Related articles and links |  1 of 2

The removal of Terri Schiavo's feeding/ hydration tube on March 18 sparked a national uproar. Indignant protests arose on both sides of the "right to die" issue.

CT associate editor Jeff M. Sellers spoke about Schiavo's case with Gilbert Meilaender, a member of the President's Council on Bioethics. Meilaender is the Richard and Phyllis Duesenberg Professor of Christian Ethics at Valparaiso University.

What are the Christian ethical guidelines for whether to remove the nutritional tube in a case such as Terri Schiavo's?

There have normally been two kinds of grounds on which one could reject a treatment: if it is useless, or if it is very burdensome for the patient.

In Schiavo's case, it is counterintuitive to say that it's useless when it kept her alive for so long, and she did not seem to experience it as a burden.

By calling nutrition a "treatment" instead of basic care, are we opening the door to calling it a "useless treatment"?

Not if we're careful. We only open that door if we say, "The treatment is useful in the sense that it will keep her alive indefinitely, but it's just not much of a life to have. It's a useless life."

Although we understand why some people might say that, it amounts to rejecting not simply a useless treatment but a useless life—and that we should not do. We can understand psychologically how any of us might feel that way, but it's a feeling that ought to be resisted.

Theologically, we don't consider ourselves the authors of life or death, as those who have authority over it. Our obligation is to care for the lives of others and acknowledge their death when the time comes, but our authority is limited to that.

When did a feeding tube go from being considered basic care to a medical treatment?

There's been an increasing tendency over the last 20 years to bring a feeding tube under the rubric of treatment. The reason for that has obviously been that nobody would say you shouldn't give a person certain kinds of basic care, whereas treatments are sometimes dispensable. So if you bring feeding tubes under the category of treatment, it's easier to dispense with them.

I'm not persuaded that it's more accurate to classify a feeding tube as treatment. Nourishment is something we all need to stay alive, and the fact that for certain people it has to be provided in different ways doesn't alter the fact that nourishment is fundamental to human life in a way that various treatments are not.

It's true, of course, that certain kinds of technical expertise are needed to provide a feeding tube. If you needed a feeding tube you wouldn't want me to insert it. But I'm not sure that alone makes it "treatment." Nonetheless, in terms of our public debate, it's increasingly been classified as treatment.

Even if we grant that, however, it's not clear that in a case like Schiavo's the criteria for dispensing with treatment apply. It was not useless, it kept her alive indefinitely, and she didn't appear to experience it as burdensome.

Does the fact that the patient is in a persistent vegetative state make any difference?

I don't think so. That's one of the things that is so muddled in the public debate about this case. We have all sorts of people, on both sides, talking as if the issue would be decided if we were only able to settle the facts of her condition.

Those facts are important. But even if she lacked all awareness and was in a persistent vegetative state, we cannot simply conclude that we are, therefore, justified in saying, "Let's make her go away, let's stop feeding her." That would not settle the question at all.

next page... |  1 of 2

share this page

May 2005, Vol. 49, No. 5