| Address
to the Annual Conference of Right To Life, Victoria
Address Given By Archbishop Denis Hart
at Xavier College, Kew,
on Saturday, 26th June, 2004, at 11.30am
Address
My dear Friends,
It gives me great pleasure as Archbishop to be with you and to
encourage you in the work for an even clearer recognition of the
dignity of human life throughout our society. It has often been
said that the womb is one of the most dangerous places in the world
for life. Increasingly, in a society, which is guided not by moral
and ethical perspectives, but by pragmatism, it can also be asserted
that old age and frailty are an increasingly dangerous situation
in our society at large.
The dialogue, which the Catholic Church and which we who respect
and fight for the dignity of life need to conduct with the society,
is to heighten the great reality of the dignity of the human person
and of the imperative of respect for existing life from its first
and weakest moment right to the end, at death.
On 20th March this year Pope John Paul II used his teaching authority
to address participants in an International Congress on the Vegetative
State. In so doing he issued the first clear and explicit papal
statement on the obligation to provide food and water for patients
in a persistent vegetative state.
The Pope’s Address is most helpful because of its clarity,
its recognition of the complexity of diagnosis at all stages and
its clarion call of making us aware of the dignity of each human
person.
Specifically:-
- The Church encourages men and women of science to dedicate
their study to the improvement of diagnosis, treatment, prognosis
and possibilities for rehabilitation for those people who rely
completely on those who care for them.
- Next follows a definition - The person in a vegetative state
shows no evident sign of self-awareness or of the environment
and seems unable to interact with others or to react to special
stimuli. Often the term, ‘permanent vegetative state’
has been used for those whose vegetative state continues for over
a year, but it must be remembered that this is not a subject of
actual diagnosis, but more a judgement on what prognosis the person
has for recovery. The longer the state goes on, the less is the
prognosis for recovery.
The Pope further highlights the complexity when he says that medical
science up until now is still unable to predict with certainty
who among patients in this condition will recover and who will
not.
Secondly, it is necessary to arrive at correct diagnosis. This
usually requires prolonged careful observation, the Pope says.
He notes the high number of diagnostic errors reported in the
literature and also that not a few of the people with appropriate
treatment and rehabilitative programmes have been able to emerge
from the state while others remain prisoners of their condition
for long stretches of time even without technological support.
- What is absolutely vital is to remember that each patient has
a truly human quality. The Pope rejects the demeaning of their
value and personal dignity and uses strong language when he says,
“I feel the duty to reaffirm strongly that the intrinsic
value and personal dignity of every human being do not change
no matter what the concrete circumstances of his or her life.
A man, even if seriously ill or disabled in the exercise of his
highest functions, is and always will be a man and will never
become a vegetable or an animal. Even in a vegetative state they
retain their human dignity in all its fullness.”
The Pope uses beautiful words, “the loving gaze of God the
Father continues to fall upon them acknowledging them as his sons
and daughters, especially in need of help.” He highlights
the grave responsibilities therefore of doctors and health care
personnel to be supported by professional ethics.
- The Pope states authoritatively that the sick person in a vegetative
state, awaiting either recovery or a natural end, still has the
right to basic health care (nutrition, hydration, cleanliness,
warmth, etc.) and to prevention of complications relating to confinement.
The patient also has the right to appropriate rehabilitative care
and to be monitored for clinical signs of eventual recovery.
- The Pope also stresses, “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 should be considered,
in principle, ordinary and proportionate and as such morally obligatory
in so far 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.”
- We have mentioned the diagnosis of the condition. Continuing
medical diagnosis is also important. The Pope reminds us that
death by starvation or dehydration is the only possible outcome
as a result of withdrawal of nutrition and hydration and if it
is done knowingly and willingly becomes euthanasia by omission.
The Pope is concerned that often the withdrawal of nutrition and
hydration is a source of considerable suffering for the sick person
even if that person can only react at the level of the nervous
system.
- Catholic moral teaching emphasises that such nutrition and
hydration must be continued and the Pope’s authoritative
statement stresses the means so that a deep respect for the human
condition will be maintained while life lasts.
- There is another important point of diagnosis, namely that
when the body is actually rejecting nutrition and hydration, and
the process of death has actually begun. Then nutrition may be
discontinued, but it is important by love and comfort to moisten
the patient’s lips, to recognise the process of death and
to surround the person with prayer, love and comfort. Indeed the
principle regarding the administration of food and liquids endures
as long as the actual process of death has not begun and as long
as its administration is not burdensome for the patient. The key
question, one commentator said, is simply whether this means of
feeding effectively provides nourishment and preserves life. It
must be noted that the obligation to provide assisted feeding
lasts only as long as such feeding meets its goals of providing
nourishment and alleviating suffering.
The Pope’s address shows a thorough familiarity with the
latest scientific findings on the vegetative state, which were highlighted
at the March Congress.
With typical compassion, the Pope stresses that we must not abandon
the families of those in a vegetative state, but we need to give
them every possible help. Respite care, financial support, the sympathetic
cooperation of medical professionals and volunteers and he urged
society to provide psychological and spiritual comfort.
The Pope emphasises the dignity of the person in this state, who
remains a human being to be treated with respect, to be loved, nourished,
cared for and supported, including those who cannot visibly respond
to our care.
If we remember the intrinsic value and personal dignity of every
human being do not change as long as they are alive and act accordingly,
as the Pope suggests, then we will recognise the various stages,
our diagnosis will be clear headed, and we will support the life
which exists while being aware at the end when the actual process
of death has begun.
+ Denis J. Hart,
Archbishop of Melbourne.
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