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March 31, 2005

Statement on the death of Theresa Schiavo

Margaret Farley
Gilbert L. Stark Professor of Christian Ethics
Yale Divinity School

This is a sad day for Theresa Schiavo's parents and family, and for her husband. To lose a child, a sister, a person who has been part of one's life for more than 40 years is cause for sorrow, and reason for all of our sympathy. Yet, there is also something very sad about the process that preceded her death. As we know, people interpreted her medical situation differently, and many disagreed on an interpretation of the meaning of medically provided nutrition and hydration. The medical evidence seems to have been overwhelmingly on the side of the conclusion that she had in the last 15 years no neocortical brain function, and hence no capability of interacting with other persons or even with God, as well as no possibility of experiencing pain or pleasure; she had no conscious awareness at all. Those who saw in her movements and groanings something else (signs of awareness) were understandably desiring with all their hearts that this was so, that the medical diagnosis and prognosis were false.

My own interpretation of her medical situation is that she was, indeed, incapable of present or future conscious awareness of any kind. The medical evidence, reviewed again and again, seems to leave no other conclusion.

On the question of the meaning of medically provided (sometimes called "artificial") nutrition and hydration: the disagreement among persons tends to pit what is literally going on against the symbolic meaning of food and drink. Of course, providing nutrition and hydration, with whatever technology is needed, may be required when the patient wants it, and/or when the diagnosis and prognosis for a patient signals some hope of sustaining or returning to consciousness. But in cases like Theresa Schiavo's, where there is no conscious awareness and no possibility of this coming to be again, the majority of medical ethicists agree that there is not only no obligation to provide nutrition and hydration in this way, but that it is pointless to do so. It is a medical treatment like other medical treatments, that can be withdrawn when it has no real purpose any more.

This, too, is the opinion of the longest standing tradition in moral theology in the Roman Catholic tradition. This is almost a classic case of "extraordinary" means, or "heroic measures." Catholics, like almost everyone else, value human life, considering it a fundamental good, to be treasured as a gift from God and as a treasure for the individual and the community. But Catholics, like almost everyone else, do not consider physical life in this world an absolute good. It is relative to other values--such as those things it makes possible (relationships with the world, oneself, other persons, God). Hence, physical life does not need to be preserved "at any cost," especially when it no longer serves to allow a person to activate what within them makes them a person. To keep someone alive for the sheer purpose of life that can no longer be realized in "personal" ways, is not necessary and ordinarily not to be desired.

This does not mean that Theresa Schiavo was not a "person" during her 15 years in her damaged state. She was a person, and hence deserved respect as a person. But respecting her as a person could mean withdrawing extraordinary medical treatments (including nutrition and hydration). Especially in the Roman Catholic tradition, Ms. Schiavo has another life, one for which she is now freed. There is no permission to actively take her physical life in this world, but there is also no obligation to preserve this physical life when it no longer benefits her in any way.

Unfortunately, I believe that Theresa Schiavo's parents received bad advice, even from representatives of the Catholic tradition. Their own suffering in this process could have been comforted in better ways than convincing them that she was consciously aware, or that even if she were not, it was obligatory to keep her alive "no matter what." I hope that all persons involved now do find comfort, including Theresa Schiavo--a woman for whom the Catholic church now sees new life and joy.


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