On August 13, the Pontifical Academy for Life (PAL), headed by Archbishop Vincenzo Paglia, released “Little Lexicon on End of Life,” which wrestles with various bioethical issues.
One particularly noteworthy issue is the necessity of providing patients in a persistent vegetative state (PVS) with food and hydration via feeding tubes. That the PAL felt the need to raise questions in the first place is troubling enough, but the documents unclear language also amplified confusion.
For example, it states that persons diagnosed as being in a PVS are victims “of a reductive conception of disease, which is understood as an alteration of a particular function of the organism, losing sight of the totality of the person,” and that “this reductive way of interpreting disease then leads to an equally reductive concept of care, which ends up focusing on individual functions of the organism rather than the overall good of the person.”
Perhaps more concerning for persons thought to be in a PVS is the PAL’s seeming undoing of the Church’s long-standing recognition of feeding tubes as basic care. It reasons that, since a person in a PVS needs their food and water prepared in a laboratory, feeding tube treatments require a form of “technology” and therefore do not qualify as “simple care procedures.” However, as faithful Catholics know, any attempt to redefine feeding tubes as something other than basic care would be contrary to the long-standing teachings of the Church.
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Rarely mentioned is that determinations of whether someone is in a PVS rest on the subjective assessments of the doctor(s) examining the patient. Thus, it has been found that the PVS diagnosis has been inaccurately applied to nearly 50% of the people diagnosed.
The term “persistent vegetative state” is often used for patients who have lost all awareness of their surroundings, exhibit no purposeful behaviors, and lack higher brain functions such as decision-making and problem-solving. Scottish neurosurgeon Bryan Jennett and American neurologist Fred Plum coined this term in 1972 and advanced PVS as a new diagnostic category.
Although individuals in a PVS have sustained serious brain injuries, they are not terminal; they are not dying and can live a normal life span if properly treated. However, the public has been encouraged to accept the veracity of PVS diagnoses and their use as justification for denying or removing a person’s feeding tube.
As far back as 1996, a study by doctors at the Royal Hospital for Neuro-disability in London who specialized in persons diagnosed as being in a vegetative state found that over 40% of patients referred to their hospital since 1992 had been misdiagnosed due to doctors lacking the proper tools to diagnose this condition with certainty.
More recently, on May 13, 2024, the Journal of Neurotrauma published a seven-year study involving 1,392 patients who had sustained traumatic brain injuries and were admitted to hospital trauma centers.
Researchers found that patients who received a poor recovery prognosis had their life-sustaining treatment withdrawn within days of their brain injuries. The study also revealed that 40% of patients who were afforded time recovered with at least some independence.
Perhaps not a coincidence, considering the recent release of the “Lexicon,” on August 14, 2024, the New England Journal of Medicine published the findings of its largest-ever research study on patients with cognitive-motor dissociation (vegetative state).
They found that 25% of the 241 of these patients whom the researchers examined had brain activity like that seen in people with no brain injury—indicating that those patients were conscious and aware.
Dr. Nicholas Schiff, a neurologist and one of the study’s authors, said the findings show that up to 100,000 patients in the United States alone might have some level of consciousness despite their devastating injuries. He also underscored the study’s importance: “Just knowing that a patient has this ability to respond cognitively can be a game-changer in terms of life-support decisions and the degree of engagement of caregivers and family members.”
All these findings are critically important because the public (including some Catholics) has been conditioned to believe that removing the basic provision of food and fluids based on PVS diagnoses is kinder than continuing to care for and love disabled people, even though this removal barbarically causes their death by dehydration and starvation.
Until this new verbiage by the “Lexicon,” the Catholic Church always maintained that providing food and hydration, even if a feeding tube is needed, is a moral obligation and that withholding food and water to end a person’s life is in violation of Church teachings and a grave sin imposed on the human person.
Pope St. John Paul II clarified this issue in a 2004 allocution (a teaching statement) where he explicitly emphasized that providing a feeding tube is a simple requirement for those who are not dying and need this form of ordinary care to live.
In 2007, William Cardinal Levada, Prefect of the Congregation for the Doctrine of the Faith, responding to questions raised by the United States Conference of Catholic Bishops, affirmed St. John Paul’s allocution and the moral duty to provide feeding tubes to patients in a PVS.
The PAL’s new wording warrants serious concern as it questions the Church doctrine that feeding tubes are required care for our medically defenseless. Confusion already exists within the laity on this issue; why the PAL would choose to create more by sharing a worldview with people who support a dangerous, nihilistic, pro-death agenda is difficult to explain.
There is no compromising with evil, especially when it intends to force an agonizing death on our medically weak. If we continue to ignore attacks on our God-given dignity that undermine the sacredness of the human person—especially in today’s bureaucratic U.S. healthcare system—there will be nothing to stop people from finding other justifications for killing our innocent, medically vulnerable brothers and sisters who will continue to fall victim to their wickedness.
Bobby Schindler and his family work as patient advocates, establishing the Terri Schiavo Life & Hope Network in honor of his sister, Terri. Protect yourself and your loved ones today by identifying a healthcare agent to speak for you if you cannot. Click here to learn more.
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