[Peace-discuss] Fwd: Catholic Bishops Enact Plan For “300,000 Terri Sch iavos”

[Jenifer Cartwright]

FireDogLake

Catholic Bishops Enact Plan For “300,000 Terri Schiavos”

By: David Dayen Tuesday November 24, 2009 8:16 am

The US Conference of Catholic Bishops released an “Ethical and
Religious Directive” this month that would ban any Catholic hospital,
nursing home or hospice program from removing feeding tubes or ending
palliative procedures of any kind, even when the individual has an
advance directive to guide their end-of-life care. The Bishops’
directive even notes that patient suffering is redemptive and brings
the individual closer to Christ.

The Catholic bishops have become more involved in political fights in
recent years, particularly the issue of abortion coverage and
immigration provisions in the current health care debate. This has
caused a schism in the American Catholic community, which bubbled to a
head yesterday with Rep. Patrick Kennedy (D-RI) being denied communion
because of his position on choice.

More quietly, however, the Church has staked out a radical position on
end-of-life care, without patients of the 565 Catholic hospitals and
other Catholic care facilities even knowing about it. As Barbara
Coombs Lee, president of Compassion and Choices, an advocacy group,
put it, “When a patient goes to one of these facilities, they don’t
know that they’re choosing Catholic dogma. The bishops see the
hospitals as an extension of their ministry.”

The “Ethical and Religious Directives for Catholic Health Care
Services” put out by the Catholic bishops would build upon a Papal
allocution given in the wake of the controversial Terri Schiavo case,
where the US Congress stepped in to keep Schiavo alive despite her
persistent vegetative state and the wishes of her husband to end care.
The papal elocution did state that the permanently unconscious should
always have access to a feeding tube, but it did not have the force of
doctrinal law behind it. “There was always some wiggle room” for
Catholic care facilities, said Coombs Lee. Catholics were allowed to
use something called a “benefit/burden balance” to determine the
ethical, moral and compassionate result in any individual case.

Now, that wiggle room is gone. In the new directive, the bishops state
that it is unethical and immoral to withhold or withdraw a feeding
tube from patients, whether in cases of permanent unconsciousness,
comas, or even cases of advanced dementia when the patient is unable
to feed themselves.

This substitutes the wishes of the bishops for the stated wishes of
families and the patients themselves, said Coombs Lee. Even if the
family can produce an advance directive or living will, Catholic
hospitals and nursing homes would be expected to maintain the feeding
tubes. In addition, all Catholic health care workers are required by
their faith to continue palliative care, according to the document.
The directive even addresses patients. “These are directives for you,
from the church,” said Coombs Lee.

In many cities, this means that every hospital or medical care
facility will not allow the withdrawal of a feeding tube. “In Spokane,
Washington, if you don’t get Catholic health care, you don’t get
health care,” Coombs Lee said. “In Eugene, Oregon, if you don’t get
Catholic health care, you don’t get health care.” Coombs Lee
characterized it as a kind of entrapment, with a sense of “my house,
my rules.” If a patient’s family wanted to comply with an advance
directive, they would have to leave the Catholic care facility, adding
a level of stress and disruption to the already difficult time of
aggrievement. “Decisions on feeding tubes are hard enough without
adding this extra adversity,” said Coombs Lee.

Coombs Lee believes that this could create “300,000 Terri Schiavo
cases,” the number being equal to the number of feeding tubes inserted
in the United States each year.

The Catholic Hospital Association disagrees. Their statement
responding to the Bishops’ Ethical and Religious Directive says that:

However, the Directive explains that this obligation ceases and the
measures become “morally optional” when the measures cannot reasonably
be expected to prolong the patient’s life or when they become
excessively burdensome. (This provision incorporates into the
Directive the teaching of Pope John Paul II and the Congregation for
the Doctrine of the Faith regarding medically assisted nutrition and
hydration to persons in a persistent vegetative state. Catholic health
care facilities have already addressed the implications of these
statements).

The Directive also distinguishes between patients in a chronic state
and those who are dying. This distinction has implications for the use
of medically administered nutrition and hydration. For dying patients,
medically administered nutrition and hydration may no longer be of
benefit and may, in fact, impose significant burdens.

Compassion & Choices says that this language distinguishing between
those cases where artificial nutrition is “excessively burdensome”
appears nowhere in the Bishops’ directive. Furthermore, while the CHA
says the directive only applies to those patients being kept alive by
a feeding tube, that is precisely their function. As Coombs Lee puts
it, “Feeding tubes keep people in chronic states like PVS and advanced
dementia alive… Feeding tubes are not indicated for people actively
dying and they are rarely inserted in any institution, Catholic or
not.”

A 60Minutes piece this weekend looked at the cost of dying in America,
showing that Medicare paid $50 billion in the last two months of
patients’ lives in 2008. Compassion & Choices focuses on the suffering
at the end of life, not federal dollars, but they agree in general
with the portrait shown by 60 Minutes. Incredibly, suffering is one of
the selling points in the Catholic Bishops’ directive. “It’s quite
specific about the role of suffering in Christian dogma,” Coombs Lee
explained. “It says that suffering is redemptive, that it’s part of
Christ’s passion. So they are pretty clear on their concern for the
suffering of the patient.”

The end of life issue became very controversial in the health care
debate, over fears that Congress was creating so-called “death
panels.” However, these secret “suffering panels” put in by Catholic
hospitals are being done without much fanfare at all. “People need to
know,” said Coombs Lee, “when they commit themselves to a hospital,
that they are submitting to a Catholic ministry, in the eyes of the
Bishops.”



      
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://lists.chambana.net/mailman/archive/peace-discuss/attachments/20091128/5a126bb9/attachment-0001.html