Tuesday, February 10, 2009

Politically Savvy, Me

Remember when I said,

The most efficacious way that the Deathmongers have used around the world to bring in legalised passive euthanasia is to have food and hydration defined in law as "medical treatment" that can be legally refused by a patient (through the proxy of guardians/physicians, of course, in the cases of incapacitated patients)...in cases like this, where there has been a celebrity victim, it should be all the easier to put the idea into people's heads that the whole mess can be avoided in future just by saying that food and water are medicine.

Well, hey, guess who's being politically prescient?

Napolitano has stressed repeatedly that the way to deal with cases such as Eluana's is through parliament passing a law on living wills, which allow people to stipulate what medical treatment they want in the event they later become unable to make a decision themselves.

Yes indeedy. The solution to all this mess...

Well, I have to admit that I got a heads-up about it some time ago:

The issue revolves around the definition of “medical treatment” under the Constitution, and whether it includes the provision of food and water. Silvestri explained that under Article 32 of the Italian Constitution, a patient has the right to accept or refuse medical therapies. But this has always been interpreted as specifically excluding food and water, which are not medical treatment, but the ordinary means of sustaining human life. Until the Englaro decision, he said, Italian law did not recognise in any way a “right” for a patient to decide to end his or her own life..

Silvestri warned, however, that while there is great interest in Parliament in the case and in closing this loophole, divisions within and between parties exist. This is particularly the case in regards to an upcoming “living wills” law, in which there is division on whether to include a “food and hydration” clause.


Anonymous said...

Hilary, there is a false distinction which some people attempt to make, that the provision of food and water by somewhat unnatural means, especially abdominal surgery, constitutes medical treatment.

I suspect that in a case in which digestion is impossible without extraordinary intervention, it might be difficult to conclude that feeding was an ordinary obligation -- but I'm not sure. Obviously if all that's needed is a feeding tube, it's routine, and _removing_ the tube in order to make feeding impossible is... unspeakable.

Is there a principle that can distinguish the ordinary provision of food and water from extraordinary intervention to allow food and water to be provided?


HJW said...

When a patient is in the last stages of life, with cancer or something similar, the body can no longer process food and fluids. In cases like that, it would be considered "extraordinary" to attempt to put food and fluids into the system that is in the last stages of shutting down adn can no longer handle it.

In cases like Terri Schiavo, Eluana, etc, these people were not dying, they didn't have cancer or any other disease that would have put them close to death. In most of these cases, the person is in a "PVS". The fact is that even neurologists don't know what, exactly, PVS means, but in practical terms, it means that hte person cannot swallow. THat is all. The body continues to be in good health but the swallwing reflex doesn't work. The body can and does process food and fluid normally because it is, essentially, healthy. There are a lot of situations in which a person can be rendered unable to swallow (including but not confined to PVS). In such cases, other means must be found to put food and fluid into the body. This is not "extraordinary measures". It is not a "life support system". It is feeding.

Anonymous said...

I do have some difficulty with equating IV or certainly interarterial feeding with the straightforward "conventional" provision of food and drink. Obviously, some degree of specialized medical skill (and medical/social resources) is required to effect feeding through veins or especially arteries.

Using Pius XII's language, it would seem that the true basis of the obligation is that in advanced, wealthy societies, such feeding should not be viewed as extraordinary. However, this may not be true in poorer countries. Certainly, in the rural Maritimes within living memory, it was not practically possible to provide such feeding, even though in larger centres IV feeding was probably conducted at that time. When someone was in a coma, they used to place a mirror at the mouth to see if the individual were still breathing. (I should add that these rural communities were Catholic in a manner far beyond what most younger Catholics have experienced, so this was not a reflections of secularist ideologies). In fact, I recall B16 did leave some caveat in his ruling (subsequent to JPII's) in connection with impoverished countries re the feeding issue.

I accept that in our societies there is an obligation to feed, but I do have concern with a complete equation of feeding with abortion, because until recently a prolonged period of coma and inability to ingest food/drink meant one was dying, just as terminal cancer equals dying given current medical knowledge and resources.


HJW said...

Food. Water.

Not "medicine".

Get it?

Anonymous said...

Yes, but it requires "medical treatment" to administer the food and water. Some feeding surgeries and treatments are quite involved; one can no more define them as "non-medical" than one can redefine the nature of marriage. Think of it this way: If you were comatose, would you want me to perform surgery (to attempt) to commence arterial feeding on you? Case closed.