Citing difficult decisions in his own family and the example of Pope John Paul II, Bishop Gregory M. Aymond of Austin said Catholic teaching would permit the withdrawal of extraordinary medical treatment for Emilio Gonzales, a dying 17-month-old boy at Children's Hospital of Austin.Catarina Gonzales, the boy's mother, has been fighting for continued medical treatment of her son at the hospital, which is part of the Seton Family of Hospitals, a 31-facility Catholic health system in central Texas.
The boy's physicians and other hospital officials have recommended that the child be removed from a respirator and given only "comfort care."
Emilio, who has been blind and deaf since birth and was admitted to the hospital Dec. 27 with a collapsed lung, has been diagnosed with Leigh's disease, a rare disorder that is causing his central nervous system to break down. The disease is considered incurable.
"I cannot imagine the pain that Catarina experiences as she faces these terrible questions that no mother wants to face," Bishop Aymond said in an April 15 statement.
But he said such questions are not unfamiliar.
"In my own family, I have been part of making end-of-life decisions for both of my parents and for my 24-year-old nephew, who was involved in a traumatic vehicle accident a few months ago," the bishop said.
He offered a brief overview of church teaching on extraordinary, or disproportionate, medical care and ordinary, or proportionate, medical care.
"Generally, if a medical procedure carries little hope of benefit and is excessively burdensome, Catholics – and Catholic institutions – are not morally obligated to pursue that procedure," Bishop Aymond said.
"Even Pope John Paul II was adamant that he would not accept extraordinary medical care as his health declined."
"Catholic moral teaching on ethically required medical care states that we realize that all reasonable means must be used to preserve human life and to promote the profound dignity that belongs to it," the bishop added.
"At the same time, we recognize that sometimes we should not use modern technology if it inflicts greater suffering on our loved one, and holds them back from being able to go home to God."
In the case of Emilio Gonzales, "numerous physicians" consider the child's condition irreversible and terminal, the bishop said, and there is "great concern that continued extraordinary treatment will only result in greater pain for Emilio, without curing or improving the condition from which he suffers."
Under the "comfort care" plan proposed, "Emilio would continue to receive food, water, pain medication and other 'ordinary' treatment to provide as much comfort as can be given by a loving and vigilant team," Bishop Aymond said. Moving to such a plan "would be morally acceptable," he added.
The bishop noted that some have compared Emilio's situation to that of Terri Schindler Schiavo, the brain-damaged Florida woman who became the center of a highly publicized debate on end-of-life issues and who died in March 2005 after a court ordered her feeding tube be removed.
But he said the two cases "are very different; in the Schiavo case ordinary means – food and water – were withdrawn, which caused her death."
Bishop Aymond said he has offered to meet with Catarina Gonzales, a 23-year-old Catholic from Lockhart, "to offer my support and to explain the teachings of the Catholic Church regarding end-of-life issues." As of late April 16, Gonzales had not responded to the offer, said Helen Osman, diocesan spokeswoman.
Travis County Probate Judge Guy Herman was to hear testimony April 19 on whether to extend a temporary restraining order requested by Gonzales that would require the hospital to continue treatment until the mother can find another facility that would admit her son.
The Texas' Advance Directives Act permits physicians to withdraw life support against a family's wishes if continued treatment is judged not beneficial to the patient and the family has been given 10 days to find another facility.
The Texas Legislature is considering revising the act to require physicians to follow the wishes of the family until a transfer of the patient can be arranged.
"Our first concern must be the well-being of Emilio, both physically and spiritually, and that appropriate pastoral and spiritual care is offered to his family, especially his mother, during this very difficult time," Bishop Aymond said.
"I ask everyone to join me in praying for Emilio, his mother, Catarina, and those who are responsible for his care."
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