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Friday, October 19, 2007
Artificial nutrition and hydration

text only version

The Congregation for the Doctrine of the Faith (CDF) recently issued a document entitled, "Responses to Certain Questions Concerning Artificial Nutrition and Hydration." The document was dated August 1, but was not released until mid-September. The full text, with commentary, was published in the September 27 issue of Origins.

The document was issued in response to two questions posed by the United States Conference of Catholic Bishops regarding the administration of food and water to those in a vegetative state. The questions had been sent to the Vatican in July 2005 in the aftermath of the national controversy over continued life-support for Terri Schiavo.

Mrs. Schiavo had been in what doctors described as a "persistent vegetative state" for some 15 years. Her only legally recognized guardian, namely, her husband, had testified before the Florida courts that his wife's wishes were that she not be kept alive by the extraordinary means that had been employed on her behalf.


A speech to a group of pro-life physicians is not to be accorded the same magisterial authority as an infallible pronouncement or a non-infallible encyclical.


The issue became highly politicized when the President of the United States, the Republican leaders of the House and Senate, and the Governor of Florida became directly involved. The then-majority leader of the Senate, Bill Frist, a medical doctor himself, even presumed to diagnose Mrs. Schiavo's condition on the basis of a videotape.

After an autopsy was done on Mrs. Schiavo, confirming previous medical diagnoses, political figures either tried to explain away their earlier statements or simply fell silent. But there was some seriously negative fallout in last year's Congressional elections.

In response to the questions from the U.S. bishops, the CDF seems now to have come down --- belatedly --- on the side of those who had pressed for the continued administration of artificial nutrition and hydration for Mrs. Schiavo.

The word "seems" is deliberately chosen here because the Schiavo case is not specifically mentioned anywhere in the document or commentary. While it is understandable why the advocates of continued life-support would read these texts as a vindication of their views, it is technically not justified.

If the CDF wanted to pronounce on that particular case, it could have --- and should have --- made it unmistakably clear. But it did not.

In fact, the document's two responses are essentially Latin translations of excerpts of an address given in March 2004 by the late Pope John Paul II at a meeting in Rome co-sponsored by the Pontifical Academy for Life and the International Federation of Catholic Medical Associations. Those with knowledge of the event insist that the speech was written for the pope by Archbishop Elio Sgreccia, president of the Pontifical Academy for Life.

Previous to this week's essay, I had devoted three columns to the controversy surrounding the care of Terri Schiavo. They are available on my Web site, www.richardmcbrien.com, at the link, "Essays in Theology."

The second of the three columns (for the week of April 18, 2005) pointed out that not all papal statements are of equal magisterial weight. An infallible pronouncement is at the highest level of papal teaching authority, but Pope John Paul II issued no infallible teachings during his 26-and-a-half years in office.

A pope may also publish an encyclical, which is a non-infallible, but authoritative, teaching instrument directed to the universal Church. After that, however, there is a kind of free-fall from those two loftier magisterial levels.

A papal talk to a group of bishops on their ad limina visit to Rome, an annual papal greeting to diplomats accredited to the Holy See, a homily at an open-air Mass attended by thousands, or indeed a speech to a group of pro-life physicians --- these and other forms of papal addresses are not to be accorded the same magisterial authority as an infallible pronouncement or a non-infallible encyclical.

To be sure, this concept flies in the face of an erroneous view still held by a number of Catholics around the world, but their erroneous understanding does not make it true. The point is: not everything a pope says is of equal magisterial authority.

Since I am not a moral theologian, much less a specialist in medical or bioethics, I must defer to the expertise of Catholic moralists who have devoted much of their academic lives to issues of this sort.

I strongly recommend some pertinent articles in the March 2006 issue of Theological Studies, the leading Catholic theological journal in the United States. Lisa Sowle Cahill, of Boston College, has an excellent essay on "Bioethics," which includes specific references to the Schiavo case and the issues it raised. There are articles on the same subject by several other prominent Catholic moral theologians.

However, those who look only for simple, neatly packaged answers are likely to be disappointed.

Fr. Richard McBrien is the Crowley-O'Brien Professor of Theology at the University of Notre Dame.



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