There are those, of course, who argue that biological life has such inherent value that to remove life-support – even in a case such as Maggie’s – is immoral, since it bases the decision on “quality of life” rather than “sanctity of life” criteria. This, however, represents a very un-Christian form of “vitalism” and is not an acceptable argument. The entire Gospel message teaches us that the true end of our biological existence is precisely to pass through the crisis of death, in order to attain eternal life in the Kingdom of God. The longing for such total communion with God does not allow us to hasten our death through some form of suicide or euthanasia. But when we become the victim of an accident or illness to the extent that life is permanently and irreversibly characterized by unbearable suffering, then artificial measures to sustain that life represent a violation of life’s sanctity, a violation of the person, and may morally be withheld or withdrawn. In those cases where the patient has entered the terminal phase of life (engaged irreversibly in the actual process of dying), then removal of life-support may include not only a ventilator or dialysis machine, but also food and hydration.

This last measure, however – withdrawing food and liquid – can only be morally accepted in cases that are truly “terminal,” that is, where the patient has entered the final phase of life and “the soul is struggling to leave the body.” This implies that death is imminent and that the dying process is in fact irreversible.

Such was clearly not the case with Terri Schiavo. Films taken of her during her final months of life, the recognition she showed of her family members, and the awareness she demonstrated in response to various external stimuli, made it clear that she was not, as it was held, in a “persistent vegetative state.” That _expression properly describes persons whose upper hemispheres are irreversibly non-functioning and whose brain is effectively “dead” except for the brain stem (which controls breathing and heart rate) and perhaps portions of the limbic system (body temperature, blood pressure, blood levels of sugar). It seems that in her case, as in many others, the term “PVS” was redefined for political rather than medical reasons. Under these circumstances, for the courts and Terri’s guardian (her estranged husband Michael) to force removal of her feeding tube was tantamount to murder: the willful taking of a life against the best interests of the victim. ~Fr. John Breck, Orthodoxy Today

Fr. Breck is one of the foremost Orthodox moral theologians in America today, and his book, The Sacred Gift of Life, has provided a valuable Orthodox witness in the field of bioethics. If anyone is qualified to speak credibly on this matter from an Orthodox perspective, it is Fr. Breck, so it is fortunate for the general quality of public discourse on such controversial matters that he has chosen to write on the subject.

His discussion of Mrs. Schiavo’s case possesses an unusual degree of thoughtful and serious reflection on the difficulties of these instances of extreme injury. Even though I am still not convinced by his final arguments and his claim that the autopsy is not significant and indeed conclusive evidence of the extent of Mrs. Schiavo’s physical (and therefore personal) deterioration, he is perhaps the only person denouncing the treatment of Mrs. Schiavo as murder who has presented a rational, seriously Christian argument rather than sentimentality and vitalism (the latter of which he quite rightly condemns) that Christians and “conservatives” have embraced in this case and in recent years.

One gets the sense from Fr. Breck’s article that he is striving mightily to avoid falling into the vitalist trap that was set by many of the advocates in favour of keeping Mrs. Schiavo “alive,” which was that because Mrs. Schiavo was not deemed to be “dying” and “only” needed artificial aid for nutrition and hydration it would be immoral to deprive her of that aid. Alas, Fr. Breck does seem to fall into this trap by the end, even though he grants that nutrition and hydration are extraordinary measures (something most arguing his position have never granted).

He seems unconvinced that a woman whose higher brain functions have ceased due to extensive brain damage is, at some level, no longer meaningfully alive. Such a person would necessarily be in the terminal phase of life for the very basic reason that she could not be in any other stage of life when all hope of rehabilitation has vanished–the only thing that has prevented the “actual process of dying” is extraordinary intervention from without. If Terri Schiavo was not in the terminal phase of her life, and she was not in a “persistent vegetative state,” what was her condition? Isn’t it the case that some loophole will be found in any general rule of moral guidance provided by Christian moral theology to vindicate the undue devotion to the now-lost cause of prolonging Mrs. Schiavo’s shadow of a life? It certainly has begun to seem that way.

If it is medically heroic and extraordinary to continue life support for someone who is terminal, conscious and suffering unbearably, bereft of any chance of recovery, as Fr. Breck maintains (I think, correctly), and if this persistence in a soul-deadening life violates life’s sanctity, could someone explain how continuing life support for the effectively unconscious person bereft of cognition (for whom any sensations of suffering could have no spiritual meaning even if they could be processed and felt) represents respect for the sanctity of life? Is it not even more of a charade and mockery of real human life to continue minimal bodily functions of such a person? To those who rhetorically ask why Michael Schiavo did not allow his wife’s parents to take over her care, one might reply that it would be to avoid such mockery of a human person.

Though I cannot share Fr. Breck’s conclusions, his article has illuminated the issue far better than almost any other and his arguments deserve the serious consideration of all concerned with the sanctity of life and a culture that protects and affirms it.