loved one in this particular situation, taking into account that patient’s own perspective and his or her ability to tolerate the burdens of treatment.”
The key, says Cathy Adamkiewicz, is “not to put our human parameters on the purpose of a human life.”
When she got her infant daughter’s prognosis from the neurologist, she told him, “You look at her as a dying system. I see a human being. Her life has value, not because of how much she can offer, but there is value in her life.”
“Our value,” Cathy says, “is not in our doing, but in our being.” Doerflinger agrees, and emphasizes that “every life is a gift. Particular treatments may be a burden; no one’s life should be dismissed as a burden.”
He says that human life is “a great good, worthy of respect. At the same time, it is not our ultimate good, which lies in our union with God and each other in eternity. We owe to all our loved ones the kind of care that fully respects their dignity as persons, without insisting on every possible means for prolonging life even if it may impose serious risks and burdens on a dying patient. Within these basic guidelines, there is a great deal of room for making personal decisions we think are best for those we love.”
Because of this latitude, a living will is not recommended for Catholics. Legal documents of this kind cannot take into account specific, unpredictable circumstances that may occur. Instead, Catholic ethicists recommend drawing up an advance directive with a durable power of attorney or healthcare proxy. A trusted spokesman is appointed to make medical decisions that adhere to Church teaching.
Caregivers should do their best to get as much information as possible from doctors and consult any priests, ethicists, or theologians available—and then to give over care to the doctors, praying that God will guide their hearts and hands.
Terri Duhon found relief in submitting to the guidance of the Church when a sudden stroke caused her mother to choke. Several delays left her on a ventilator, with no brain activity. “My husband and I couldn’t stand the thought of taking her off those machines. We wanted there to be a chance,” she says. But as the night wore on, she says, “We reached a point where it was an affront to her dignity to keep her on the machines.”
Duhon’s words can resonate with caregivers who make the choice either to extend life or to allow it to go: “I felt thankful that even though all of my emotion was against it, I had solid footing from the Church’s moral teaching. At least I wasn’t making the decision on my own.”
Adamkiewicz agrees. “It’s so terrifying and frustrating in a hospital,” she remembers. “I can’t imagine going through it without having our faith as our touchstone during those moments of fear.”
*********
End of life resources
Ethical and Religious Directives for Catholic Healthcare Services (from the USCCB)
Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004
NCBCenter.org provides samples of an advance directive with durable power of attorney or healthcare proxy.
This article was originally published in Catholic Digest in 2013.
“Death with dignity” laws are both sensible and compassionate; religious prohibitions of suicide are both emotional and cruel.
Too often, that’s how the narrative goes when we discuss end-of-life issues and the laws surrounding them. Secular folks claim that, when Catholics and others protest against legalized suicide and euthanasia, our arguments are based in emotion, passion, or even a sadistic appetite for pain and suffering.
On the contrary, the Catholic Church’s teachings are both consistent and compassionate.
In light of recent discussions of Supreme Court nominee Neil Gorsuch and his views on assisted suicide and euthanasia, and in light of the story of a Dutch doctor who directed family members to hold down a struggling old woman so he could carry out her “assisted suicide,” I’m sharing again this article from 2013. The research I did for it corrected many of my own misconceptions about what it means to be pro-life at the end of life.
***
“Technology runs amok without ethics,” says Tammy Ruiz, a Catholic nurse who provides end-of-life care for newborns. “Making sure ethics keeps up with technology is one of the major focuses of my world.”
How do Catholics like Ruiz honor the life and dignity of patients, without playing God—either by giving too much care, or not enough?
Cathy Adamkiewicz had to find that balance when she signed the papers to remove her four-month-old daughter from life support. The child’s bodily systems were failing, and she would not have survived the heart transplant she needed. She had been sedated and on a respirator for most of her life. Off the machines, Adamkiewicz says, “She died peacefully in my husband’s arms. It was a joyful day.”
“To be pro-life,” Adamkiewicz explains, “does not mean you have to extend life forever, push it, or give every type of treatment.”
Many believe that the Church teaches we must prolong human life by any means available, but this is not so. According to the Catechism of the Catholic Church, “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment” (CCC, 2278).
Does this mean that the Church accepts euthanasia or physician-assisted suicide—that we may end a life to relieve suffering or because we think someone’s “quality of life” is too poor? No. The Catechism continues: “One does not will to cause death; one’s inability to impede it is merely accepted” (CCC, 2278).
Richard Doerflinger, associate director of Pro-Life Activities at the USCCB, explains that caregivers must ask, “What good can this treatment do for this person I love? What harm can it do to him or her? This is what Catholic theology calls ‘weighing the benefits and burdens of a treatment.’ If the benefit outweighs the burden, in your judgment, you should request the treatment; otherwise, it would be seen as morally optional.”
Palliative care is also legitimate, even if it may hasten death—as long as the goal is to alleviate suffering.
But how are we to judge when the burdens outweigh the benefits?
Some decisions are black and white: We must not do anything, or fail to do anything, with the goal of bringing about or hastening death. “An act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator (CCC, 2277).
The dehydration death of Terry Schiavo in 2005 was murder, because Schiavo was not dying. Withdrawing food and water had the direct goal of killing her.
But if a man is dying of inoperable cancer and no longer wishes to eat or drink, or his body can no longer process nutrition, withdrawing food and water from him might be ethical and merciful. He is already moving toward death, and there is no reason to prolong his suffering.
Moral Obligations
Our moral obligations are not always obvious. Laura Malnight struggled with doubt and fear as she contemplated the future of her tiny newborn quadruplets. Two of them had pneumonia.
“It was horrible to watch them go through what they had to go through to live, being resuscitated over and over again,” Malnight says.
One baby was especially sick and had suffered brain damage. The doctors who had pushed her to do “selective reduction” while she was pregnant now urged her to stop trying to keep her son alive. “They said we were making a horrible mistake, and they painted a terrible picture of what his life would be like in an institution,” Malnight says.
Exhausted and overwhelmed, Malnight was not able to get a clear answer about the most ethical choice for her children.
Everyone told her, “The baby will declare himself,” signaling whether he’s meant to live or die. “But,” says Malnight, “my only experience with motherhood was with these babies, in their isolettes. The thing was, we would put our hands over our son and he would open his eyes, his breathing would calm.”
“We just kind of muddled through,” she says. Her quadruplets are now 13 years old, and her son, while blind and brain-damaged, is a delightful and irreplaceable child.
Doerflinger acknowledges Malnight’s struggle: “Often there is no one right or wrong answer, but just an answer you think is best for your loved one in this particular situation, taking into account that patient’s own perspective and his or her ability to tolerate the burdens of treatment.”
The key, says Cathy Adamkiewicz, is “not to put our human parameters on the purpose of a human life.”
When she got her infant daughter’s prognosis from the neurologist, she told him, “You look at her as a dying system. I see a human being. Her life has value, not because of how much she can offer, but there is value in her life.”
“Our value,” Cathy says, “is not in our doing, but in our being.” Doerflinger agrees, and emphasizes that “every life is a gift. Particular treatments may be a burden; no one’s life should be dismissed as a burden.”
He says that human life is “a great good, worthy of respect. At the same time, it is not our ultimate good, which lies in our union with God and each other in eternity. We owe to all our loved ones the kind of care that fully respects their dignity as persons, without insisting on every possible means for prolonging life even if it may impose serious risks and burdens on a dying patient. Within these basic guidelines, there is a great deal of room for making personal decisions we think are best for those we love.”
Because of this latitude, a living will is not recommended for Catholics. Legal documents of this kind cannot take into account specific, unpredictable circumstances that may occur. Instead, Catholic ethicists recommend drawing up an advance directive with a durable power of attorney or healthcare proxy. A trusted spokesman is appointed to make medical decisions that adhere to Church teaching.
Caregivers should do their best to get as much information as possible from doctors and consult any priests, ethicists, or theologians available—and then to give over care to the doctors, praying that God will guide their hearts and hands.
Terri Duhon found relief in submitting to the guidance of the Church when a sudden stroke caused her mother to choke. Several delays left her on a ventilator, with no brain activity. “My husband and I couldn’t stand the thought of taking her off those machines. We wanted there to be a chance,” she says. But as the night wore on, she says, “We reached a point where it was an affront to her dignity to keep her on the machines.”
Duhon’s words can resonate with caregivers who make the choice either to extend life or to allow it to go: “I felt thankful that even though all of my emotion was against it, I had solid footing from the Church’s moral teaching. At least I wasn’t making the decision on my own.”
Adamkiewicz agrees. “It’s so terrifying and frustrating in a hospital,” she remembers. “I can’t imagine going through it without having our faith as our touchstone during those moments of fear.”
*********
End of life resources
Ethical and Religious Directives for Catholic Healthcare Services (from the USCCB)
Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004
NCBCenter.org provides samples of an advance directive with durable power of attorney or healthcare proxy.
This article was originally published in Catholic Digest in 2013.
I keep forgetting to tell you! There’s a new women’s wellness and fertility center opening in Manchester, NH, right inside Catholic Medical Center. They offer standard OB/GYN services and well woman exams, and their new doctor, Dr. Sarah Bascle, is a surgeon who is trained in NaProTechnology.
As you may know, NaPro is not only ethically sound for Catholics, but it often has a high rate of success treating women suffering infertility, repeat miscarriages, endometriosis, PCOS, and other fertility issues, bringing healing where standard medical procedures fail. NaPro isn’t magic, but it’s real medicine, not woo, and it can be life-changing.
The Women’s Wellness & Fertility Center of New England opens in winter of 2017, and they are now pre-registering patients. Check out their webiste here, or call 603.314.7595.
They are also still hiring for a few positions, including an experienced Certified Nurse Midwife. Here’s some more info about that.
Best of luck to them! Many couples will travel for hundreds of miles to work with a NaPRO-trained doctor, so I’m thrilled to finally have one in New Hampshire.
Many pro-lifers still decline to use any vaccine that was not ethically derived, choosing instead to face the risk of contracting and spreading preventable, often fatal diseases.
Whatever is keeping Americans from taking full advantage of vaccines, this potential new shingles vaccine is a step in the right direction, and pro-lifers are rightly heartened by the possible advent of at least one ethically-derived vaccine. It’s a bit early to celebrate, though.
Read the rest at the Register.
photo courtesy of Wellcome Images
The bill’s sponsor, state representative Keith Murphy of Bedford, describes the practice as unethical.
“To me there’s something fundamentally wrong about strapping a baby boy to a board and amputating perfectly healthy, normal tissue,” says Murphy.
The American Association of Pediatrics doesn’t agree that the practice is “fundamentally wrong.” In an August, 2014 statement, they said (emphasis mine):
Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it, however, existing scientific evidence is not sufficient to recommend routine circumcision. Therefore, because the procedure is not essential to a child’s current well-being, we recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions.
Sanest thing I’ve heard all year. Give the parents lots of sound, medical information, and then let them make up their own minds when they’re deciding how to get their kids the best care for their circumstances.
PIC pregnant woman on chemo
Pregnant women have been successfully treating their cancer in the second and third trimesters without harming their babies for over twenty years — and yet this fact is far from common knowledge. When we hear that a woman has cancer while pregnant, the first thought that comes to mind is that she has a horrible choice to make. Why is this?
Read the rest at the Register.
