Editor's note. Please send me your thoughts on this at daveandrusko@hotmail.com.

"Life is, however, the first and most basic good of the human person, the condition for all others…The way we treat this life here and now--especially the life of those who are most helpless and least able to care for themselves--has consequences for our own eternal destiny."
     From "Human Dignity and the End of Life," America magazine."

The Catholic Church plays a highly significant role in the health care system both because the Catholic Church operates many health care facilities and because its pronouncements on the care that is owed to vulnerable patients help shape public policy debates in a life-affirming manner.

In the August 4-11 issue of the influential magazine America, Cardinal Justin F. Rigali, Archbishop of Philadelphia and chairman of the Committee on Pro-life Activities of the U.S. Conference of Catholic Bishops, and Bishop William E. Lori, chairman of the U.S.C.C.B. Committee on Doctrine, address an enormously important area: what is the moral obligation to provide food and fluids to patients diagnosed to be in a "persistent vegetative state" (PVS).

They write that two recent articles in America, written by John J. Hardt and Thomas A. Shannon, "appear to misunderstand and subsequently misrepresent the substance of church teaching on these difficult but important ethical questions." Their essay is nourished by clarity and nuance and a concern that the Catholic Church's position on this vitally important issue not be misunderstood.

They recall for their audience that in 2004 Pope John Paul II issued a statement on providing food and hydration to patients in a PVS. For some there was ambiguity in what the late Pontiff had said, and last year the USCCB posed two questions to the Vatican's Congregation for the Doctrine of the Faith (C.D.F.).

Last September, the C.D.F. issued a response which along with "its accompanying Commentary confirm and explain the statements made by Pope John Paul II on March 20, 2004, on the moral obligation to provide food and fluids to P.V.S. patients when they need such assistance to survive." The response was approved by Pope Benedict.

For our purposes, let me draw your attention to three points made by Cardinal Rigali and Bishop Lori. (Rather than elaborate on what Hardt and Shannon had written, I will highlight the clarifications.)

1. "Pope John Paul II and his successor held that food and water, even when their provision may require technical medical assistance, constitute the 'basic care' that patients should receive. The value of such medical assistance is not to be judged by its efficacy in curing the patient or improving the patient's condition. Supplying the basic necessities of life can often require the assistance of others, in the case, for example, of those who are very young or very old, or simply very weak at any age. In the case of medically stable patients in a 'vegetative state,' who may live a long time with continued nourishment but will certainly die of dehydration or starvation without it, the obligation to care for our fellow human beings presents a very direct challenge. Such a patient's condition should not be characterized as 'unstable' or terminal simply because it would become so if the patient were deprived of food and water."

2. "By omitting food and fluids, what are we trying to achieve? Assisted feeding is often not difficult or costly to provide in itself, but the housing, nursing care and other basic needs of a helpless patient can be significant. To discontinue assisted feeding in order to be freed from such burdens puts the caregiver's interests ahead of the patient's, even if we prefer not to recognize the reality of our choice."

3. Cardinal Rigali and Bishop Lori are polite but unflinching in their criticism of those who would withhold food and fluids on the specious grounds that someone in a PVS "is not a fully human life because it is not capable of interaction with other persons." Wrong in itself, it represents a classic example of the slippery slope.

In a section titled, "The Unity of the Living Human Person," they write, "Such an argument has deeply disturbing implications, since it challenges the value of anyone with mental illness, retardation or cognitive disabilities who is not able to pursue what such critics deem 'worthwhile' activity. … Our love and support for patients in P.V.S. should be modeled on God's love, which is based not on their current ability to act and respond but on their enduring dignity as human beings, made in his image and likeness and facing an ultimate destiny with him."

Their conclusion is very powerful, beginning with the admonition that "Persons in the so-called 'vegetative state' deserve our unconditional respect." They are, after all, our brothers and sisters.

And "even if such efforts at recovery do not succeed, we need to provide friendship and practical help to their families and treat these patients always as fellow human beings in need of basic care. In this way our Catholic community can build a culture of life that excludes no one from the circle of love and mutual support."

Part Three -- Bombay Court Rules Against Abortion