Editor’s note: this article was edited on 08/08/2024 for brevity.
CV NEWS FEED // An author and former University professor of bioethics is accusing the Vatican’s bioethics research entity the Pontifical Academy for Life (PAV) of condoning euthanasia in a recent publication.
In July, PAV published an 80-page booklet in Italian that provided definitions of various terminology used in current bioethics debates, the Church’s teachings on bioethics topics and end of life care, and “current Italian law on end of life issues,” among other topics, according to a Catholic News Service news release.
The booklet includes warnings about the “multitude of dangers” that could result from legalizing euthanasia, including dangers that are “beyond the intentional violation of human life,” the news release states:
It jeopardizes the role of the doctor whose mission is to care for and preserve the lives of their patients, it could lead to reduced support for assisting those dying a natural death, and it infringes on the freedom of people who may feel pressured to pursue euthanasia to avoid being a burden on their family or society.
However, in an Aug. 8 Daily Compass article, author Tommaso Scandroglio accused PAV of showing support, via the booklet, for assisted suicide and supporting “euthanasia masqueraded as a rejection of therapeutic obstinacy (or a rejection of unreasonable obstinacy in treatment).” According to his LinkedIn profile, Scandroglio was a professor of ethics and bioethics at the European University of Rome from 2014 to 2017.
Scandroglio explained that for the refusal of life-saving treatment to be licit, there is both an objective principle and a subjective principle to consider. The objective principle, he wrote, is the potential ineffectiveness of a life-sustaining treatment. The subjective principle that must be taken into account is whether the patient considers the life-saving treatment to be disproportionate in his or her particular situation.
PAV’s booklet refers to the Italian law called Advance Treatment Provisions (DAT), which is essentially a “living will” in which a patient can specify in advance his or her health treatment preferences, including regarding acceptance of life-sustaining treatments.
Scandroglio argued that DAT “is generally used for euthanasia purposes and therefore should not in principle be sponsored” and criticized PAV for indicating approval of DAT by offering, at the end of the booklet, an example of a DAT form for Italians’ reference.
In the booklet’s proposed DAT form, Scandroglio explained, the registrant may be able to refuse invasive and non-invasive mechanical ventilation, among other life-sustaining interventions. Scandroglio argued that PAV’s booklet “opens up the possibility of refusing assisted nutrition and hydration,” arguing that “PAV considers it permissible to discontinue these therapies because they could constitute futile treatment.”
The Catholic Church generally considers artificial food and water as “ordinary care,” unless those measures fail to provide nourishment to the patient in extreme cases, such as when the body can no longer absorb the nutrients.
Scandroglio acknowledged that in “exceptional” and “rare cases,” these treatments are futile, but added that PAV’s booklet does not specify that these cases are rare.
Turning to discuss the subjective principle, he noted that PAV’s booklet, on numerous pages, highlights the subjective opinion of the patient as a factor in determining the licitness of refusing life-sustaining treatment.
One such example was on the booklet’s page 64, which reads: “Even if the treatments were clinically appropriate, they might nevertheless be disproportionate if the sick person considered them too burdensome in his circumstances. Not to undertake or to suspend those treatments is, at this point, not only possible, but, as Pope Francis says, ‘dutiful’”.
Scandroglio later highlighted that, according to a passage from the Catechism of the Catholic Church that the PAV booklet quotes, the patient’s wishes and interests can only be complied with if they are in accord with reason and justice. As a result, while the patient’s circumstantial needs and preferences are important, he wrote, “the final word” is found in the objective criteria of the treatment’s benefits, rather than the patient’s subjective opinion.
