The same reader from earlier writes:
If I understand our Church’s teaching, it is wrong to purposefully
forego "reasonable" treatments such as medicines, food and water, and
defribbrilation. In essence, a DNR (do not resuscitate) order is not
allowable for a Catholic hospital patient. Is this understanding correct?
No. DNR orders can indeed be morally licit. The Church has not judged that defibrillation is required in all cases of heart failure. The Church hasn’t determined that defibrillation is morally obligatory at all, and there are certain situations in which it clearly is not morally required. For example: Suppose that someone’s heart is failing because there is a systemic problem in their body that simply restarting the heart will not fix–even if you bring them back with a defibrillator, you won’t have them back for very long (perhaps just minutes) and they may suffer horribly if you bring them back.
In such a circumstance, the costs of using defibrillation are not proportionate to the good to be achieved and it is permissible to simply accept the coming of death and refrain from resuscitation.
We also have to be careful about the other things you mention–food, water, and medicine. There are situations in which these also are disproportionate to the good that may be achieved through them. For example, if a person’s body has stopped maufacturing albumin then putting additional fluids into them will cause them to swell up until their skin literally tears open and their flesh weeps. This is not good of the person, and it reveals that there are circumstances in which more water will actually harm the person because of the way their body has broken down. The same is true, in other circumstances, of food and medicine.
That being said, as long as food, water, medicine, and anything else ARE proportionate to the good to be achieved then their use cannot be morally foregone as one has a duty to take reasonable (proportionate) means in caring for one’s life.
What about 100 years future, when a cheap medicine or procedure may
offer us unlimited natural life?
It’d be really sweet! (Maybe.)
Would we be bound to forego the
treatment, welcoming our natural mortal ends?
Not necessarily. As I discussed in an earlier post today, there is no such thing as true immortality this side of the Resurrection, only a prolongation of the human lifespan. That, in itself, is not a problem.
If so, is that any
different than a person rejecting medical treatments of today that did
not exist until recently?
This question has already been answered per se since one would not be required to refuse a dramatically life-extending treatment, but there’s an issue here that’s worth surfacing: Technological changes have indeed impacted what treatments one may reasonably refuse. The fact that so many conditions can be treated so much more easily today means that we are obliged to undertake many treatments now that we would not have been obliged to undertake in the past.
Until the 19th-20th centuries, medicine had only been slowly getting better (if that) for thousands of years. As a result, there was a kind of consensus among theologians about what one was and was not be required to do medically. This distinction was expressed in the ordinary/extraordinary distinction: One was obliged to undertake ordinary forms of care but not extraordinary ones.
The rapid change in medical technology–particularly in the last 40 years–has put huge pressure on this distinction, as it’s no longer obvious what’s "ordinary" vs. "extraordinary." As a result, the ordinary/extraordinary distinction has been giving way to a new one: proportionate vs. disproportionate. This is a much more useful way of getting at the underlying issue (does the treatment overall cause more harm than good to the patient when all factors–physical, mental, financial, etc.–are taken into account?). The new distinction has become sufficiently established in moral theology that Vatican documents have taken note of the shift and are starting to use the proportionate/disproportionate language, which has the advantage of not being easily undermined by future technological developments. As medicine progresses, more treatments will fall into the "proportionate" category.
Basically the question is this: when does it [refusing a radical life-extension treatment] become "suicide?" When
does it become "euthanasia?"
This is a good question. Refusing to take a life-extension treatment would, under the current calculus, be immoral if the treatment is proportional to the good to be achieved. This is something we just don’t know enough about right now.
What the good is in having a human live to 1,000 years old is
something that we just can’t say at this point. There may be unforeseen
costs in such a thing (like having incurable major depression set in as
soon as you hit 150, for instance). We’ll just have to get farther down
the road and remain attentive to the Magisterium before we can answer
this question.
Even before the development of radical life-extension technologies (if that ever happens) there’s going to be further doctrinal development in this area. The rapid aging of Europe will force that to the front of the theological burners at the Vatican. We’ve already seen some of this, and there will be more to come, possibly as soon as this papacy and, if not, definitely within the next two or three.
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