Peter Baklinski

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Bioethicist argues PVS diagnosed patients should not be kept alive

Peter Baklinski
Peter Baklinski
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April 11, 2012 (LifeSiteNews.com) - If an American bioethicist gets her way, all patients evaluated as being in a “permanent vegetative state” (PVS) would by default have artificial nutrition and hydration (ANH) withdrawn unless they have made a prior wish to be kept alive.

In the March 2012 issue of Bioethics, Dr. Catherine Constable argues that “in the absence of clear evidence that the patient would opt for this existence over death, keeping him alive by any means of assistance is ethically more problematic than allowing him to die.”

Constable’s article however, does not appear to adequately confront recent research indicating that many patients have been misdiagnosed as PVS and have in fact had functioning, fully conscious brains. They have been unable to communicate their situation to caregivers and to those who in many cases made misguided decisions to end their lives. The highly respected Discover Magazine published a dramatic report on such research last year.

The term PVS itself is also being increasingly being challenged as inappropriate for human beings who it is argued can never be considered to be “vegetative”.

In her article titled Withdrawal of Artificial Nutrition and Hydration for Patients in a Permanent Vegetative State: Changing Tack, Constable suggests that the current medical presumption that favors providing nutrition and hydration to PVS patients is a “violation of autonomy” and that it “goes against the best interests of the patient”.

Constable, who teaches at New York University School of Medicine but who studied bioethics at the Ethox Centre at Oxford University, justifies her position using the philosophical premise of Peter Singer that “[whether or not] a being is human, and alive, does not in itself tell us whether it is wrong to take that being’s life.” She drew heavily on Singer’s method for valuing persons in terms of consciousness that allows him to argue that “the most significant ethically relevant characteristic of human beings whose brains have ceased to function is not that they are members of our species, but that they have no prospect of regaining consciousness.”

“Without consciousness, continued life cannot benefit them [PVS patients],” Singer argued.

Constable runs with Singer’s line of reasoning, concluding that “a decision to preserve the life of a patient in a state of permanent unconsciousness based on respect for life itself is morally no more sound than a decision to take that life.”

For Constable, an individual’s autonomy is the highest human good, overriding any other good, including what she calls the “sanctity of life”. Since a PVS patient presumably no longer has consciousness and therefore lacks autonomy, her argument runs, then there is no moral reason that such a patient should be kept alive.

“In view of this conclusion, other considerations, such as the cost to the healthcare system (public, or any other kind) would seem poised to be deciding factors,” she argues.

Constable goes as far as making the case that those who provide a PVS patient who may not have wanted to be kept alive with ANH “have arguably committed a worse violation of autonomy by treating the patient than if we had not treated him against his wishes.”

Bringing in surveys that indicate that a majority of people would not want to continue living in a permanent vegetative state, Constable argues that in continuing to provide ANH to PVS patients “we are employing a treatment that most do not consider beneficial without consent.” For Constable, ANH is simply a “form of treatment” that is concomitant with all the “ethical ramifications” that would normally accompany any other kind of treatment.

Constable even argues against keeping PVS patients alive through ANH under the pretext of a chance of recovery for the reason that the new life gained would be “far less likely to resemble [the life that was] lost” and would likely resemble “some state of middle consciousness”. She suggests that the life of a recovered PVS patient would be “quite possibly, worse than non-existence”.

Renowned bioethics critic Wesley J. Smith called Constable’s position paper a “radical proposal” that would set the stage for what he called a “‘default for death’ policy [that] would establish the foundation for a veritable duty to die”.

Smith warned that Constable’s arguments for killing PVS patients are not limited to the PVS.

“Some bioethicists already claim that those with minimal consciousness have an interest in being made to die. And don’t forget Futile Care Theory and health care rationing bearing down on us.”

The Vatican’s Congregation for the Doctrine of the Faith (CDF) stated in 2007 that the withdrawal of artificial nutrition and hydration from PVS patients is immoral. Their statements were approved by Pope Benedict XVI.

“The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.”

The CDF clarified that even if a competent physician judges with moral certainty that a PVS patient will never recover consciousness, nonetheless, a PVS patient is “a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.”

The late John Paul II had also taught that “the administration of water and food [to a sick person], even when provided by artificial means, always represents a natural means of preserving life, not a medical act.”

“We had better push back on this agenda”, warned Smith on his blog.

“The lives of tens of thousands of people may be at stake.”

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Obama remakes the nation’s courts in his image

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By Dustin Siggins
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It has often been said that the Affordable Care Act (ACA) is President Obama's greatest achievement as president. However, that claim may soon take second place to his judicial nominees, and especially their effect on marriage in the United States.

In a new graphic, The Daily Signal notes that while President George W. Bush was able to get 50 nominees approved by this time in his second term, Obama has gotten more than 100 approved. According to The Houston Chronicle, "Democratic appointees who hear cases full time now hold a majority of seats on nine of the 13 U.S. Courts of Appeals. When Obama took office, only one of those courts had more full-time judges nominated by a Democrat."

Three of the five judges who struck down state marriage laws between February 2014 and the Supreme Court's Windsor decision in 2013 were Obama appointees, according to a CBS affiliate in the Washington, D.C. area. Likewise, the Windsor majority that overturned the Defense of Marriage Act included two Obama appointees, Justices Sonia Sotomayor and Elena Kagan. Obama has nominated 11 homosexual judges, the most of any president by far, says the National Law Journal.

Only one federal judge has opposed same-sex "marriage" since the Supreme Court's Windsor decision. He was appointed under the Reagan administration.

This accomplishment, aided by the elimination of Senate filibusters on judicial nominees, could affect how laws and regulations are interpreted by various courts, especially as marriage heads to a probable Supreme Court hearing on the constitutionality of state laws.

Democrats eliminated the filibuster for all judicial nominees except for Supreme Court candidates last year, saying Republicans were blocking qualified candidates for the bench. However, the filibuster was part of the reason Democrats were able to keep the number of approved Bush appointees so low.

The Supreme Court may hear multiple marriage questions in its 2015 cycle. 

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Lisa Bourne

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Cardinal Dolan: Debate on denying Communion to pro-abortion pols ‘in the past’

Lisa Bourne
By Lisa Bourne

As America heads into its 2014 midterm elections, a leading U.S. prelate says the nation’s bishops believe debate over whether to deny Communion to pro-abortion Catholic politicians is “in the past.”

The Church’s Code of Canon Law states in Canon 915 that those “obstinately persevering in manifest grave sin are not to be admitted to Holy Communion.” Leading Vatican officials, including Pope Benedict XVI himself, have said this canon ought to be applied in the case of pro-abortion Catholic politicians. However, prelates in the West have widely ignored it, and some have openly disagreed.

John Allen, Jr. of the new website Crux, launched as a Catholic initiative under the auspices of the Boston Globe, asked New York Cardinal Timothy Dolan about the issue earlier this month.

“In a way, I like to think it’s an issue that served us well in forcing us to do a serious examination of conscience about how we can best teach our people about their political responsibilities,” the cardinal responded, “but by now that inflammatory issue is in the past.”

“I don’t hear too many bishops saying it’s something that we need to debate nationally, or that we have to decide collegially,” he continued. “I think most bishops have said, ‘We trust individual bishops in individual cases.’ Most don’t think it’s something for which we have to go to the mat.”

Cardinal Dolan expressed personal disinterest in upholding Canon 915 publicly in 2010 when he told an Albany TV station he was not in favor of denying Communion to pro-abortion politicians. He said at the time that he preferred “to follow the lead of Popes John Paul II and Benedict XVI, who said it was better to try to persuade them than to impose sanctions.”

However, in 2004 Cardinal Joseph Ratzinger, who became Pope Benedict XVI the following year, wrote the U.S. Bishops a letter stating that a Catholic politician who would vote for "permissive abortion and euthanasia laws" after being duly instructed and warned, "must" be denied Communion. 

Cardinal Ratzinger sent the document to the U.S. Bishops in 2004 to help inform their debate on the issue. However, Cardinal Theodore McCarrick, then-chair of the USCCB Task Force on Catholic Bishops and Catholic Politicians, who received the letter, withheld the full text from the bishops, and used it instead to suggest ambiguity on the issue from the Vatican.

A couple of weeks after Cardinal McCarrick’s June 2004 address to the USCCB, the letter from Cardinal Ratzinger was leaked to well-known Vatican reporter Sandro Magister, who published the full document. Cardinal Ratzinger’s office later confirmed the leaked document as authentic.

Since the debate in 2004, numerous U.S. prelates have openly opposed denying Communion to pro-abortion Catholic politicians.

In 2008, Boston Cardinal Sean O’Malley suggested the Church had yet to formally pronounce on the issue, and that until it does, “I don’t think we’re going to be denying Communion to the people.”

In 2009, Cardinal Donald Wuerl of Washington D.C. in 2009 said that upholding of Canon 915 would turn the Eucharist into a political “weapon,” refusing to employ the law in the case of abortion supporter Rep. Nancy Pelosi.

Cardinal Roger Mahoney, archbishop emeritus of Los Angeles, said in a 2009 newspaper interview that pro-abortion politicians should be granted communion because Jesus Christ gave Holy Communion to Judas Iscariot.

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However, one of the Church’s leading proponents of the practice, U.S. Cardinal Raymond Burke, who is prefect of the Vatican’s Apostolic Signatura, insists that denying Communion is not a punishment.

“The Church’s discipline from the time of Saint Paul has admonished those who obstinately persevere in manifest grave sin not to present themselves for Holy Communion,” he said at LifeSiteNews’ first annual Rome Life Forum in Vatican City in early May. "The discipline is not a punishment but the recognition of the objective condition of the soul of the person involved in such sin."  

Only days earlier, Cardinal Francis Arinze, former prefect of the Congregation for Divine Worship and the Discipline of the Sacraments, told LifeSiteNews that he has no patience for politicians who say that they are “personally” opposed to abortion, but are unwilling to “impose” their views on others.

On the question of Communion, he said, “Do you really need a cardinal from the Vatican to answer that?”

Cardinal Christian Tumi, archbishop emeritus of Douala, told LifeSiteNews around the same time that ministers of Holy Communion are “bound not to” give the Eucharist to Catholic politicians who support abortion.

Pro-life organizations across the world have said they share the pastoral concern for pro-abortion politicians. Fifty-two pro-life leaders from 16 nations at the recent Rome Life Forum called on the bishops of the Catholic Church to honor Canon 915 and withhold Communion from pro-abortion politicians as an act of love and mercy.

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Cardinal Raymond Burke, prefect of the Vatican's Apostolic Signatura Steve Jalsevac / LifeSiteNews
John-Henry Westen John-Henry Westen Follow John-Henry

Sources confirm Cardinal Burke will be removed. But will he attend the Synod?

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By John-Henry Westen

Sources in Rome have confirmed to LifeSiteNews that Cardinal Raymond Burke, the head of the Vatican’s highest court, known as the Apostolic Signatura, is to be removed from his post as head of the Vatican dicastery and given a non-curial assignment as patron of the Order of Malta.

The timing of the move is key since Cardinal Burke is currently on the list to attend October’s Extraordinary Synod on the Family. He is attending in his capacity as head of one of the dicasteries of the Roman Curia, so if he is removed prior to the Synod it could mean he would not be able to attend.

Burke has been one of the key defenders in the lead-up to the Synod of the Church's traditional practice of withholding Communion from Catholics who are divorced and civilly remarried.

Most of the Catholic world first learned of the shocking development through Vatican reporter Sandro Magister, whose post ‘Exile to Malta for Cardinal Burke’ went out late last night.

If Burke’s removal from the Signatura is confirmed, said Magister, the cardinal “would not be promoted - as some are fantasizing in the blogosphere - to the difficult but prestigious see of Chicago, but rather demoted to the pompous - but ecclesiastically very modest - title of ‘cardinal patron’ of the Sovereign Military Order of Malta, replacing the current head, Paolo Sardi, who recently turned 80.”

At 66, Cardinal Burke is still in his Episcopal prime.

The prominent traditional Catholic blog Rorate Caeli goes as far as to say, “It would be the greatest humiliation of a Curial Cardinal in living memory, truly unprecedented in modern times: considering the reasonably young age of the Cardinal, such a move would be, in terms of the modern Church, nothing short than a complete degradation and a clear punishment.”

On Tuesday, American traditionalist priest-blogger Fr. John Zuhlsdorf also hinted he had heard the move was underway. “I’ve been biting the inside of my mouth for a while now,” he wrote. “The optimist in me was saying that the official announcement would not be made until after the Synod of Bishops, or at least the beginning of the Synod. Or at all.”

“It’s not good news,” he added.

Both Magister and Zuhlsdorf predicted that the controversial move would unleash a wave of simultaneous jubilation from dissident Catholics and criticism from faithful Catholics. The decision to remove Cardinal Burke from his position on the Congregation for Bishops last December caused a public outpouring of concern and dismay from Catholic and pro-life leaders across the globe.

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Both men speculated on the reasons for the ouster. 

Magister pointed out that Burke is the latest in a line of ‘Ratzingerian’ prelates to undergo the axe.

“In his first months as bishop of Rome, pope Bergoglio immediately provided for the transfer to lower-ranking positions of three prominent curial figures: Cardinal Mauro Piacenza, Archbishop Guido Pozzo, and Bishop Giuseppe Sciacca, considered for their theological and liturgical sensibilities among the most ‘Ratzingerian’ of the Roman curia,” said Magister.

He added: “Another whose fate appears to be sealed is the Spanish archbishop of Opus Dei Celso Morga Iruzubieta.”

Fr. Zuhlsdorf observed that Pope Francis may also be shrinking the Curial offices and thus reducing the number of Cardinals needed to fill those posts. He adds however, “It would be naïve in the extreme to think that there are lacking near Francis’s elbows those who have been sharpening their knives for Card. Burke and for anyone else associated closely with Pope Benedict.” 

“This is millennial, clerical blood sport.”

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