Is it sinful to remove a ventilator?

I saw that Frontline programme on physician-assisted suicide (same one that they showed in Britain and got a lot of publicity becuase it showed the patient's actual death) and I am having trouble understanding our stance on it.

So say there's a patient suffering from Lou Gherig's Disease who needs the help of a ventilator. If he decides to de-activate the ventilator, is it a sin?

My understanding is that we do not require extraordinary measures to keep a person alive. Would a ventilator be considered an extraordinary measure? Thus, wouldn't removing it just bring a natural death, so technically it isn't suicide or euthanasia?

Do ordinary measures just mean nutrition and water? Would a feeding tube be considered an extraordinary measure? It seems to me that it wouldn't be sinful to remove a feeding tube, because the person's natural state is the disability to take in any food. I didn't quite understand the Schiavo thing. I'm sure that the people fighting for her life were right, since the Church officials sided with them, but I don't quite understand why.

It is sinful to remove the ventilator, because it is euthanasia. However, you do not have a moral obligation to get started on a ventilator. This exactly the opposite of a vasectomy, it is sinful to have one but you do not have a moral obligation to reverse it. I am quite sure that a feeding tube would be considered an extraordinary measure, but once you get started on it you cannot remove it. The bottom line is that you do not have the moral obligation to start extraordinary measures.

[quote="Cristiano, post:2, topic:189493"]
It is sinful to remove the ventilator, because it is euthanasia. However, you do not have a moral obligation to get started on a ventilator. This exactly the opposite of a vasectomy, it is sinful to have one but you do not have a moral obligation to reverse it. I am quite sure that a feeding tube would be considered an extraordinary measure, but once you get started on it you cannot remove it. The bottom line is that you do not have the moral obligation to start extraordinary measures.

[/quote]

Thanks so much for your reply. It really helped, I understand it now. Last question though, are nutrition and water considered ordinary measures? So would everything beyond that be considered extraordinary?

[quote="JesuXPIPassio, post:3, topic:189493"]
Thanks so much for your reply. It really helped, I understand it now. Last question though, are nutrition and water considered ordinary measures? So would everything beyond that be considered extraordinary?

[/quote]

As I understand it, and IANAP, the difference is whether the person's body state is such that they can remain alive, if provided with the natural means of being alive. If their body can still convert food and breath to life, but they cannot eat because unconscious, then providing nutrition and water simply keeps them provided with the means to keep alive. But if they cannot breathe, then you are artificially postponing death in a failing body.

Again, IANAP and welcome corrections if I am wrong. ICXC NIKA

[quote="Cristiano, post:2, topic:189493"]
I am quite sure that a feeding tube would be considered an extraordinary measure, but once you get started on it you cannot remove it. The bottom line is that you do not have the moral obligation to start extraordinary measures.

[/quote]

The Holy See has stated quite clearly that giving water and nutrition, even if it is necessary to do this via a tube down the throat because the person cannot safely swallow unaided without danger of choking, is not an "extraordinary measure" (at least in circumstances such as a hospital or clinic in a wealthy country where such tubes are easily obtainable) and that carers do in fact have a moral obligation to feed a person through such a tube if necessary, if the person is merely disabled and is not dying.

[quote="Petergee, post:5, topic:189493"]
The Holy See has stated quite clearly that giving water and nutrition, even if it is necessary to do this via a tube down the throat because the person cannot safely swallow unaided without danger of choking, is not an "extraordinary measure" (at least in circumstances such as a hospital or clinic in a wealthy country where such tubes are easily obtainable) and that carers do in fact have a moral obligation to feed a person through such a tube if necessary, if the person is merely disabled and is not dying.

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Can you please provide a reference? I am not saying that your are wrong. I am just curious because my understanding that intubation for breathing can be refused, and so I am not clear how food and water would get higher priority respect to air. I agree that it cannot be removed once in place, except at the end of life when feeding would just bring discomfort, and with the removal the person would not die of starvation.

[quote="Petergee, post:5, topic:189493"]
The Holy See has stated quite clearly that giving water and nutrition, even if it is necessary to do this via a tube down the throat because the person cannot safely swallow unaided without danger of choking, is not an "extraordinary measure" (at least in circumstances such as a hospital or clinic in a wealthy country where such tubes are easily obtainable) and that carers do in fact have a moral obligation to feed a person through such a tube if necessary, if the person is merely disabled and is not dying.

[/quote]

What if it has nothing to do with choking? What if the person has suffered several strokes, was already severely disabled, and cannot stay conscious enough to eat? Isn't that person already dying a natural death? I'm asking because this happened to a patient I saw this week. They withdrew care yesterday. No tube feedings, no IV, no antibiotics. Only morphine and hospice care.

It is not sinful to remove a ventilator.

People in intensive care units can end up on a ventilator because of a decision that is made in the middle of the night by a well intentioned doctor when the family has not been able to accept a medical condition with no reasonable chance of recovery.

Often the family soon comes to accept that the situation is hopeless. It would be cruel to inflict extreme suffering on a patient and the family in a hopeless condition because of a rigid interpretation of theology.

[quote="Rence, post:7, topic:189493"]
What if it has nothing to do with choking? What if the person has suffered several strokes, was already severely disabled, and cannot stay conscious enough to eat? Isn't that person already dying a natural death? I'm asking because this happened to a patient I saw this week. They withdrew care yesterday. No tube feedings, no IV, no antibiotics. Only morphine and hospice care.

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Because in some cases it causes the person to just die of starvation and/or dehydration. This is cruel and inhumane treatment.

~Liza

[quote="dedo, post:8, topic:189493"]
It is not sinful to remove a ventilator.

People in intensive care units can end up on a ventilator because of a decision that is made in the middle of the night by a well intentioned doctor when the family has not been able to accept a medical condition with no reasonable chance of recovery.

Often the family soon comes to accept that the situation is hopeless. It would be cruel to inflict extreme suffering on a patient and the family in a hopeless condition because of a rigid interpretation of theology.

[/quote]

Can you provide a reference where it says that it is not sinful? The Italian Council of Catholic Bishops made very clear that is sinful to remove a person from the ventilator. There was a case going on several months ago in Italy.

In Evangelium Vitae Pope John Paul II discussed euthanasia and condemned it. Removing a ventilator kills a patient and is done to kill the patient - it is euthanasia and is morally wrong. What Pope John Paul II thought could be justified though was refusing treatment that is exceptionally burdensome. The types of treatment that can be refused seem to be those that prevent one from being physically aware or active. Refusing the treatments does not in itself cause death, although receiving the treatments might lengthen life. The question is whether or not it is proportionate to lengthen life with the treatment or not. The patient who refuses treatment is about to die and refuses treatment not with the intention of dying or to shorten life, but to live out their life in consciousness and being physical able. A justifiable refusal of treatment is not euthanasia since it does not kill the patient.

Cristiano was right - removing the ventilator is euthanasia since it is a willful act to kill a sick person.

Nutrition and water are ordinary measures - these are the types of treatment that Pope John Paul II was referring to when he said those could not be taken away. Removing these things causes death.

For further explanation, see the BBC.

[quote="lizaanne, post:9, topic:189493"]
Because in some cases it causes the person to just die of starvation and/or dehydration. This is cruel and inhumane treatment.

~Liza

[/quote]

That claim is due to an lack of understanding. Someone on the Atkins diet could tell you that's wrong.

This is the first time I've heard people claim that removing someone from a ventilator is automatically sinful. It's not consistent with what I've been told and read by Catholic priests and catechists.
If it is true, then it is worrying that the Church would require people to practice bad medicine. There's no real difference legally, practically or morally between not starting a treatment like ventilation and stopping it.

[quote="JesuXPIPassio, post:1, topic:189493"]

Would a ventilator be considered an extraordinary measure?

Do ordinary measures just mean nutrition and water? Would a feeding tube be considered an extraordinary measure?

[/quote]

Let me give you some references that are more authoritative than an anonymous voice on the Internet. I suggest you read the entire documents in these references for the full context. I will give you some short extracts which represent my understanding of what they say...but you are the one accountable before God if you are making the decision; therefore, you should have the facts:

First of all, you have Pope John Paul II's encyclical letter, :Evangelium VitaeINDENT Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment", in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience "refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted".77 Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death. 78
[/INDENT]Congregation for the Doctrine of the Faith, Declaration on Euthanasia:INDENT If there are no other sufficient remedies, it is permitted, with the patient's consent, to have recourse to the means provided by the most advanced medical techniques, even if these means are still at the experimental stage and are not without a certain risk. By accepting them, the patient can even show generosity in the service of humanity. - It is also permitted, with the patient's consent, to interrupt these means, where the results fall short of expectations... Therefore one cannot impose on anyone the obligation to have recourse to a technique which is already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community. - When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted.

[/INDENT]In my understanding, it's far too complex a situation to have a black and white answer. A lot of it has to do with the motivation of the people involved. What might be acceptable in one circumstance might be unacceptable in another.

First of all, you have Pope John Paul II's encyclical letter, Evangelium Vitae:

    (from paragraph 65) Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment", in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience "refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted".77 Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death. 78

Congregation for the Doctrine of the Faith, Declaration on Euthanasia:

    (From section IV) If there are no other sufficient remedies, it is permitted, with the patient's consent, to have recourse to the means provided by the most advanced medical techniques, even if these means are still at the experimental stage and are not without a certain risk. By accepting them, the patient can even show generosity in the service of humanity. - It is also permitted, with the patient's consent, to interrupt these means, where the results fall short of expectations... Therefore one cannot impose on anyone the obligation to have recourse to a technique which is already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community. - When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted.

Thanks Mark:

That is a nice reference.

Best,

Dedo

[quote="Cristiano, post:2, topic:189493"]
It is sinful to remove the ventilator, because it is euthanasia.

[/quote]

Removing a ventilator allows for natural death to occur. Natural death is not euthanasia.

[quote="markomalley, post:14, topic:189493"]
Let me give you some references that are more authoritative than an anonymous voice on the Internet. I suggest you read the entire documents in these references for the full context. I will give you some short extracts which represent my understanding of what they say...but you are the one accountable before God if you are making the decision; therefore, you should have the facts:

First of all, you have Pope John Paul II's encyclical letter, Evangelium Vitae:INDENT Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment", in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience "refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted".77 Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death. 78
[/INDENT]Congregation for the Doctrine of the Faith, Declaration on Euthanasia:INDENT If there are no other sufficient remedies, it is permitted, with the patient's consent, to have recourse to the means provided by the most advanced medical techniques, even if these means are still at the experimental stage and are not without a certain risk. By accepting them, the patient can even show generosity in the service of humanity. - It is also permitted, with the patient's consent, to interrupt these means, where the results fall short of expectations... Therefore one cannot impose on anyone the obligation to have recourse to a technique which is already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community. - When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted.

[/INDENT]In my understanding, it's far too complex a situation to have a black and white answer. A lot of it has to do with the motivation of the people involved. What might be acceptable in one circumstance might be unacceptable in another.

[/quote]

In my understanding, it's far too complex a situation to have a black and white answer. A lot of it has to do with the motivation of the people involved. What might be acceptable in one circumstance might be unacceptable in another

Your sentiments would hold very true in my thoughts also.
A similar topic on Ventilators was posted in late 2009

**Ventilator as extraordinary means?

forums.catholic.com/showthread.php?t=401751**

My father was on a ventilator for eleven years at home with loving nurses and family always at his side. Yes he suffered in all those years. And I cannot speak for him personally he passed away a few days before Christmas in December, 2007. But I can tell you he did enjoy the happiness of his family always with him.
My youngest brother now 42 has suffered with A.L.S. ("Lou Gehrig's Disease") for the last twelve years. He too will undergo a similar fate in the not to far distant future of being on a ventilator. But his beloved family will always be with him.

[quote="Zatzat, post:16, topic:189493"]
Removing a ventilator allows for natural death to occur. Natural death is not euthanasia.

[/quote]

I agree with this. (All things being equal.)

[quote="Doc_Keele, post:12, topic:189493"]
That claim is due to an lack of understanding. Someone on the Atkins diet could tell you that's wrong.

[/quote]

Are Atkins dieters starved or dehydrated?

[quote="GEddie, post:19, topic:189493"]
Are Atkins dieters starved or dehydrated?

[/quote]

Did I say either of those things?

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