The Truth about Life-or-Death Decisions

The January 26, 2010 Science section of The New York Times carried an article by St. Louis writer Alicia von Stamwitz titled “An Ill Father, a Life-or-Death Decision,” which described her chilling hospital experience caring for her gravely ill father.

The patient was sixty-nine, suffered from bi-polar alcoholism, had had two open-heart surgeries, several strokes, and couldn’t speak. The attending physician further diagnosed that his liver was severely damaged from taking Lithium, his heart was weak, kidneys were failing, lungs were filling up with liquid, and a tube had to be inserted in his windpipe.

Ms. von Stamwitz was taken aback in a meeting with the doctor. Instead of receiving medical advice, she was asked if her father had a living will and had given her power of attorney. She wrote that when she said, yes, “Visibly relieved, [the doctor] looks me in the eye and gently but pointedly asks: ‘Does your father want us to employ extreme measures. . .knowing that he is not likely to improve?’”

Instead of deciding for her father, she asked him to squeeze her hand if he wanted to be intubated again. The father didn’t squeeze but firmly nodded his head, yes.

The reaction from the attending nurses also shook up von Stamwitz. One nurse, “grunts and rolls her eyes,” and another mutters, “Oh brother, here we go again.”

Ms. von Stamwitz confesses it would have been terribly wrong for her to stop treatments: “I supposed my father’s decision was a mistake. But it was his decision to make, not mine. My role was to support my father no matter what, and to tell the truth, no matter how hard.”

What is most distressing about the von Stamwitz narrative is the behavior of the medical professionals. The attitude they displayed has become common place since the U.S. Supreme Court in Curzan v. Director, Missouri Department of Health (1990) ruled that artificially supplied food and liquids could be denied to patients who had cognitive disabilities regardless of whether they were conscious or unconscious.

To make it easier for doctors to follow the court decision, the American Medical Association revised its canon of ethics to read: “Even if the patient is not terminally ill or permanently unconscious, it is not unethical to discontinue all means of life-sustaining medical treatment [including food and fluids] in accordance with a proper substituted judgment or best interest’s analysis.”

Sadly, many secularists have applauded this death-by-dehydration court decision. In Rethinking Life and Death, Peter Singer jubilantly wrote: “The lives of such patients are of no benefit to them, and so doctors may lawfully stop feeding them to end their lives. With this decision the law has ended its unthinking commitment to the preservation of human life that is a merely biological existence. . . . In doing so they have shifted the boundary between what is and what is not murder. . . . Now, conduct intended to end life is lawful.”

Contrary to claims of the culture-of-death crowd, dehydration is not a “good death.” It’s one of the worst ways to die. Here’s one physician’s description of death by dehydration: “A conscious person would feel it [dehydration] just as you or I would. They will go into seizures. Their skin cracks, their tongue cracks, their lips crack. They may have nosebleeds because of the drying of the mucus membranes, and heaving and vomiting might ensue because of the drying out of the stomach lining. They feel the pangs of hunger and thirst. Imagine going one day without a glass of water! Death by dehydration takes ten to fourteen days. It is an extremely agonizing death.”

Cognizant that many in the field of medicine are abandoning their Hippocratic Oath and recognizing the need to protect human dignity through feeding the sick, Pope John Paul II in March 2004, said the following to an international Congress convened to study the ethics of Life-Sustaining Treatments:

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 he will never become a “vegetable” or an “animal.

Even our brothers and sisters who find themselves in the clinical condition of a “vegetative state” retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as his sons and daughters, especially in need of help.

The Church understands the pressures people like Alicia von Stamwitz encounter in caring for their aging and sickly loved ones. Hence, the Church insists health officials have an obligation to promote and make accessible proper palliative care and should be dedicated to promoting a wide range of programs to improve the state of care for the ill and disabled. The chronically ill have the right to compassionate, humane, and medically indicated treatment and care to live with dignity until the moment of natural death.

George J. Marlin, Chairman of the Board of Aid to the Church in Need USA, is the author of The American Catholic Voter and Sons of St. Patrick, written with Brad Miner. His most recent book is Mario Cuomo: The Myth and the Man.