If Death Shall Be No More

When Joseph and Julia Quinlan asked that their daughter be allowed to die, they had the full support of their Roman Catholic priest, Father Thomas Trapasso of Our Lady of the Lake Church. Said he: "Extraordinary means are not morally required to prolong life." The vice chancellor of his diocese, Father Herbert Tillyer, agreed: "There is a profound difference between killing someone and allowing a person to spend his or her last few hours or days free from the maze of machinery that is beautiful only so long as there is hope for some recovery."

Other Catholics did not agree. As the case went to trial last week, Vatican Radio broadcast an interview with Corrado Manni, a physician at Rome's Catholic University who specializes in resuscitation. He remarked that a decision to remove the respirator that is keeping Karen Quinlan alive would be "extremely dangerous," and his fellow doctors must not accept even an indirect form of euthanasia (mercy killing), "which renounces therapy." The Vatican daily L'Osservatore Romano then published a similar commentary by one of its staff members, Father Gino Concetti. He wrote: "It is impossible to support the claim of the right of 'death with dignity.' A right to death does not exist...Love for life, even a life reduced to a 'ruin,' drives one to protect life with every possible care."

Is this then the Vatican view? Father Trapasso's diocesan authorities insisted that both comments were merely private opinions, an accurate statement since only unsigned editorials in L'Osservatore are used to reflect papal thinking. In Rome, one theology professor fumed, "Concetti is no moral theologian, and what he wrote is stupid." Said Father Sean O'Riordan, a moral theologian at Rome's Alphonsianum College: "Concetti's article is clearly contrary to the teachings of Pope Pius XII and the unanimous moral tradition existing for centuries."

Many theologians make a sharp distinction between euthanasia and allowing the patient to die a natural death, usually by failing to take extraordinary or heroic measures. Direct action to kill people who suffer pain or are deemed worthless has always been opposed by both Christianity and Judaism (in contrast to many of the religions and philosophies of the ancient world). It was a simple matter of applying the general commandment against murder: "The innocent and just man thou shall not put to death" (Exodus 23:7).

But Christianity, in common with a large body of secular thought, also holds that the patient, the family and their doctors are not morally required to use every conceivable means to sustain a damaged life. In Catholicism, which has the most developed literature on such questions, one notable exponent of this view was the brilliant 17th century Spanish Cardinal Juan de Lugo, who said "ordinary" efforts are required, but "extraordinary" methods are not.

The definition of what is "extraordinary" varies not only with individual cases but with medical advances. In the centuries when moral theology was developing the distinction, surgical operations that would be routine today were dangerous or unbearably painful and thus extraordinary; on the other hand, many of today's extraordinary measures were then unknown. Whatever the ambiguities, there is no doubt that use of the respirator in the Quinlan case falls within Catholicism's definition of "extraordinary." In 1957 when Pope Pius XII reaffirmed the centuries-old view on "extraordinary" means in an address to anesthesiologists, he included removal of a respirator "to allow the patient who is already virtually dead to pass away in peace." A few years later, a Church of England study pamphlet said all such life-support machines should have only one purpose: to keep vital organs going until doctors can tell whether the organs can ever again function on their own.

While most Catholic spokesmen have rallied behind the Quinlans, at least one Protestant, surprisingly, has come out against any court ruling in their favor. Ethicist Thomas C. Oden of New Jersey's Drew University is concerned mainly about establishing a precedent that could weaken the legal barriers against all kinds of euthanasia. That concern is discounted, however, by fellow Methodist Paul Ramsey of Princeton University, author of The Patient as Person (Yale University Press). Says Ramsey: "Everybody has reason to fear the onset of euthanasia, but it doesn't seem to me that a carefully drawn court opinion would be the edge of the wedge toward active killing of terminal patients." Ramsey regrets that the Quinlans took their case to court for the opposite reason. He thinks the judge may be forced to rule against them and thus set a precedent in favor of nonstop treatment until patients "at long last succeed in dying, despite our machines."

As Ramsey and others have noted, death is a dread enemy to Christians, but it is not ultimately evil. In John Donne's words, "One short sleepe past, wee wake eternally,/ And death shall be no more, death thou shalt die."

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