The church & end-of-life care.

It seems Paul Lauritzen has rushed to judgment ("Caring at the End," March 10). John Paul II's statement concerning tube feeding for PVS patients is not as definitive as he indicates. First of all, when evaluating a prudential papal statement, we are told to "assess the nature of the document and the insistence with which the teaching is repeated" (Instruction on the Ecclesial Vocation of the Theologian, Congregation for Doctrine of the Faith, July 5, 1990). The statement in question was an allocution, the lowest level of papal teaching, and has not been repeated in the two years since it was issued. John Paul later that year spoke again to health-care professionals and could have repeated the statement. Instead, he stated: "True compassion encourages every reasonable effort for patient recovery. At the same time, it helps to draw the line when it is clear further treatment will not serve the purpose .... Indeed, the object of the decision whether to begin or to continue a treatment has nothing to do with the value of the patient's life, but rather with whether such medical intervention is beneficial for the patient" (Allocution to Palliative Care Conference, November 12, 2004).

Second, the original statement (March 20, 2004) maintained that tube feeding for PVS patients is ordinary care in principle (the French translation is rendered "as a general rule"). Clearly, in some circumstances it will be extraordinary care. This is in keeping with the traditional teaching. Hence, it seems that if there is moral certitude that a patient is in a persistent vegetative state, tube feeding may be removed because it is no longer beneficial for the patient.

KEVIN O'ROURKE, OP

Chicago, III.

The writer teaches at the Neiswanger Institute of Bioethics and Health Policy at Loyola University Chicago.