In the wake of the Texas Catholic Conference of Bishops' ("TCCB" or "TCC") "Parish Advisory" (see this post) seeking to ban Texas Right to Life ("TxRTL") from parish properties statewide, embargoing any information coming from them in order to keep it from Catholics, and making all sorts of allegations against it for which there factual support is still entirely lacking (and I'm not the only one who has been asking for it), various questions have arisen. One is where the TCCB stands on certain matters, including the Texas Advance Directives Act ("TADA") to which this blog has been almost entirely dedicated. The Parish Advisory mentions in Issue 2 "Conflicts on end-of-life reform" but that is code for TADA. I have been asked how I can claim that the TCC supports TADA, and, therefore, involuntary passive euthanasia of patients. What evidence do I have? Well, first, I have covered it on this blog for four years (but it has been going on much longer than that) and below I catalog and summarize prior posts on all of these matters for you. Second, I'm presenting here the Amici Curiae brief that the TCCB and other organizations filed supporting TADA in a lawsuit brought to challenge its application to a patient and its constitutionality. In their own words, they explain their support of TADA and all it stands for.
Let me begin with a note about terminology. I've discussed this before but let me recap. Why do I refer to TADA as "involuntary passive euthanasia"? First, TADA allows a hospital to withdraw your life-sustaining care against your will; it does not require anyone to consider your thoughts on the matter at all. Thus, if it is used against you against your will, you are subjected to something that is involuntary. Second, "passive euthanasia" is distinguished from "active euthanasia." "Passive euthanasia"is death brought about by the denial of something without which you will die. It can be air (ventilators), nutrition, hydration, etc. "Active euthanasia," on the other hand, is that which Jack Kevorkian promoted - a shot or pills, etc. are administered - to directly and quickly bring about your death. TADA allows for passive, but not active euthanasia. But allowing the one sets up a slippery slope. There have already been calls to allow active euthanasia in Texas.
One other term should be addressed as well. This dispute has been characterized as being about "end-of-life" reform or legislation. Understand that in some cases the patient is not at the end of their lives. Often the issue is a refusal to treat a patient with a serious illness, a need for medical intervention to sustain their lives (but who might live a long time if treatment is not denied), a person with a disability, or even someone who suffered a serious traumatic injury and just needs more time to heal, and who might make a full recovery. It is simpler and maybe "cleaner" for some to characterize such people as always being at death's door; a person who someone is trying to keep alive at all costs in some hopeless, cruel endeavor meant to only cause suffering so that the clueless, distraught family doesn't have to "face reality." That paints a narrative where euthanasia seems the humane thing (even if it were moral).
The truth is, there is a great deal of discrimination here against those with disabilities or medical needs that are not otherwise "terminal." The situation is not so unlike the exception in Texas allowing abortion of unborn babies diagnosed with "fetal abnormalities" at all points in the pregnancy even after the important 20 week gestational age when science proves that babies can feel pain. Certain Republicans (not endorsed by TxRTL, of course) refused to even consider an amendment to a bill that would have closed this loophole and prohibited all abortions after 20 weeks. Babies diagnosed with "fetal abnormalities" do not have the same right to life in Texas even among certain "pro-life" Republicans. There is great discrimination in existence here against those with disabilities from womb to tomb including among those who call themselves pro-life. Think about that.
Concerning the matter at hand, I have publicly stated that the TCCB supports TADA and I have received some flack and pushback from people, who I am sure are well-meaning, but refuse to believe that their Bishops could err (clericalism is an error, by the way) and have demanded proof that the TCCB supports involuntary passive euthanasia and/or TADA. Although this proof exists in the statements made in the Parish Advisory itself coupled with the language of TADA, some are not convinced.
I have also directed people here, to this blog, which has covered this issue for nearly four years - in great substantive detail. You can look at any number of the following posts to learn more about the law, the morality, the victims, the organizations involved, the conflicts (between victims and the law; between the law and morality; between organizations; between the TCCB and Church teaching; there is a lot of conflict here; but just as we can't split the baby that one might seek to abort, we can't half way kill the ill patient). You can read:
- this post (where I lay out the issues with TADA and the TCCB for the first time);
- this post (where I discuss the issues in more detail);
- this post (where I take issue with a PolitiFact hit piece on the issue and discuss the really unfortunate, macabre language the TCCB uses in the context of TADA (and has continued to use, more on that below));
- this post (where some of the TCCB's thinking is exampled in more detail);
- this post (where I describe one of my experiences attending a hospital ethics committee hearing where TADA was invoked in order to withdraw a patient's life-sustaining care in order to hasten his death);
- this post (where a proposed reform to TADA was amended so that it could be supported as an incremental improvement to the law; NOTE: one of the TCCB's primary complaints (Issue 1) is that TxRTL opposes incrementalism; this is just one piece of evidence demonstrating the falsity of the allegations against them);
- this post (where we see TADA being used against a patient, Chris Dunn);
- this post (the date of Chris Dunn's death; the hospital never diagnosed or treated him for his underlying condition while in the hospital; he did not die because of the withdrawal of his care, but only because a lawsuit was filed to prevent that, and the hospital relented);
- this post (where I analyze the lawsuit filed by Dunn prior to his death (and then continued by his Estate and mother) to challenge the constitutionality of the law as it provides absolutely no due process for a patient; and the difference between a natural and hastened death);
- this post (where I provide the actual court documents in the Dunn case and show the hospital sought to be his guardian so as to make his life-ending decisions for him; present a pro-life out-of-state doctor's published article discussing TADA after Dunn's death; TAL's response to that article and public endorsement of euthanasia; the doctor's reply; TAL's and the TCCB's close association (as further proven by the Parish Advisory); and explain the "feud" between TAL and TxRTL);
- this post (where I provide an update of the Dunn case where even the State of Texas says that TADA is unconstitutional and the Attorney General - who is charged with defending the State's laws - will not); or
- this post (where I describe yet another experience I had while attending a hospital medical ethics committee hearing seeking to withdraw a patient's life-sustaining care in order to hasten his death and note, among other things, that two of the members SLEPT during the proceedings).
In addition to that above: the TCCB, TAL, Texans for Life Coalition ("TLC") and others filed an Amici Curiae brief in the Chris Dunn case when it was pending at the trial court level in support of TADA. This is a "friend of the court" brief which is filed by those who are not technically parties to the case who want to jump in, put in their two cents, and claim an interest in the outcome. It is rather unusual for that to be done in a case still at the trial court level as this is normally done at the appellate court level. (FULL DISCLOSURE: The Dunn case is on appeal and I am one of the attorneys who helped write the appellate brief. Therefore, I will not discuss the appeal itself further at this point.)
NOTE: The Parish Advisory stated: "Texas Right to Life is not to be confused with Texas Alliance for Life or Texans for Life Coalition, which are separate organizations and remain consistent with the bishops' positions." (Emphasis added.) Thus, TAL and TLC were given a robust, unqualified, absolute endorsement in the Parish Advisory. That will become more significant as we delve deeper into the substance.
Here is the file-stamped cover page for their brief:
Then, significantly for the purpose of this blog, I want you to see the stated "Interest of Amici Curiae" - in other words, the organizations' explanations to the Court for why they believe they have an interest in this litigation and why the court should listen to what they have to say. I'll present each of the four pages and then comment below.
So there you have it. The TCCB, TAL, and TLC have each come out in support of TADA in a brief opposing the constitutional challenge to the law which gives you - the patient - no due process rights. None whatsoever.
TLC goes further and says you have no Constitutional right to medical care at all! So if medical care is required to sustain your life, you have no Constitutional right to life by this logic. Good to know. Also, and this is relevant, the executive director of TLC, Kyleen Wright gave this testimony in support of using aborted baby tissue for research so long as the women know what will happen to their babies' bodies.
NOTE: The Parish Advisory stated: "Texas Right to Life is not to be confused with Texas Alliance for Life or Texans for Life Coalition, which are separate organizations and remain consistent with the bishops' positions." (Emphasis added.) Arguably then, these are the positions of the TCCB. There were no qualifications given to the absolute TCCB endorsement of these organizations and what they stand for. The Catholic Church does not support using aborted baby remains for medical research. Apparently, the TCCB does. Do you see why the TCCB, and Bishop Olson in particular, are in need of both correction and to meet with someone else on these matters?
It simply cannot be said that a patient's rights are "balanced" in a law that provides them with no rights at all. Read the law. Google what is required by due process. Then read the law again. As I have discussed in various posts above it is patently false to claim any sort of balance between patient and doctor rights, due process protection, constitutionality, or morality under Catholic Church doctrine. Balance is not just lacking, it is non-existent.
The TCCB is actively opposing the death penalty in Texas. While I make no statement on the morality of that, it is important to note here the irony: people on death row received full due process rights - both substantive and procedural - that the ill patient in the hospital is entirely denied by the law that the TCCB claims is "indispensable for ensuring dignity at the end of life." The convicted felon has a right to appeal his conviction, any denial of due process rights, etc. The TCCB supports the denial of due process rights for the ill patient but cries out to the Heavens for the convicted criminal who received those very rights TADA and the TCCB (and TAL and TLC) deny to the ill. How does this make sense?
Further, I have written before about the TCCB's usage of the language "prolonging death," how unfortunate, even nonsensical it is, and how it shows the true philosophy here. Not only does the TCCB use that language, but so do those promoting TADA in the PolitiFact article, which I discussed here. I said there, referring to my prior post on Bishop Gracida's blog, the following:
There is so much wrong with this letter [from the TCCB in 2014], but a few things occurred to me immediately. It refers to “unnecessarily prolong[ing] a patient’s death…” as a reason to withdraw care. Such is an awkwardly worded statement that literally makes no sense. The definition of prolong is “to extend the duration of,” but we cannot extend the duration of death. Once you die it’s done; this earthly life is over. It seems to me that what they are saying is that they don’t want to unnecessarily prolong a patient’s life.
The whole letter, like everything else the TCC has done on this issue, is focused on how soon we can withdraw care so one can die. It uses the term “dignity” again veering very closely to arguing for “death with dignity.” This sickens me to my core. From the beginning of the HB 1444/SB 303 battle, there were references to “dignity” and I noted then that:
When you lose control of the language, you are well on your way to losing the battle and even the soul of the movement. When representatives of the Texas Catholic Conference are making statements like: “The Texas Catholic Conference advocates advance directives reform legislation that recognizes the dignity of a natural death. Human intervention that would deliberately cause, hasten, or unnecessarily prolong the patient’s death violates the dignity of the human person.” This is very close to just saying, “We favor death with dignity.” This is a concept we in the pro-life movement have heretofore rejected. I am sorry to see that change.
The TCCB has not (to my knowledge) wavered in its opposition to anything that might keep you here longer if that's what you wish. Your "death with dignity" should not be "prolonged" - whether you like it or not. Your life? Not so much concerned about prolonging that - given this consistent choice of language - but we must get you to that death ASAP - death must not be prolonged. (This also really affects the individual's preparation for dying, facing judgment, and hopefully meeting God. There is a whole spiritual process that needs time to unfold here that should not be truncated. Perhaps in time I will write more about this. It has been the topic of discussion between myself and certain ethicists and religious leaders. It should not be dismissed, but is beyond the scope of this particular post.)
Also, and this cannot be stated enough, I have never gone into a hospital ethics committee hearing and had doctors complain that their consciences were violated by continuing life-sustaining treatment, nor has anyone else I've ever talked to that has attended one. Doctors and advocates of the institution of involuntary passive euthanasia for a patient have, however, stated (in front of the family) if the patient were in a forest and had been still that long, he would have been eaten. I wrote about this experience here and used it as part of my testimony before a legislative committee hearing on TADA. Doctors have said that this person was "gone" and would never be the same; that the person the family knew had left. These are quality of life determinations made by people utterly unqualified to do so. No one is qualified to make that decision for you but you or your chosen surrogate.
Significantly, in the wake of Chris Dunn's death, TAL publicly came out in favor of euthanasia and argued that removing life-sustaining care to alleviate "suffering" was "morally legitimate" This is the very definition of euthanasia. Suffering is not the same as a disproportionate burden or harm from the expected outcome of a medical procedure or intervention. I suffer when I have a wisdom tooth pulled, but that procedure is not disproportionate to my needs. See CCC 2278 below, where this is discussed in more detail, as well as who should make that determination. (The Catholic Church also teaches about "redemptive suffering" so this is all the more reason why the decision about how much suffering one wishes to endure must be left to the patient. Again, that is a topic for another post, but not a throw away consideration in this context.)
NOTE AGAIN: The Parish Advisory stated: "Texas Right to Life is not to be confused with Texas Alliance for Life or Texans for Life Coalition, which are separate organizations and remain consistent with the bishops' positions." (Emphasis added.) Arguably then, this is the position of the TCCB. Taking action to alleviate "suffering" (as opposed to the reasons set forth in CCC 2278) is euthanasia which is not supported by the Catholic Church. Doing this against a patient's will is also not supported by the Church. Yet, this this is the position of TAL and TAL's positions, according to this most recent Parish Advisory of the TCCB, are "consistent with the bishops' positions." The TCCB - thankfully - does not go so far as to say these are consistent the the Church's position. This is a distinction with an important difference as this situation makes painfully clear.
Incidentally, there was no factual evidence that Dunn was suffering from his life-sustaining care, even were that a justification to pull the plug on him early against his will. Moreover, he prayed for his life as evidenced by the video of him. Moreover, this is all beside the point because a hospital should not be making the decision for you as to whether your death is hastened by the withdrawal of life-sustaining care or not. That is yours and yours alone. And, should you argue that life-sustaining care is not natural, you should know that the hospital in Chris Dunn's case argued that as they did not withdraw his life-sutaining care, his death was "natural."
As I have argued before, if a doctor's conscience is pricked by allowing you to continue your life-sustaining care as your underlying disease, illness, or infirmity consumes you and leads you to a natural death, then why can he not step aside and allow another doctor to take over? Why must the fulfillment of his conscience lead to your hastened death? Your only option under TADA is to, in a maximum of 10 days, find a new facility (which is very difficult and usually impossible to do once the current hospital has made a futility finding) or the hospital can then withdraw your life-sustaining care against your will and hasten your death. You are completely at their mercy.
From the Catholic Church's standpoint, there is no moral justification for this. A supporter of the TCC - who herself had never read TADA before last night - sent me a reference to the Catechism of the Catholic Church paragraph 2278 as support for TADA. It does not support TADA, the TCC, TAL, or anyone else who promotes involuntary passive euthanasia. Let's take a look:
It says that "[t]he decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected." (Emphasis added.) That in no way supports TADA, involuntary passive euthanasia, or its lack of due process rights.
I want to make one more observation. In Issue 3, "Texas Right to Life's voter guide," the TCCB's Parish Advisory states: "Unfortunately, a number of legislators who have consistently voted for pro-life and end of life legislation have been opposed by Texas Right to Life." Ignoring that the premise of this statement is incorrect - let's look at that language more closely. It does not state that the legislators have voted for pro-life (or even pro-patient) end of life legislation. Rather, it says that they have voted for end-of-life legislation (read: "ending your life prematurely against your will" legislation). Exactly. Freudian slip? Perhaps. Consistent? Yes. Of course TxRTL will oppose them! Gosh. (That is not the only problem with Issue 3, but it relates to the problems with Issue 2, which is the point of this particular post.)
End-of-life legislation could actually be pro-life - it could actually promote the value and dignity of each life until a person's natural death, but that has been a difficult task - because of the TCC, TAL, and TLC (which has gone back and forth on TADA).
Finally, I have been asked what the difference is between the TCCB and TxRTL on end-of-life (and I'd add to this refusal to treat) issues. I do not speak for TxRTL at all. I do not have that authority. My view of the difference between the two organizations is based on my own observations, statements by the organizations, review of their written works, testimony before the legislature, etc. With that caveat, as I see it, TxRTL wants, at a minimum, the patient's will to be upheld which, if we persist in having a law like TADA, should at least require due process rights for ill patients in hospitals so that a decision may not be made to withdraw their life-sustaining treatment against their will in a bid to hasten their death because someone else has decided that their life has no value, no quality, and is futile. Ideally, this would require a hospital to treat until a patient could be transferred to another facility willing to continue that patient's life-sustaining treatment until their underlying condition (if any) results in their natural death or until natural death otherwise occurs.
The TCCB supports TADA as a "balance of patient autonomy and [ ] physician conscience protection." See Parish Advisory at par. 2. The TCCB, as noted above in their Amici Curiae brief, "strongly supports §166.046 as indispensable for ensuring dignity at the end of life." Id. at 2. As noted, the TCCB sees "unnecessarily prolong[ing] the patient's death [as] violat[ive of] the dignity of the human person." Id. at 1. The TCCB has opposed such reforms as treatment until transfer and in the otherwise fatally flawed SB 303 faux TADA reform bill in 2013, and would only agree to extend the time to transfer from 10 to 14 days. Gee, thanks.
TxRTL, as I see it, does not believe that TADA provides any patient autonomy at all and therefore provides no "balance" between that and doctor conscience. It is important to note that there is a difference between life-sustaining care and life-saving care. This is not a call to provide what the Church has called "extraordinary measures." It is not chemotherapy or radiation or such treatments. Rather it is "basic" care such as artificially administered nutrition and hydration or even ventilators; oxygen, like food and water, is necessary to life. (Since the removal of artificially administered nutrition and hydration has been tightened up, I have personally seen an increase in hospitals wanting to remove ventilators from patients to hasten their death now.) Primarily, I believe that TxRTL sees the patient's wishes as paramount and does not see why there cannot be real balance between doctors and patients without the patient's hastened death through the premature withdrawal of life-sustaining care being necessary.
So now you have yet more evidence as to the TCCB's support of TADA and the nature of the dispute.
I renew my request to Bishop Olson to meet with me to discuss these matters. I submit that the evidence is overwhelming that he has not been well-served by his advisors on these matters. This Advisory is just an example of the problems in the TCCB and the Church as a whole. As I have said, this should be the genesis of a larger movement to take back our troubled Church.
Indeed, it has been suggested to me that I may actually have a moral obligations to do what I am doing. And so do the rest of you!
According to the Code of Canon Law, Can. 212 §3:
According to the knowledge, competence, and prestige which they ["the Christian faithful" or laity] possess, they have the right and even at times the duty to manifest to the sacred pastors their opinion on matters which pertain to the good of the Church and to make their opinion known to the rest of the Christian faithful, without prejudice toward their pastors, and attentive to the common advantage and the dignity of persons.(Emphasis added.)
Please call, email, tweet, or mail Bishop Olson and respectfully request that he meet with me to discuss these issues that affect us all, Catholic or not.
Thanks for reading!