Bioethics in Faith and Practice, Volume 2, Number 1

8 Smith ⦁ ANH and PVS Patients each of which helps to ground the ERD firmly in the Church’s emphasis on social justice in its teaching. For example, the obligation of responsible stewardship over the creatures and resources of the world is logically extended to the health care arena, along with the need to promote the common good . 24 As mentioned, CST is a prominent feature of ERD5 and the organization of each of the Parts thereof (including Part Five with which we are most concerned here) includes an introduction that is expository in nature, but also provides the “context in which concrete issues can be discussed from the perspective of the Catholic faith.” 25 The second section of each Part includes specific guidance on particular matters, such as is contained in Directive 58. By its very structure, then, the intent is clear that we should be reading ERD5 as a whole to understand the full meaning of the Church’s guidance. The entire text of Directive 58 is further qualified by the introductory phrase ‘in principle’ in dealing with the extent of the moral obligation to provide nutrition and hydration to patients, including those in PVS. This moral obligation to sustain life with food and water is not unlimited, as we were taught centuries ago by Francisco de Vitoria, discussed below. M. Therese Lysaught confirms David Cloutier’s 26 view of fulfillment when she argues that to “explore the Christian moral life, then, is to explore what it means to love God…[and that implies] worship…the liturgy…the Mass…the Lord…who loved us first and longs for our love…and invites us to become his friends. ” 27 Like learning to play the game of golf well, “Christian moral living is a skill that can be acquired only over time, through ongoing practice (and much grace). ” 28 Part of that effort needs to include acquisition of the cardinal virtues [justice, prudence, temperance and fortitude] because they may “rightly be called the path to the good life.” 29 Thomas Aquinas is often credited as the thinker who most fully developed natural law theory as applied to the Church’s teaching. Stated simply, while we understand that all God’s creatures are endowed by their creator with “proper ends and purposes,” humans alone may “use reason to discern good and evil…to choose the path that God…has laid out for human fulfillment and well being…” 30 While many Catholic thinkers trace the roots of their thought back to natural law, controversy exists over how natural law should be viewed, including some feminist critiques that deserve attention. 31 Some prefer a static approach (unchanging norms) or a dynamic one (evolutionary norms), while others, such as O’Rourke, advocate for a middle position, which “emphasizes the unchanging and essentially human, while acknowledging but according less significance to historical change.” 32 O’Rourke’s middle ground seems to have been endorsed by Pope John Paul II (JPII), at least on some occasions, as when he declared that “’This triumph of the moral law…unfolds down the centuries: the norms expressing the truth remain valid in their substance, but must be specified and determined…in the light of historical circumstances.” 33 Earlier, among the lessons of Vatican II, the Church taught that Catholics should “remain attuned to the progressive revelation of Christ through history.” 34 Regardless of whether a Catholic thinker may be classified as having adopted an approach that is static, dynamic or occupies the middle ground, all share “an abiding commitment to the promotion and defense of human dignity from conception to death.” 35 As creatures made in God’s image, we may use the gift of reason “in combination with our natural inclination to recognize and seek the good… [and] to reflect upon and discover laws, in the form of general tendencies, that satisfy basic human needs and fulfill the divinely intended nature of human beings. ” 36 Among our natural inclinations that are divinely intended is the preservation of life, from which arise obligations of self-care and avoidance of risk and danger, such care and avoidance being “rationally extended to the dignity and lives of others. ” 37 Consistent with these observations, we find Directive 56 that requires us to use ‘ordinary means’ to preserve life and Directive