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Voices Online Edition
Advent 2000
Volume XV, No. 4

Steven Becker and the Fight for the Soul of Catholic Health Care

by Nancy Valko, RN

Several years ago, I was asked by the late Archbishop May of St. Louis why I wasn't working as a nurse in a Catholic hospital. I replied that, as a Catholic pro-life nurse, I felt safer at a non-Catholic facility that recognizes conscience rights rather than at a Catholic facility that tries to argue doctors and nurses out of them.

From allowing abortions of infants with anencephaly to dispensing contraceptive prescriptions even to teenagers to the withdrawal of feedings from people with various levels of brain injury, many Catholic hospitals have become virtually indistinguishable from most secular hospitals. And, just as outrageously, doctors and nurses are being told that Catholic ethics allows these travesties. Pro-life doctors and nurses who object are often harassed and/or told that they should seek employment elsewhere. Its difficult nowadays to invoke conscience rights as I myself have had to do as a health care professional in any institution, but it is especially discouraging to have to do it in a allegedly pro-life Catholic institution and risk losing one's job.

In large part, the responsibility for this terrible situation has to lie with several prominent Catholic ethicists and theologians who disagree with many traditional Catholic principles but who nevertheless teach and promote their opinions as true Catholic doctrine. Bishops statements, Vatican documents and even the Pope are ignored as these ethicists and theologians attempt to bring Catholic institutions more in line with the prevailing secular ethics mentality.

This state of affairs did not happen overnight but it is dramatically exposed in the Steven Becker case through the continued defiance of Catholic principles by some of the most influential Catholic ethicists and theologians in the United States.

Steven Becker (see related article) was a 28-year-old married father of three young boys who was admitted to St. John's Mercy Medical Center in St. Louis in March for treatment after it was discovered his severe headaches were being caused by increased pressure on the brain. Steven was offered an advance directive at the time but refused to sign one.

During a test, however, he became unresponsive and an emergency operation was performed to relieve the pressure on the brain. Unfortunately, he never fully regained consciousness.

Rehabilitation was started and, according to family members, Steven was making progress when, less than three months later, Steven's wife agreed to withdraw his tube feedings on the recommendation of the hospital's ethics committee, which deemed Steven's condition hopeless.

Steven's mother obtained a temporary court injunction to stop the withdrawal of feedings and a judge issued the order pending a court hearing scheduled for September. The court also appointed a lawyer as a temporary guardian, who made it clear from the beginning that his only concern was whether Steven was in a "permanent vegetative state" and if he had a chance for a meaningful life. The case made the front page of the St. Louis Post-Dispatch on June 2, 2000.

Pro-life and disability activists picketed the hospital, protesting the hospital's intention to withdraw feedings.

In July, Archbishop Rigali issued a statement reiterating the Church's position, citing Pope John Paul II's 1998 statement calling food and water even when medically assisted an ordinary means of preserving life subject to the same ethical standards as any other basic medical care. The archbishop's statement was ignored by the media and apparently continued to be resisted by the Catholic hospital.

It was later revealed that when the decision was made to withdraw Steven's feedings, all rehabilitation efforts and most beneficial medications were also stopped, (including even antibiotics, which were now termed life-support). However, muscle relaxants were administered, and Steven, not surprisingly, became less responsive. He was no longer even permitted to be sat up in a chair for stimulation.

Steven's story eventually became an internet phenomenon and was written about by Zenit, a Rome-based news service, and various other publications from around the world. E-mails offering prayers, support, and personal stories began pouring in for Steven and his family.

On September 13, 2000, the court hearing on Steven's case began but was inexplicably closed to the press and public by the judge. After two days of hearing medical testimony, the judge continued the case until September 29 when friends of Steven's wife testified that Steven had made past statements indicating that he would not want to be kept alive in his present condition.

Although this hearing was also closed, a source told me that one of the witnesses had dated Steven when they were teenagers and testified that Steven made his comments about not wanting "artificial [sic] nutrition and hydration" while they were in the drive-through lane at a fast food restaurant!

This testimony about past statements was offered to counteract Steven's refusal to sign an advance directive when he was admitted to the hospital. The court-appointed guardian not surprisingly recommended withdrawal of feedings, and that Steven's wife be named his guardian.

In apparent defense of the "need" for a speedy resolution in this case, the court-appointed guardian said that Steven's oldest son Kyle, age 6, was asking. "When is daddy going to leave the hospital and go to heaven?"

(According to public records, Steven's wife claimed that the hospital helped her to make funeral plans after the decision to withdraw feedings was made in May, and also helped her to obtain counseling on how to tell their young sons that Steven was going to die, which is why the sons were allegedly asking when their daddy was going to heaven.)

Amicus briefs filed in early September by disability, legal, and pro-life groups citing Missouri law, the refusal of the advance directive, etc., were rejected by the court and the judge named the wife guardian immediately after the last hearing.

Within days, however, Steven was secretly spirited out of the hospital after Archbishop Rigali had told the hospital that they could not allow the removal of feedings in such cases, citing Church teaching that food and water may be withheld in only two instances: when a person is actually dying and food and water can bring no comfort to that person, or when the body cannot assimilate the nutrition and hydration.

The hospital issued a statement that, in accordance with the wife's request, they would not reveal where Steven was taken. The mother and the rest of Steven's family obtained a restraining order against removing the feedings pending an appeal, but the order could not be served because Steven was being hidden.

It was reported that the feedings were stopped and five days later, on October 10, it was revealed that Steven had "suddenly" died at home while being attended to by a doctor, nurse and priests just one hour before a judge was to issue another ruling on Steven's case.

The results of an autopsy were pending at this writing.
The circumstances of Steven's case, secret transfer and sudden death are shocking; but just as appalling were the responses to this case of several prominent Catholic ethicists and theologians:

Dominican Father Kevin O'Rourke, on the family's contention that Steven had some purposeful responses, supported by observations in the medical records, said, "There's always people who will say, 'Oh, he can smile, he can laugh'. They're making this up. It's fictitious".

Father Kevin O'Rourke, OP
Former Director of the Center for Health Care Ethics, St. Louis University ("Saving Steven Becker",National Catholic Register, August 27/September 2, 2000.)

Patrick Cacchione uses Steven's case as an opportunity to promote refusal of feedings and other treatment by means of living wills and other advance directives: "Unfortunately, Becker did not exercise any of these ways of stating his desires (and one cannot assume the decision not to fill one out is an indication of his feelings one way or the other). Maybe his family's tragedy will compel people of all ages and health status to discuss this issue openly and honestly".

Patrick Cacchione
Vice president of advocacy/communications of the Carondolet Health System and Chairman of Supportive Care of the Dying, a consortium of Catholic health care institutions which include St. John's Mercy Medical Center and the Catholic Health Association.

(Letters to the editor, St. Louis Post-Dispatch, 9/5/2000.)

"It cannot be required of persons that they use every technology available to prolong dying or postpone death. If that is the case, we ought first to provide minimal food, drinking water and health care to the desperately poor of the world, rather than amass medical technology to ease our own inordinate fear of death".

Father John Kavanaugh, SJ
Professor of philosophy, St. Louis University (Ethics Notebook column on the Steven Becker case, America, September 23, 2000.)

"Clinically, this situation seemed to be quite clear. The chances of recovery were very slim. Secondly, medically speaking, we have the technology to keep such patients alive for a long time, and that generates the third obstacle in the room: Do you keep them alive at all costs, or do you accept the medical impossibility that you're facing?"

Father Gerard Magill,
Director of the Center for Health Care Ethics and Ph.D degree program in ethics at St. Louis University.

("Man at center of fight over life support dies at home", St. Louis Post-Dispatch, 10/11/2000.)

"Life support in the form of artificial [sic] hydration and nutrition to prolong a person in a coma who has mere physiological function is of no benefit to the patient".

Father Kevin O'Rourke,OP,
("Religious leaders grapple with question of when to let life end", St. Louis Post-Dispatch, 10/15/00.)

"In a telephone interview, he described Archbishop Rigali's stance as troubling and idiosyncratic. O'Rourke said Rigali had catered to the vitalist position, the extreme pro-life view.... 'The ultimate goal of Catholic medical care', O'Rourke said, 'is to help people strive for eternal life. To exaggerate the importance of a person's physical existence, when that person has been deprived of intellect and will, undermines human dignity, a proximate goal to eternal life', he said".

Father Kevin O'Rourke
(quoted in "Rigali Intervenes: Feeding Tube Must Stay",National Catholic Reporter, 10/20/00)

"James Drane, a Catholic bioethicist in Pennsylvania, said it even more strongly. 'Use of a feeding tube to extend a process that can only end in death without recovery is a violation of basic principles of Catholic moral teaching about end-of-life care', he said.... Drane described Rigali's recent intervention as another instance of a turn in the Church hierarchy away from Catholic moral teachings toward an exaggerated pro-life kind of philosophy that ignores all of the subtleties and distinctions of a rational pro-life position".

James Drane
Russell B. Roth professor of clinical bioethics at Edinboro University of Pennsylvania. (quoted in "Rigali Intervenes: Feeding Tube Must Stay",National Catholic Reporter, 10/20/00.)

But Steven Becker's case was more than just about feeding tubes.
Why did the hospital give up on him so quickly? Why was he left to languish in bed while his court case dragged on for months? How did routine antibiotics suddenly become life-support? The answer is that the right to die mentality has become entrenched, even in Catholic facilities, thanks to Catholic ethicists who recognize no authority but their own.

Steven Becker's case is only the most recent glaring example of dissident Catholic ethicists and theologians challenging the pro-life movement, the bishops, and even the pope. The battle lines are being drawn and only a clear demand by the bishops and the public to return Catholic health institutions to the culture of life will change the current state of affairs. Nothing less than human lives and the soul of Catholic health care is at stake.

Related Statement
Taking a stand against causing death, March 2,2005

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