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February 17, 2014

The lack of universal awareness that there is no moral obligation to continue medical treatment of those who are brain dead is surely something that must be overcome. (See story on Page 24.)

There is no duty to keep a dead person on life support systems in the hope that a miracle may resuscitate that person. Indeed, undue prolongation of care may itself be immoral if it wastes medical resources that could be used to treat other patients.

Nevertheless, a contrary concern exists to that of continuing to treat those who are already dead. Treatment can also be withdrawn too quickly in order to hasten the death of either a dying person or someone in a “persistent vegetative state.” There are even instances of food and water being withdrawn from patients who are not in immediate danger of death, but who have decided that it is time to bring life to a close.

These are cases, not of needlessly extending treatment, but of euthanasia by omission.

In 2004, Blessed John Paul II stated that continuing to provide food and water to those in a persistent vegetative state is morally obligatory. To withdraw such care of a person is to intentionally bring about their death. It is never acceptable to kill a patient; that is euthanasia. It can also be morally wrong to fail to take action that would keep a person alive.

There are some limited exceptions. If feeding a patient is excessively burdensome to the patient or if the person cannot absorb the food and water that is being provided, it can be morally legitimate to stop providing such care.

The bishops of England and Wales raised another issue. While it is important to provide relief to patients who are suffering pain, the dying should not be overly sedated if it prevents them from having “a good death.”

The bishops were concerned that excessive sedation could prevent the dying from being conscious enough to make peace with God and their neighbours or from saying their last good-byes to loved ones. There is “hidden violence,” they said, in reducing death to a clinical event without regard for its spiritual dimension.

In the culture of the Western world, pain and suffering are often seen as the worst of all evils, and euthanasia is gaining greater acceptance. Our decisions about death cannot be seen outside that context.

On one hand, even Catholics can fall prey to the belief that it is morally acceptable to accelerate one’s death. They may (wrongly) see the Church’s teaching as overly rigorous. On the other hand, one may over-react to the diminished value society places on the lives of the sick and dying by trying to preserve even the appearance of life at all cost.

Neither approach is acceptable. It is wrong to deliberately end life before its time; it can also be wrong to act in ways that fail to respect the natural process of dying.