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Archbishop Vincenzo Paglia

ROME, March 12, 2018 (LifeSiteNews) — The head of the Pontifical Academy for Life appears to be siding with a British judge who has ordered 22 month-old Alfie Evans to be denied life support against his parents’ will.

Archbishop Vincenzo Paglia said in an interview on Friday that Judge Anthony Hayden’s decision to remove the ventilator from Alfie is an interruption of “overzealous treatment” for the child. He said the judge’s sentence is therefore not at odds with the teaching of the Catholic Church and of Pope Francis.

But some members of the Pontifical Academy for Life are not in agreement with Archbishop Paglia’s position and argue that little Alfie’s ventilator is not “overzealous treatment” but essential life support that cannot legitimately be discontinued.

The Ruling

In a February 20 decision, Judge Anthony Hayden of the London High Court authorized doctors at Alder Hey Children’s Hospital in Liverpool, where Alfie Evans is hospitalized, to remove the life support that keeps him alive. 

Little Alfie suffers from a serious neurodegenerative disease whose precise cause is unknown, and for which currently there is no known medical treatment.

Judge Hayden justified his decision to remove Alfie’s ventilator, in part by citing a message Pope Francis delivered on Nov. 7, 2017 at a Vatican meeting hosted by the Pontifical Academy for Life (That same message was successfully manipulated in Italy last year by those pushing for “living wills” which many regard as euthanasia through the back door).

Quoting a select passage from the Pope’s message, Justice Hayden argued that one can reasonably make a “decision that is morally qualified as withdrawal of ‘overzealous treatment’.” 

However, in the Pope’s message, the rejection of “overzealous treatment” does not mean depriving the patient of what is indispensable for him to continue living (i.e. life support) — ventilation, hydration and nutrition — but only futile therapeutic measures that cause suffering with no benefit. 

In fact, nowhere in the passage of the Pope’s message quoted by Justice Hayden, nor anywhere in the previous magisterium is it mentioned that continuing to provide the incurably sick person with life support (air, nutrition, water) is “overzealous treatment.”

On the contrary, according to a statement issued by the Congregation for the Doctrine of the Faith in 2007, regarding patients in a vegetative state, it is obligatory to continue essential life support as long as it is achieving its end. To discontinue it would be a form of euthanasia, even if the incurably sick person’s death is unavoidable over time. 

As stated in the judge’s decision, the physicians who examined Alfie determined that the 22 month-old is in a “semi-vegetative state,” meaning that he more than qualifies for the cases that the CDF document addresses. 

Furthermore, the British judge failed to mention a portion of Pope Francis’ message in which he said we “must always care for the living, without ourselves shortening their life.” The Pope also said it is a “categorical imperative” to “never abandon the sick.” 

The Holy See has remained silent in response to Judge Hayden’s decision and his selective interpretation of the Pope’s words. According to Italian media reports and well-placed Vatican sources, Santa Marta and the Secretariat of State have been flooded with messages and telephone calls asking the Vatican to intervene. To date, the Holy See press office has not issued a statement.

Paglia weighs in

On March 9, the Italian website Tempi published an interview with Archbishop Paglia, President of the Pontifical Academy for Life, about little Alfie, in which he argued that the judge’s decision “was not meant to shorten his life, but to suspend a situation of overzealous treatment.”

But critics say that Archbishop Paglia, in agreeing with Judge Hayden’s interpretation of Pope Francis’ words, is confusing (as did the judge) the suspension of a treatment, which in some cases is licit based on the Church’s teaching and tradition, with the removal of essential life support, which is never licit. 

A Vatican source with knowledge of the issue told LifeSiteNews that Paglia seems to be playing with the word “treatment,” for example when he says: “If killing were at stake, we could only be opposed to it…. But here, the issue is about a possible suspension of treatments.”

What “treatments?,” the source asked. What the Liverpool doctors and Judge Hayden want to suspend, he pointed out, are not futile treatments. Ventilation, hydration, and nutrition, he stressed, are life support, not therapy.

Yet a ventilator is not always considered ordinary and proportionate care and could be discontinued, a moral theologian in Rome clarified.

“When it is no longer medically beneficial, it is morally acceptable to stop the treatment; this includes giving food or water. A ventilator is not always a reasonable treatment when a person cannot breathe on his own and has no hope of recovery. So long as a person can metabolize food and water, these should be provided. But if a person cannot metabolize food and water, they should no longer be provided, nor is a ventilator morally necessary in that case,” he said.

If there is no hope of recovery for little Alfie, he added, the right thing to do would be to let the parents make the decision as to when to remove the ventilator. But as long as Alfie continues to metabolize food, that should be given to him.

Interestingly, the ethical reference points Archbishop Paglia used in making his argument can be found in liberal ethical positions on end-of-life questions found in the Italian Jesuit journal “Aggiornamenti Sociali” [Social Updates]. Its working group is headed by Jesuit Father Carlo Casalone, and Italian moral theologian Fr. Maurizio Chiodi, both new members of the Pontifical Academy for Life.

Fr. Chiodi is the newly appointed Pontifical Academy for Life (PAV) member who argued that responsible parenthood can require married couples to use contraception in some cases.

In the interview, Paglia also referred to the Board of the Italian Association of Catholic lawyers, an association whose president Francesco D’Agostino is also a PAV member. D’Agostino in the past has supported the possibility of suspending life support in some circumstances for the incurably ill. He has characterized the case of Charlie Gard as a similar rejection of an overzealous treatment. 

Sgreccia differs with Paglia

In contrast to Paglia’s position, former Academy for Life President Cardinal Elio Sgreccia endorsed an article by Fr. Roberto Colombo, a member of the Faculty of Medicine and Surgery at the Catholic University in Rome, who explained that the Bambino Gesù Pediatric Hospital (Vatican City) offered to welcome little Alfie and provide him with full palliative care as long as he continued to live.

The proposal was noted in Judge Hayden’s decision, Fr. Colombo pointed out. The doctors of the Bambino Gesù Hospital had no intention of removing either mechanical ventilation or hydration and nutrition. As they themselves are reported in the judge’s decision to have said: “It is therefore possible that a prolonged ventilator support, with surgical tracheostomy should be performed. Feeding and hydration have been artificially provided through a nasogastric tube for several months, a clear indication for a gastrostomy is evident. Renal and liver functions seemed normal.”

However, Judge Hayden did not agree to little Alfie being transferred to the Bambino Gesù Hospital at the Vatican, nor to his transfer to a German medical center that offered him the same palliative care. 

The fact that the doctors of the Bambino Gesú Hospital determined that providing a ventilator for little Alfie was both possible and reasonable life support, and offered to welcome him, may demonstrate that the judge’s order is intended to end little Alfie’s life.  

Fr. Colombo ended by stating: “If a ruling intends to justify a further step towards the ‘throw away culture and culture of death’ it ought not to do so by manipulating the Pope’s words, whose meaning, in the context of the Church’s Magisterium, moves in the opposite direction, that is, to the ‘culture of welcome and of life’ — of every human life whose origin is from God, and from Him alone is brought to the end of its earthly existence.” 

No response from Paglia

In comments to LifeSite, Fr. Colombo reiterated that “mechanical ventilation should not be considered as a therapy for Alfie, but rather a form of life support, as are enteral hydration and nutrition.” 

“This is consistent with the statement of the physicians from the Bambino Gesù Pediatric Hospital who visited Alfie in Liverpool — that a tracheostomy and gastrostomy are the recommended and appropriate palliative care for Alfie,” he added.

“Using this support cannot be ‘therapeutic obstinacy,’ because there is no therapy to be considered or discussed for his disease. Ventilation is provided to take care of him (his life) until his death occurs, soon or later, as a consequence of his disease.”

LifeSiteNews also contacted Archbishop Paglia’s office and received no response. But it seems that not all of his colleagues are in agreement with him. 

The Vatican Dicastery for Laity, Family and Life today tweeted an article by the Italian pro-life organization ProVita, titled: “Taking care of Alfie is not overzealous treatment.”

Little Alfie’s parents, Tom Evans and Kate James, are asking that the ruling be overturned.



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