Lately I’ve been reading Pope Benedict’s third and most recent encyclical, Caritas in Veritate. The whole thing so far has been an enlightening read, but I was particularly struck by this passage I read recently:
The right to food, like the right to water, has an important place within the pursuit of other rights, beginning with the fundamental right to life. It is therefore necessary to cultivate a public conscience that considers food and access to water as universal rights of all human beings, without distinction or discrimination (27)
Now, for the purposes of the encyclical, the pope is talking about the importance of trying to end world hunger. But, I can’t help thinking here about the sick and disabled people who starve to death after being deliberately deprived of nutrition and hydration by doctors and at the request of their family members. A few recent examples that actually made it into the news:
1. In Georgia, Trisha Rushing Duguay, 27, had her feeding tube removed when she fell into a coma after failed attempt to remove a brain tumor – which had been discovered on the day of her wedding. She starved for 8 weeks before finally passing away. What I find a little odd about this situation is that they removed her feeding tube, but kept her on a ventilator. Why? If their goal was to “let her die” why wouldn’t they have removed everything that was “keeping her alive?”
2. This one is even more disturbing (h/t Wesley Smith): In Canada a case study was presented to the 18th International Congress on Palliative Care about the “prolonged survival” of infants after withdrawal of nutrition and hydration and the “psychological distress” this causes parents and clinicians. Said Hal Siden, MD, from Canuck Place Children’s Hospice in Vancouver, British Columbia:
“These babies live much, much longer than anybody expects. I think that neonatologists and nurses and palliative care clinicians need to be alerted to this.”
Of the 5 cases that clinicians at his hospice had overseen over a 5-year period, 2 infants had severe neurologic impairment, 2 had severe hypoxic ischemia, and 1 had severe bowel atresia. After nutrition and hydration were removed, the babies lasted between 3 to 26 days before dying and it turns out (shocker) starvation is not easy to watch. While the hospice workers go to great lengths to take away the “sensation of hunger” so that there would be “absolutely no signs of discomfort” there’s not a whole lot they can do about the “visual signs of emaciation.”
“The longer a child lives, the more emaciated he or she becomes. This is something that we as clinicians need to anticipate. You can alleviate some of the physical symptoms, but this is one symptom, or result of our action, that we can’t relieve. A critical factor for counseling is to anticipate the kind of suffering that comes with witnessing the emaciation. It isn’t something people can prepare themselves for.”
Well, what the hell do you expect?! You’re starving someone do death!
Autopsies are often encouraged in such neonatal palliative care cases to help both parents and medical staff gain a better understanding of the reasons for the death, said Dr. Siden. Parents should be warned that the report will document the technical cause of death as “starvation” — a loaded word for all concerned. It is important that parents separate this word from any notion of suffering, he said.
Amazing. Not only do they admit the fact that they are, in fact, killing these children – that starvation is the cause of death, but they’re honestly trying to suggest that this method of killing is not as brutal as it looks and sounds. Starvation is a loaded word? Starvation should not be associated with any notion of suffering? I’m sorry, then should I not feel bad when I see the skeletal images of “starving” children in third world countries or want to send them aid for food?
According to Dr. Siden, the children they starve to death are surprisingly quiet and show “no overt signs of hunger behavior.” That is why he is calling for…wait for it….further investigation into the “physiologic processes” that occur while babies starve to death so that clinicians can both “inform and reassure parents.” Oh my. There really are no words to express how outrageously grotesque and eerily Nazi-esque this is. Starving babies and observing them for science – Lord have mercy on us.
What’s even more tragic about these stories is that this happens way more often than we hear about. For example, according to this story about Trisha Duguay, Emory University Dr. Carisa Hines, Trisha’s hospice doctor, said that the longest any other patient she’d treated had survived without any nourishment was 21 days. What? Exactly how many people has this “Dr.” starved to death??? And Dr. Siden in Canada says this is an “everyday occurrence in the pediatric setting.” Just because we don’t hear about this much, doesn’t mean that it’s not going on. Let’s face it, the only reason Terri Schiavo’s case got so much attention was because her family was not in agreement about her medical care and those who didn’t want her starved to death actually fought to save her life. But, with a few exceptions, that’s just not always the case. Sadly, many people, not wanting to prolong their own suffering or be a “burden” on their families, even ask for this gruesome death themselves through written advance directives.
Nourishment and hydration ARE NOT extraordinary means of sustaining life! Even a healthy person needs food and water to stay alive. If a feeding tube is the only thing keeping someone alive, they are not dying, as these stories obviously show. Severely disabled? suffering terribly? sure, but they’re still entitled to the basic human right to nutrition and hydration as long as they are available and they can contain them. In fact, denying them of these basic human needs can really only add to their suffering and discomfort – not to mention be an even harder sight for loved ones to bear.
The more acceptable the practice of withdrawing basic health care from the sick and disabled becomes, the more important it is for those of us who do not want our basic human rights violated to make our own wishes clear if we are ever in a situation in which we cannot speak for ourselves. Find out about “The Will to Live” at Priests for Life.
Very good post, Chelsea. Thank you!
Chelsea, the case of both instances was not about locked-in syndrome but of persistent vegetative state. It is a state where no recovery is possible anymore.
Neither Terri Schiavo nor Trisha Duguay had any chances of recovery. None whatsoever. They were nothing but living corpses anymore – mere the shells of what once was a human being. Neither of them had any brain functioning except basic reflexes left anymore. They were unable to see, hear, feel, express themselves, or perform any other human functions than mere existence.
There are two facts in the life. First is that we are born and the second is that we all will die. We should not play God on what comes to creation and destroying life, but we should neither play God on what comes to needlessly prolonging agony and postponing the inevitable. Since in both Terri’s and Trisha’s cases death was inevitable and there was absolutely no hope of recovery whatsoever, what is the point on prolonging the agony and playing God – or, should I say, defying God?
It is not respect of the sanctity of life, it is life fetishism!
That is the difference. We are both simultaneously so horrified of death that we want to postpone it indefinitely and prolong existence as long as we can, and also fascinated of it with the euthanasia and extermination programs that we no more can relate to it naturally. Death is nothing more than God’s call that the sojourn at Earth is over now and it is time for His children to come back to Heavenly home. Nothing more and nothing less.
And we should remember that when thinking of a) terminating human life prematurely b)of extending human life meaninglessly.
You might be correct if, in either case, these women were actually dying. But they were not. There is a difference between a dying person who can no longer contain nutrition or hydration and a severely brain damaged/disabled person who cannot feed herself. There is a difference between just allowing nature to take its course and actively starving a person to death. Whether there is hope for “recovery” or not, whether one is self-aware and just “locked in” or has no cognitive brain function does not change the fact that each is a human being who should be loved and cared for, not killed. Again, food and hydration are NOT extraordinary means of sustaining life.
IronMistress: “Since in both Terri’s and Trisha’s cases death was inevitable and there was absolutely no hope of recovery whatsoever, what is the point on prolonging the agony and playing God – or, should I say, defying God?”
Terri Schiavo was not in agony. She was living her life, simply with fewer mental faculties than we have. She was most certainly not brain-dead; she was brain-damaged (which is a different term altogether). And she didn’t owe it to us to “recover” or to become “fully normal” again. She was a living human being (not a “corpse” — well, until her husband had her painfully starved and dehydrated to death, I mean) and deserved respect as such. If you think the argument against letting her die is one of “she could get better!” then you don’t understand the Schiavo case at all.
You might be correct if, in either case, these women were actually dying.
They were by all means de facto dead already. Permanent vegetative state is merely one step to the actual brain death.
But they were not. There is a difference between a dying person who can no longer contain nutrition or hydration and a severely brain damaged/disabled person who cannot feed herself.
There is also a certain difference of containing food by oneself and force-feeding. In both cases, the poor women (or rather the shell what was left of them) were virtually force-fed and coerced to continue their existence.
Permanent vegetative state is brain death by all means except involuntary functions such as breathing, reflexes and heartbeat. Individuals in PVS are seldom on any life-sustaining equipment other than a feeding tube because the brainstem, the center of vegetative functions (such as heart rate and rhythm, respiration, and gastrointestinal activity) is relatively intact. Yet they express no awareness of themselves or the surrounding environment.
If you checked Sciavo’s brain scans and autopsy results, she was de facto brain dead. Her brain was destroyed because of autolysis (spontanous necrotic tissue decomposition) beyond any recovery.
There is a difference between just allowing nature to take its course and actively starving a person to death.
And there is also difference with actively killing someone by lethal injection, asphyxiation by toxic gas or making someone to drink poison and declining from force-feeding someone.
Whether there is hope for “recovery” or not, whether one is self-aware and just “locked in” or has no cognitive brain function does not change the fact that each is a human being who should be loved and cared for, not killed.
I beg to disagree here.
The difference is whether or not the individual in question is able to perform active conscious functioning and self-awareness. That is also a fundamental question in Catholicism; the free will. Without consciousness and without awareness, there is no free will either. Do you approve the Calvinist doctrine of predestination and that the salvation is not dependent of the actions and will of the individual, but rather whether we end up in Heaven or Hell is nothing short of pure lottery?
Again, food and hydration are NOT extraordinary means of sustaining life.
But in these cases, where no recovery whatsoever is possible, it is futile means of sustaining life.
The situation goes even more complicated with the fact that Schiavo herself had asked to be let die and not taken care of should something like that happen. She was treated against her expressed will. And Michael Sciavo worked not to kill her wife but to fulfill her wish. All in all, this is a VERY grey area in the medicine.
Terri Schiavo was not in agony.
She was beyond the point of feeling any agony anymore. It was her kinsfolks who were in agony. Why their agony was to be prolonged – especially when Terri Schiavo herself had expressed that in such situation her life was not to be extended needlessly?
She was living her life, simply with fewer mental faculties than we have.
No. She was not living her life. She was existing. There is a certain difference between life and existence.
She was most certainly not brain-dead; she was brain-damaged (which is a different term altogether).
There is just one step between brain death and permanent vegetative state and it is the condition of the brain stem (which controls the basic life supporting infrastructure). She was by all means a living corpse. Nothing more and nothing less.
And she didn’t owe it to us to “recover” or to become “fully normal” again.
What is the point of prolonging a meaningless existence? I mean, do you understand the respection of dignity of human life – and life fetishism? Prolonging meaningless existence is life fetishism.
She was a living human being (not a “corpse” — well, until her husband had her painfully starved and dehydrated to death, I mean)
Terri Schiavo had herself asked Michael Schiavo to do so should something like that to happen. Michael kept his promise. Nasty, but things like that do happen in the real life.