Let Me Go, the new book co-written by Pope John Paul II’s personal physician, reveals few details about the pope’s death that were not already divulged in the official Vatican report last fall. But news writers have done their best to incite interest, by highlighting Dr. Renato Buzzonetti’s testimony that John Paul tried to delay the tracheotomy he underwent in his last hospital visit, refused to return to the hospital when death was imminent, and received care from physicians who rejected “any new aggressive therapeutic measure” on the day he died. Headlines trumpet these nuggets suggestively: “Pope John Paul Shunned Medical Treatment,” shouts one; “John Paul a Tough Patient,” proclaims another.
Given the headlines and the tone of the reports, casual readers might assume that the decisions made by the pope and his physicians fell short of the Catholic Church’s standard for sustaining life. It is a high standard, after all. The Church has always taught that both passive and active euthanasia are grave evils and the late pope regularly criticized the “culture of death” in which physicians give up too soon on the lives of the frail and elderly. In 2004, as Catholic hospitals were increasingly sanctioning the removal of food and water from patients in a persistent vegetative state and Michael Schiavo was winning his battle to starve his wife, Pope John Paul II declared that food and water are always part of the basic care due to all patients, even those in a persistent vegetative state. He allowed only two exceptions to this principle: Food and water may be taken away when the patient’s body is no longer able to absorb them or when they no longer alleviate the patient’s suffering. An example of the latter case is a patient who is on the brink of death from another underlying cause and food and water are of no benefit, use, or comfort to him anymore.
The Church’s teachings on end-of-life issues, and the late pope’s articulation and clarification of those teachings, had long infuriated euthanasia advocates. They also riled many Catholic ethicists and health-care professionals, who criticized the pope’s position on end-of-life issues as severe, unrealistic, and inconsistent with the Church’s longstanding distinction between ordinary and extraordinary means of sustaining life. If John Paul’s own deathbed decisions contradicted Church teachings as he had proclaimed them, that would be news.
The key to interpreting the circumstances of John Paul’s death can be found in the very distinction that his critics accused him of ignoring. The Catholic Church has long held that ordinary or proportionate care–which is beneficial, useful, and not unreasonably burdensome to the patient–is morally obligatory. Extraordinary or disproportionate care–which may include exotic, experimental, or excessively burdensome treatments that are unlikely to benefit a patient or that include unreasonable costs relative to benefits–is not morally obligatory, though a patient may choose to accept it. The categories of ordinary and extraordinary care allow us to navigate between two dangerous extremes: the vitalism that would have us preserve life at all costs by any means necessary without regard for the burdens imposed on the patient, and the fatalism that would tempt us to give up on gravely ill patients before their time and violate their rights to life and basic care.
When it comes to discerning the difference between ordinary and extraordinary care, Catholic teaching maintains a strong bias for life. Decisions on end-of-life issues must be consistent with the core Catholic principle that requires us to do what we can within reason to preserve life and never do anything directly intended to end life.
The details published in Let Me Go suggest that in his final days, John Paul upheld this principle and avoided both the fatalism of his critics and the vitalism of which they accused him. He patiently endured years of suffering from Parkinson’s disease and accepted feeding and breathing tubes in his final weeks to sustain his life. On March 31, when faced with what his doctors recognized as imminent death, the pope decided to stay home, surrounded by his loved ones, and spend his waning hours praying and preparing to meet God. John Paul uttered his final words on April 2: “Let me go to the house of the Father.” Then he lapsed into a brief coma. After running an electrocardiogram for more than 20 minutes that night, Buzzonetti declared him dead.
The new details of the pope’s death reaffirm what we already knew. John Paul loved this life and accepted its joys and sorrows in equal measure. He did not seek an easy exit from suffering. Nor did he ignore the reality of his own death. He faced it with courage, trusting in the promise of eternal life that he had proclaimed to the whole world, the promise upon which he had staked his entire life.
–Colleen Carroll Campbell, an NRO contributor, is a fellow at the Ethics and Public Policy Center, a former speechwriter to President George W. Bush, and author of The New Faithful: Why Young Adults Are Embracing Christian Orthodoxy.