By now I’m sure you’ve heard about Alfie Evans – the 23-month-old British boy who was removed from life support last week.
Let me begin by saying that most of us were not in that Liverpool hospital for the year or so that Alfie was on a ventilator and receiving care. Most of us do not have all the details and there is so much misinformation, anger and vitriol out there that it’s hard to keep it all straight.
My hope is not to explain what went on, because it's impossible to know with certainty. I don't know what exactly happened. There are a lot of very good articles from very reliable sources that can help you piece that together if you are really interested.
No prospect of recovery?
What I do know is that when someone is at the end of life with no prospect of recovery – and it’s the doctors who are the experts that can tell us when that is – they are offered palliative care. That means there is no extraordinary care – no respirators, no feeding tubes, no IV.
It doesn’t mean the person is starved or dehydrated to death. It doesn't mean that the person is given enough pain medication to stop their heart. It does not mean that they are sedated permanently. However, at that point, the person’s body cannot process nutrition and so forcing food or fluids into the body is difficult, even harmful.
The body is shutting down.
Many of us have experienced this in hospital when a loved one is at the end of life. Good palliative care means that the person is cared for, appropriately, until they die naturally. The death is not hastened. They may receive pain medication or sedation, but not for the purpose of ending their life, rather, for the purpose of making them more comfortable. Most people, when they are in the last days, are not able to receive any form of nutrition, not even intravenously.
I've been with people who have lived up to 10 days after the ventilator was removed.
Alfie's situation was compounded by the fact that Alfie's parents did not agree with the doctors' diagnosis that Alfie was, in fact, at the end of life, with no prospect of recovery. This is why the courts had to step in. I personally am not sure whether I agree with the courts ruling that a parent cannot take a child home or seek further treatment or care elsewhere, but that's the law in most places including the U.S. and in Canada.
(It's one thing to have the courts rule against a parent's wishes when that means saving a life, as in providing a blood transfusion; it's another complete matter when the courts' ruling means that the parents can't do anything else to help their child. It's easy if we accept that the law and the courts are perfect, but it's not so easy to accept when we know people make mistakes and often make decisions based on misconceived ideas, prejudices, values and even – sadly for us Christians – secularist, humanist, atheistic ideology.)
If we follow the law objectively, the judge has to rule in favour of what is in the best interest of the child. It is hard to accept that it is in the best interest of anyone to let them die. However, when there is no prospect of recovery and the person is at the end of life, we must accept, objectively, that the compassionate (and morally right) thing to do is to allow the person to die naturally.
While following Alfie's story, I couldn't help but remember Terri Schiavo.
Some of you may think that the Church teaches that we must prolong life no matter what. This is not what the Church teaches. The Church instead says that we must not do anything to hasten death. If the patient is dying, then we are to make them as comfortable as possible, ease their pain but not necessarily keep them alive by extraordinary means. (In fact, Pope Francis said this exact thing
at the European Regional Meeting of the World Medical Association in November 2017.)
However, if the person is not dying, they are breathing on their own and their heart is beating on its own, as was the case of Terri Schiavo
, then withdrawing food and water is, in effect, murder. Terri Schiavo was not dying – she was not on a respirator – she was healthy. Food and water were administered through a feeding tube. But feeding a patient who cannot feed him or herself should not be considered extraordinary care.
Food and water are very much ordinary care.
I don’t know how Alfie was treated – did I say that there is a lot of misinformation out there? But I can only hope that he was receiving adequate palliative care. If that was the case, then it is not euthanasia. Alfie’s death was not hastened. He simply was allowed to die a natural death.
But I don’t know.
I cannot imagine what it's like to watch my child die. I know that, as a Dad, I too would do everything I can to help my child. Let’s hope that Alfie’s parents, Tom and Kate, are able find solace in knowing that the care given to their child was the best appropriate care and that he is now in Heaven interceding for them.
It's always good to be reminded what the Church teaches about end of life issues. If you are interested, here is my Deacon-structing End of Life series: part 1, part 2, part 3, part 4, and part 5.
Here's my Deacon-structing End of Life Issues blog series:
Life, Liberty and Security
You may also be interested in watching the Every Life Matters series hosted by Archbishop Smith of Edmonton.
I also produced a series of Catholic Focus episodes on end-of-life issues:
Human Life Matters
What Does the Church Say?
Ending the Pain
Quality of Life
And you should definitely watch our award-winning documentary, Turning the Tide. Produced in 2007, it is still very relevant today.
Every week, Deacon Pedro takes a particular topic apart, not so much to explore or explain the subject to its fullness, but rather to provide insights that will deepen our understanding of the subject. And don’t worry, at the end of the day he always puts the pieces back together. There are no limits to deaconstructing: Write to him and ask any questions about the faith or Church teaching: firstname.lastname@example.org