Vatican Documents Supporting Concepts On SB 303

During the House Public Health Committee hearing on SB 303, some were either confused or lacking in Catholic doctrine about end-of-life care. Church teaching on medically proportionate treatment reaches back centuries and is based on a long history of consistent theological reasoning articulated by successive Popes. Below are just a few of the more relevant citations on the Church’s teaching on treatment decisions particularly at the end of life.

Pope Pius XII on Principle of Disproportionate Means

This principle constitutes an important approach to the analysis of ethical questions arising from the general obligation to preserve human life and the limits of that obligation. Among other questions, the principle addresses whether the foregoing of life-sustaining treatment constitutes euthanasia or physician-assisted suicide in certain circumstances and it guides individuals and surrogate decision-makers in the weighing of benefits and burdens. Pope Pius XII gave magisterial expression to the distinction between ordinary and extraordinary means in his November 24, 1957 address to Catholic physicians and anesthesiologists:

“Normally one is held to use only ordinary means--according to the circumstances of persons, places, times and culture--that is to say, means that do not involve any grave burden for oneself or another. A stricter obligation would be too burdensome for most people and would render the attainment of the higher, more important good too difficult. Life, health, all temporal activities are in fact subordinated to spiritual ends. On the other hand, one is not forbidden to take more than the strictly necessary steps to preserve life and health, as long as one does not fail in some more serious duty.”

Pope Paul VI on the Role of the Physician

Pope Paul VI addressed the role of physician in delivering end of life care in his Oct. 3 1970 letter to the International Federation of Catholic Medical Associations:

"The physician's duty consists rather of endeavoring to soothe the suffering instead of prolonging as long as possible by any means and under any conditions a life that is naturally approaching its conclusion."

He further developed this theme of the physicians role to respect life and dignity in his 1975 address to the International College of Psychosomatic Medicine, stating:

“Keeping in mind the value of every human person, we wish to recall that it is the physician's duty always to be at the service of life and to assist it until the end without ever accepting euthanasia or renouncing the exquisitely human duty to help it complete it’s earthly course with dignity.”

Vatican on Balanced Resolution of Disagreements on End-of-Life Care and Death with Christian Dignity

The Declaration on Euthanasia, published by the Congregation for the Doctrine of the Faith on May 5, 1980, explained the distinction between proportionate and disproportionate means, and between therapeutic treatments and the normal care due to the sick person

“It is also permitted to interrupt these [disproportionate] means, where the results fall short of expectations. But for such a decision to be made, account will have to be taken of the reasonable wishes of the patient and the patient’s family, as also of the advice of doctors who are specifically competent in the matter.” (IV)

In addition, this critical Vatican document also outlined the concept of a Christian life and death.

“Today, it is very important to protect, at the moment of death, both the dignity of the human person and the Christian concept of life, against a technological attitude that threatens to become an abuse. Thus some people speak of a “right to die” which is n expression that does not mean the right to procure death, either by one’s own hand or by means of someone else’s one pleases, but rather the right to die peacefully with human and Christian dignity.” (IV)

Pope John Paul II on Forgoing Aggressive Medical Treatment

Pope John Paul II’s 1995 encyclical, The Gospel of Life, is the seminal document on the protection of the life and dignity of the human person. In this encyclical, Blessed Pope John Paul II makes the distinction between euthanasia and forgoing aggressive medical treatment:

“Euthanasia must be distinguished from the decision to forego so called ‘aggressive medical treatment,’ in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family.” (No. 65)

“In such situations when death is clearly imminent and inevitable, one can certainly in conscience ‘refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted." (No. 65)

Vatican on Provision of Artificially Administered Nutrition & Hydration

In August of 2007, the Congregation of the Doctrine of the Faith responded to questions posted by the United States Bishops concerning the moral obligation to provide artificially administered nutrition and hydration. It is here that they outlined exceptions to it’s use:

“Nor is the possibility excluded that, due to emerging complications, a patient may be unable to assimilate food and liquids, so that their provision becomes altogether useless. Finally, the possibility is not absolutely excluded that, in some rare cases, artificial nourishment and hydration may be excessively burdensome for the patient or may cause significant physical discomfort, for example resulting from complications in the use of the means employed.”