THE PUBLIC MIND: MORAL CASE CAN BE MADE FOR REMOVING CRUZAN FEEDING TUBE

Dear Editor:

Nancy Cruzan's feeding tube has been disconnected. During these difficult days, our hearts and prayers go out to Nancy, her parents, friends and the caring staff of the Missouri Rehabilitation Center. Religious people believe Nancy will begin a new life now, beyond the hospital room where she has been so long.

A reasonable case can be made that removing the feeding tube from Nancy's stomach was morally permissible. Catholic moral teaching offers two principles. First, only ordinary and not extraordinary measures must be taken to maintain health and life. Second, the burden of any medical procedure should be proportionate to its benefit. Much care must be taken in applying these two principles to a particular situation, but they clearly offer helpful guidance with serious and terminal illnesses.

The Catholic Church has consistently taught that a patient can morally decide about whether or not to accept certain treatments. Mentally competent patients, through discussions with their family and health-care professionals, soberly make such decisions. But what should be done for a patient who was formerly competent or never competent? It seems as though incompetent persons should have the same rights as competent persons. Finding legitimate ways of bringing that about, however, is complicated and quite difficult.

Missouri law states that patients in situations like Nancy Cruzan's must have medical treatments continued unless there is "clear and convincing evidence" that the patient would not want them continued. Living wills, durable powers of attorney, patient-designated proxies and health-care surrogates will be discussed in the months ahead in our state legislature in clarifying the nature of "clear and convincing evidence." Great care must be taken in order to protect the incompetent patient. Many potential abuses are possible even from family members. There are real dangers, also, that interpretations about a person's "quality of life" can be readily and seriously misguided. Even with competent patients, the community in general and the state in particular have an interest in requiring of individuals serious reasons for refusing medical treatment.

An individual's right to make ethically sound health-care decisions must be respected. At the same time, potential abuses must be prevented. Striking a balance between the two will shape the debate ahead.

John J. Leibrecht

Catholic Bishop

Diocese of Springfield-Cape Girardeau