Bioethics in Faith and Practice, Volume 2, Number 1

Bioethics in Faith and Practice ⦁ 2016 ⦁ Volume 2 ⦁ Number 1 7 as a vegetative state present one month after acute traumatic or nontraumatic brain injury or lasting for at least one month in patients with degenerative or metabolic disorders or developmental malformations. 12 When referring to PVS patients, I have also assumed that the determination of PVS has been made by qualified and experienced physicians, consistent with the definition from NEJM above and based upon reasonable medical certainty. Although I am not a clinician, I have had the opportunity more than once in my law practice to observe PVS patients first hand and the NEJM description of ‘complete unawareness’ is quite consistent with my experience with such patients. In order to benefit from Harvey’s distinction noted above, the cause of PVS for each patient would have to be determined, so that a judgment can be made as to this particular patient whether the case at hand is one where recovery is possible, but unlikely, or one where recovery is not just unlikely, but impossible. The term ANH is used here to mean the use of a feeding tube. Two primary invasive methods of such feeding are common, using either a nasogastric (NG) tube or a percutaneous endoscopic gastrostomy (PEG) tube, with the selection of method being determined by clinical considerations. 13 Overview of CST: If to do good were as easy as to know what is good to do, chapels would be cathedrals and poor men’s cottages princes’ palaces. 14 The United States Conference of Catholic Bishops (USCCB), the author of the ERD , 15 describes CST as “a rich treasure of wisdom about building a just society and living lives of holiness amidst the challenges of modern society. ” 16 As in ERD4, ERD5 confirms the Church’s “full commitment to the health care ministry” 17 and provides a theological basis for the guidance contained therein. There is a particular emphasis on the Church’s social responsibility in the ERD, grounded in human dignity, the preference for the poor and disadvantaged, the common good, responsible stewardship and avoiding moral wrong . 18 The specific guidance provided in Directive 58 of ERD5, however, must be read in the context of Part Five of ERD5, especially Directives 56 and 57, along with the remainder of ERD5, in order to discern its true meaning and proper application, consistent with CST. The USCCB describes seven themes of CST, including the following: (a) life and dignity of the human person; (b) call to family, community, and participation; (c) rights and responsibilities; (d) option for the poor and vulnerable; (e) the dignity of work and the rights of workers; (f) solidarity; and (g) care for God’s creation . 19 Mark S. Latkovic has identified eight principles of CST, including the following: (a) respect for the dignity of the human person; (b) distributive equality of common goods; (c) respect for a division of labor or function of each human person; (d) authority as the “capacity to make decisions on behalf of a community…to benefit the common good of a community;” (e) the participation; (f) subsidiarity and functionalism; (g) the common good; and (h) Christian love. 20 According to Latkovic, these principles are the “core principles which undergird Church teaching in… [the] areas…of social, political and economic realities. ” 21 Latkovic’s ‘core principles’ appear to be in general harmony with USCCB’s ‘themes’ of CST. The late Kevin P. O’Rourke, 22 who died in 2012, constantly reinforced that a full consideration of the sources of ethical thought in CST would include the teachings of Jesus (love God and your neighbor), biblical counsels, commandments and parables taken from scripture, along with theology (human reason using principles of faith) and the authoritative teaching of the Church and natural law. 23 Over time CST has developed its own discrete literature, themes and principles as summarized above and discussed below,