Sunday, August 30, 2009

Talent development 2: beware perfectionism

I would like to follow-up my post of two days ago, Secret to top-notch development of one's talent, with an important caveat.

I emphasized that you must be able to honestly and accurately criticize yourself if you are to develop your natural gifts to the highest possible degree. This is true. However, there are some whose natural disposition can cause them to fall into a nasty problem as they try to do this. I am speaking of the nasty vice of perfectionism.

It is good to want to do your best and try your best as you work on developing your talent. However, this can become perverted by perfectionism. Excessive perfectionism is actually one of the myriad subtle forms of pride rearing its ugly head. It is one thing to recognize a flaw and then work to remove it; it is another to become obsessed with being "perfect" at all costs. The former is good; the latter, bad. And it can be difficult to accurately distinguish between the two, especially in regard to oneself.

I have no foolproof solution for preventing perfectionism while still maintaining appropriately high standards. But, I do think that simply being aware of this potential pitfall is a very helpful first step toward avoiding it.

Following are a few suggestions as to how we might recognize when we are sliding towards being excessively perfectionistic (i.e. self-absorbed in a prideful way, which is unhealthy) rather than appropriately self-critical (which is healthy). For the sake of being specific, I will have in mind a musician who has just finished a practice session (something of which I have experience from my younger days).

Immediately after practicing . . .

1. Are you angry, hurt, or upset? These are signs of perfectionism (or, of biting off more than you can chew, or trying to excel at something in which you truly do not have much talent). A person who practices with humility and patience can be highly self-critical and demanding of himself yet at the end of a practice session will be at peace; he will not be angry. He should be able to enjoy the spiritual exhilaration that comes with doing something he loves and for which he has talent even while being physically and mentally tired. Prideful perfectionism ruins this inner delight while healthy self-criticism does not. Imagine the difference between a musician storming off a stage seething versus leaving the stage essentially joyful and grateful. Practice should be like this as well.

2. Can you practice alongside others who are more advanced than you are without being envious of them or angry at your own shortcomings? A mature and humble approach to developing one's talent accepts that there is a curve of growth that everyone must go through. And while the rate of the curve is steeper at first, a great musician never stops learning and growing. Also, aspiring musicians know that in order to be the best they can be it is essential to play with others who are more advanced. Solo practice, as necessary as it is, can never duplicate the irreplaceable value of playing alongside accomplished masters. Musicians who have the potential to be great know this and take every opportunity when they are young to learn all they can from those whom they aspire to emulate. Prideful young musicians would rather play in mediocre groups where they can stand out as the best. Humble young musicians who are serious about being the best they can be do not avoid situations where they are not the star of the group--they hunger for chances where this is the case so they can continue to grow and learn.

3. Were you focused on giving your all for the sake of the music, or were you occupied with imagining yourself as the center of attention in future performances? There is a big difference between demanding the best of yourself because you passionately love and respect the greatness of the musical arts, versus wanting to be good because you desire attention and praise. The former attitude is selfless and conducive to great artistry; the latter is selfish and stifles great artistry.

So these are a few ideas that hopefully might help to evaluate our motivations as we strive to develop our God-given gifts. We want to hit that mature place where we can be humble and selfless even as we are demanding and critical of ourselves, all the time keeping a healthy perspective that the human endeavor in which we are engaged is about something bigger and more important than ourselves. Themes that summarize this balanced attitude would be: 1) giving rather than taking, 2) gratitude and appreciation for the gifts of others, and 3) learning rather than showing off.

In my opinion, great musicians who are blessed to have long careers, are beloved by the public, and who will end up contributing the most to the enrichment of human culture are able to maintain an approach whereby they love their art more than praise (and thus see music as bigger than their own personal careers), never lose great respect and appreciation for their peers and forebears, and understand that no matter how accomplished they become they will never know it all and will never cease learning more about their art and growing as an artist.

New book on beauty for women

I am happy to note that Gina Loehr (formerly Gina Giambrone), sister of newly ordained Dominican priest (one of my former classmates and brothers in religion and still a good friend), Fr. Anthony Giambrone, has recently completed her second book. Published by Servant Books, is Choosing Beauty: A 30-Day Spiritual Makeover For Women. [Amazon link here]

About a week ago I happened to be tuned in to EWTN radio in my car and up came an hour-long interview with Gina about her new book. She was interviewed by host Steve Wood on the Faith & Family radio program and did a great job. Gina's book (while I haven't read it, I did hear her speak about it on the radio) is about authentic beauty (which is spiritual and physical both), and how women can pursue beauty by nurturing the virtues.

I'm sure the book is very good. And Gina comes from the perspective of a young woman (now a wife and mother) who in younger days did not always embrace her faith wholeheartedly. So, as her Catholic faith has grown she has gone through a transformation of how she understands beauty, becoming more aware of the difference between what our society says is beautiful, versus the real thing.

Congratulations Gina on your book!

Friday, August 28, 2009

Secret to top-notch development of one's talent

Have you ever wondered why some people with a natural talent for something (e.g. music) are never able to develop that talent very well, while others do (assuming they want to and try to)?

To my observation, here is an absolutely crucial component to be found among the personal traits of those who achieve top-notch development of their natural gifts: you must be able to honestly and accurately criticize yourself. You must be your own harshest critic. And you must nurture this ability so that you become faster and ever more accurate at evaluating how you are progressing. Folks with a talent for something who never become good at self-evaluation will not be able to develop their talent to its fullest potential. Two elements come together here: a highly-tuned self awareness, and humility.

There are many people with a high degree of natural ability to do something who never become great at it because they are too proud to tell themselves when the result is below what it should be. Those who become great are able to tell themselves with brutal honesty when something is not right or is not as good as it could be or should be. They do not accept the status quo from themselves when they know they could do better.
[Update: Here is a good example of this in action from writer and blogger Jennifer Fulwiler]

This subject comes to my mind in the context of being somewhat of a fan of one of those TV cooking shows: Top Chef. The best chefs always have an outstanding ability to evaluate their own food--to know what is wrong as well as what is right with their efforts.

The same is true of great musicians, great athletes, and great artists. The cycling phenomenon Lance Armstrong certainly has many athletic gifts. But, he would never be the legend he is today had he not developed those gifts with a very regimented and exacting program of training during which he was keenly aware of how he was performing, always striving to push himself to his personal best, never accepting a poor effort from himself.

An Olympic-level archer knows when the arrow leaves the bow if something is off with his shot--it doesn't feel quite right. Top musicians are much more critical of their own playing than the vast majority of their audiences. They have a finely developed ear for their music and can hear and feel the subtlest of differences in tone, energy, pitch, etc., in their playing.

It is a sad thing when a person with an especially high level of talent for something sabotages himself with his own blindness. Pride blinds that critical auxiliary gift of astute self-evaluation that all great artists, chefs, musicians, etc. have. If we want to honor God and inspire and exhilarate others with our gifts to the highest degree possible we need humility, self-awareness, and honest self evaluation as constant companions. Helpful toward this end is never to forget that all our gifts come from our Creator. While He wants us to develop our gifts as best we can and use them for the benefit of others, He will not look approvingly upon our efforts when we fail to do so because of the inevitable blindness caused by vainglory. Humility, among other needed virtues, lays a foundation for the fullest unlocking of the beauty latent within our natural talents.

Monday, August 17, 2009

Joe Satriani 2; importance of developing your craft the right way

Following up from my first Satriani post, here is another segment from the Joe Satriani interview that I especially like. This clip is part 10 (of 11 total).
[Apologies again for the wide frame]

I transcribed the comments I think are the most illuminating:
There’s no substitute for practicing. Students have to be completely honest with themselves about what they don’t know, and that they have to get on track and start learning it. . . . You don’t have to learn it all today, but do something where every day you get better and better. . . . It’s really quite obvious, we just have to be very straightforward with ourselves, and that’s how we arrange our practicing. But I would say that, and I remind students all the time, they will not have a career based on the demonstration of practice techniques. [. . .]

The ultimate goal is playing music, being evocative, lifting people’s spirits, being an entertainer; it’s all part of it. The practicing is supposed to help you do that. [. . .]

Find out what it’s like to play for human beings. . . . I don’t want to reduce it to a job, but I mean that’s what a musician does; Society wants musicians to make music for them—I mean, that’s what we’re supposed to be doing. So, if you’re practicing and it’s not helping you do that, well then you’re not practicing right. [emphasis mine]

I think the key phrase above can be altered to apply to all realms of art:

Society wants artists to make art for them. That's what artists are supposed to be doing. Indeed!

By this, I mean that great art is made both for the artist and for his audience. It's the for the audience part that I think, especially in artistic realms outside music (which immediately dies as a money-earning venture if it ignores the audience), tends to get lost today. Great art involves a relationship, a community of sorts, between artist and audience.

Sunday, August 16, 2009

Joe Satriani on music

I have been getting reacquainted via the wonder of YouTube with one of my favorite musicians I used to listen to some years back: the incredible rock guitarist, Joe Satriani. He is one of a handful of instrumental electric guitar players who is successful as a solo musician. He is a "guitar player's guitar player."

Joe (known also as "Satch") is the youngest of five children from an Italian family. I assume he is probably Catholic, but I don't know for sure. His style is mostly hard rock, but, in my opinion, his music is very purposeful, very musical, and very distinctive. His songs can be quite beautiful, imaginative, and melodic, even as they are "rock'n." He doesn't just thrash for the sake of thrashing. He plays with a musical vision clearly in mind and communicates that vision well through his playing. If great electric guitar playing interests you, check out some of Satriani's live performances here, here, and here. (The last one, "Flying in a Blue Dream," is awesome!)

One of the things I like about Satriani, as is evident from interviews with him, is that he is not a stereotypical rocker with a big ego and a party-hard attitude. He seems to be a very down-to-earth, really nice guy. And he takes his music very seriously--a dedicated, hard-working musician. He is first and foremost a professional musician and artist. This is one reason why his career has been primarily as a solo artist. He prefers to perform his own songs rather than play someone else's music. In this way (he remarked in an interview), he can maintain a strong personal, emotional attachment to every piece of music. Each song has a unique personal meaning for him and comes out of a particular mental world to which he returns as he performs; each one transports him to a certain emotional place. And this is what he prefers as a performing artist.

I found an 11 segment video interview with Joe on YouTube, part of a "Living Legends Music" series. The whole interview is very interesting. But I want to highlight two parts. The first in this post, and the second in a post following this.

Here is part 9 of the interview
[sorry about the width, there is no smaller window available]:

The following items from this segment struck me as especially interesting. They remind me of themes that are similar to previous posts I have made about music and art.

1. Speaking of how his music is always under development and that his experience of life is always in contact with his musical art,
My way of dealing with it [life] has always been to internalize it and turn it into music, that’s what I do. So I write all the time. Maybe an eighth of what I write winds up being heard by the public.
2. And this remark is suggestive to me of the dual goals that good artists have to hold together harmoniously if they are going to create art that an audience can relate to and that has a chance of lasting--the twin goals of being faithful to your own personal artistic vision and of creating art that is accessible to and mindful of your audience.
During the playing of a song, part of me is on some sort of, um, trip—I don’t know how to explain it. I’m sure there’s a part of me that is being the professional musician, keeping it together, making sure that I represent this melody the way the fans need it to be represented. [emphasis mine]
Satriani has a well developed sense of how a good song is both a) unique, personal, special to the artist creating it, and b) something the audience can attach to and love as well. This involves using a dynamic interplay of the artist’s unique inner vision together with perennial sounds and ideas loved by his audience.

In this segment he also spoke about dealing with and preparing for the unexpected in performances, and, making each song unique and connecting to each emotionally.

Schizophrenia in our treatment of human life

Here is a thought-provoking video put together by Justice for All. It asks a very good question pertaining to the schizophrenia that exists in our laws. One sort of death is considered legal, even a "right"; the other is prosecuted in most states as murder. Should we treat them differently? Watch the video to see what they mean.

[HT, Jill Stanek]

Saturday, August 15, 2009

Family headship; dryness in prayer

I would like to give accolades to a very good blogger I have come across recently. She is Jennifer Fulwiler and her blog is Conversion Diary. She used to be a feminist atheist and is now Catholic and married with children.

On August 12 she wrote an insightful post, "Why it makes sense to be obedient to my husband." In it she describes how her thinking has changed from being against the idea (as it would be contrary to woman's equal value) to being in favor of it. She approaches the subject from several angles including leadership, limitations, equality, fairness, motivation, providence, and love. If this subject interests you, it is well worth reading.

I would also like to highly recommend an excellent post Jennifer wrote, "The greatest nothing I ever felt." She writes about the issue of emotionally intense prayer as compared to more spiritually quiet, dryer prayer, and how God helped her realize during adoration that a close relationship to Christ does not always have to translate into intensely moving prayer experiences. Here is an excerpt:

Other women began to sniffle and lean their heads on the pews, and I grabbed a couple Kleenex from the box next to me for when my own powerful experience began. As regular readers know, God rarely speaks to me so clearly as when I'm in Adoration, . . . and it seemed inevitable that going to Adoration in such a beautiful chapel surrounded by such God-loving women at such a Christ-centered retreat would leave me open to the Lord's promptings as never before. I crossed myself, prayed, gazed at the monstrance, and waited.

And waited.

And waited some more.

Jennifer addresses a subject that is very relevant for many Christians striving to grow closer to Christ--especially for those whose personalities tend to be highly passionate. Later in her post she writes,

I realized that this relatively new understanding of God gave me a certain kind of joy. It wasn't a shout-from-the-rooftops, overwhelming kind of joy borne of a powerful visceral reaction to some event; rather, it was the calm, steady, quiet joy borne of knowledge of the truth.

If you sometimes struggle wondering why the Lord does not always grant the consolations in prayer that you desire, do check out Jennifer's comments in full.

Monday, August 10, 2009

Muddled ideas about Life Sustaining Medical Treatment

I would like to return to a paragraph from the AAP's "Guidelines on Forgoing Life-Sustaining Medical Treatment," which I reproduced in my August 5 post about the AAP's approval of withholding nutrition and hydration from non-dying children:

Life-sustaining medical treatment encompasses all interventions that may prolong the life of patients. Although LSMT includes the dramatic measures of contemporary practice such as organ transplantation, respirators, kidney (dialysis) machines, and vasoactive drugs, it also includes less technically demanding measures such as antibiotics, insulin, chemotherapy, and nutrition and hydration provided intravenously or by tube.
[Guidelines on Forgoing Life-Sustaining Medical Treatment, pdf]

This description of what falls under LSMT is confused, for it does not make distinctions among interventions that have important fundamental differences.

First, a little background. The human body needs a constant supply of a few things from the external world in order to sustain life: air, water, and food. The body must receive these from outside itself, as it does not have its own internal supply of these things. These are necessary for life. Helping to provide or ensure access to air, food, and water, does not come under the purview of what it means to practice medicine. This is simply required of any moral person as among those things owed to other persons without qualification. In the judgment of a reasonable person, deliberately shutting off the supply of any of these necessary things to the point of causing death, would be murder. The difference is that shutting off air would bring about death the fastest, then water, then food. But, whether fast or slow, shutting off access to any of these three would, without exception, bring about death sooner or later. Killing someone slowly as compared to killing someone quickly does not make an act less murderous. (The Nazis used starvation bunkers in their concentration camps as a particularly cruel way to kill those whose deaths they intended to be a punishment and a warning to others. They would lock up the condemned without food or water and retrieve the bodies days later.)

In addition to a constant supply of air, water, and food, the human body, in order to sustain life, must also carry on in a coordinated fashion a large array of internally regulated physiological processes. A few of these include heartbeat and circulation, breathing, digestion, cleansing the blood of chemical waste products, regulating blood pressure, recognizing and destroying pathogens (potentially disease-causing agents such as viruses and bacteria), controlling the uptake of glucose from the blood, and many others. Any of these complex, internally controlled physiological processes can stop working properly for a variety of reasons. The practice of medicine aims to support or cure injured, diseased, or weakened physiological processes, returning them, if possible, to a healthy state.

Also, in order that bodily life might endure in a healthy state, the body needs to be sufficiently free of aberrations--abnormalities that might impair or destroy necessary bodily functions. For example, cancer.

Now, turn again to the paragraph above about life-sustaining medical treatment. As I see it, there are three categories of "intervention" in this statement. They are:

1. Assisting in delivering the exterior things all human bodies must continuously bring in to sustain life (air, food, and water). Thus, ventilators, feeding tubes, and intravenously supplied nutrition.

2. Assisting the body to restore to a state of healthy operation any physiological functions that have been compromised or damaged. Normally, these functions do not need outside help. This might be done pharmacologically, nutritionally, mechanically, electromagnetically, or surgically (or in combination). Thus, antibiotics, insulin, vasoactive drugs, organ transplantation, and dialysis.

3. Destroying, removing, or otherwise neutralizing aberrations (such as tumors) that threaten to seriously impair or ruin necessary functions. Thus, chemotherapy (also surgery and radiation).

We must do what we can to provide category one assistance as long as the body can still actually make use of air, food, and water, and in the case of food and water, as long as the body is not in a state of near death from causes other than a lack of food and water.

For categories two and three, we must use all ordinary means at our disposal in the service of life, taking into account the likely benefits vs. burdens. And in considering this, restoring the body to a condition in which it is not dying (that is, from something other than normal aging) is always a benefit compared to death. If a person is truly dying and death is near ("at death's door"), and death cannot be prevented but only minimally delayed, there is no absolute obligation to try to put off an inevitable death for as long as possible. However, it must be kept in mind that allowing (i.e. not aggressively trying to prevent) a near and certain death to unfold--as in "letting nature take its course"--is not in the same moral category as killing someone by commission or omission. A deliberately chosen action or inaction which is chosen because it will bring about death, is immoral killing.

There is a problem here, as I see it, with the use of the term "life-sustaining medical treatment." The term itself seems to imply that anything that is "life-sustaining" should by that fact also be considered "extraordinary" (as a Catholic analysis would use the term) in potentially fatal situations. It seems like the mere acknowledgment of an intervention as LSMT gives permission to consider it optional (i.e. non-obligatory) when death enters the picture as a possibility.

What this seems to me to allow is a severe downgrading of what used to be a presumption in favor of life as medical professionals discharge their obligations to society. Formerly, so long as there was a reasonable chance of saving a patient's life, physicians accepted an obligation to try their best to save life. Now, under the more recent approach, if death is merely a possibility (but not a certainty), physicians no longer have an obligation to try to save life. The mere labeling of a medical intervention as LSMT seems to contain tacit permission to choose to forgo it when death is possible. It's a thought process almost like this: this treatment has the possibility of prolonging life; this case has a chance of being fatal; this treatment is therefore optional and may be omitted even if for the purpose of making death certain. It is a horrendous perversion of the most fundamental values that until recently have underpinned the medical profession throughout Western civilization.

If this sort of muddled thinking becomes more and more common in the realm of medical ethics, it won't be long before the only treatments that will be considered obligatory for medical professionals to undertake will be some treatments that have a high potential to heal non-fatal conditions.

Saturday, August 8, 2009

Killing Hospital Patients By a 2nd Disease

In my previous post I spoke about the immoral policy of the American Academy of Pediatrics to approve of withholding nutrition and hydration (or, antibiotics or insulin) from a very sick, injured, or disabled--but not dying--child for the express purpose of ending that child's life.

Now I would like to consider an example where such a policy would make it possible for medical personnel to approve of killing a hospitalized patient (child or adult; young or elderly) by means of a secondary (typically non-lethal) infection or otherwise usually treatable disease. This would not be considered killing by the AAP. However, in a Catholic moral analysis a person can indeed be guilty of killing--here, euthanasia by omission--by deliberately not treating a second disease process which, due to a primary pre-existing disease condition, would be too much for the patient's body to handle on its own in combination with the primary disease and so would be likely to cause death.

Secondary infections can occur which are a different (and not-necessarily lethal) disease process added on to the condition of an already present primary disease. With sound medical care, these can be treated and resolved or at least minimized while the more serious (lethal) primary disease condition remains.

For example, many patients in the hospital with advanced cancer have some sort of "central line" in place (a surgically installed intravenous line that permits intravenous access to the patient without needing to use peripheral IV lines in the arms that only last a few days and thus need frequent changing--not good for prolonged IV therapy, such as is needed for chemotherapy). Any IV line, including central lines, can become infected. In fairly rare circumstances, an IV infection can take hold in the patient's blood in a potentially lethal condition called "sepsis." A person already weakened by cancer, chemotherapy, and/or age, is very vulnerable to sepsis. In the case of a new IV site infection, skilled nursing staff should notice the early signs of infection appearing around any IV access line (whether central or peripheral). A typical medical response would be to remove the IV line at the infected site, and, if needed treat the patient with antibiotics to clear the infection. A new IV line could be established at a different location free from infection while antibiotic treatment is clearing up the old site. An infection from an IV that might spread to the blood is a different disease (treatable with antibiotics) than cancer.

Now, if a patient with cancer develops an infection and the medical staff makes a deliberate choice not to treat the infection (and the patient's body does not heal the infection on its own), that patient would die from infection--not from cancer--an infection which itself very well might not have been lethal if treated properly and quickly. In such a scenario the infection would have progressed to the point of becoming lethal because of the decision to omit antibiotics. In this way (e.g. not treating a secondary infection), physicians may actually choose to bring about the death of a patient by omission. Death, in such situations, would not have been caused by the original lethal disease but by a secondary (treatable) disease. By not treating the secondary disease doctors have a (convenient?) means of making death come sooner--perhaps much sooner--than it otherwise would have come. Is this morally much different from just shooting the person, like a farmer might do with an old sick dog?

This is a crude analogy, but it applies. If I walk up to a dying man who has sustained a lethal snake bite delivering ten times the amount of poison needed to kill a human and shoot him in the head, I have killed an innocent person (murder) and committed a grave offense against God, that person, all of human society, as well as my own dignity. Christians do not do this. This is never permissible under any circumstances. The time involved would be longer, but killing a man by withholding antibiotic treatment for a curable infection is not, morally speaking, very much different from putting a bullet in his head. One is faster, more gruesome, and more direct--but they both produce a dead body. Both cases would involve making a free choice with one's will to end the life of another human being using means known to be lethal in the given circumstances. For a Christian, such acts of commission or omission ought never be considered proper medical treatment. It makes a mockery of the medical arts. Healers are gradually turned into killers, convinced by leaders in their profession that they are doing a great service. Horrible.

The same might apply to insulin. Antibiotics and insulin are routine, ordinary care used to handle conditions which are manageable or curable when treated according to standard medical practices. If antibiotics or insulin (diabetic shock can progress to death without insulin) are deliberately withheld for the purpose of causing death, when giving them would prevent death, it is killing, not medical treatment, not benign care. It is taking life into our own hands and making ourselves God, deciding when life should end.

Please note, this does not mean there is never a situation in which antibiotics or insulin (or nutrition and hydration) could be withheld in a way that would be morally upright. I simply want to stress that we may not do something (or omit something) for the reason of ending someone's life. By listing antibiotics and insulin (as well as food and hydration) in the LSMT category the AAP makes euthanasia by omission (of these treatments) a more likely scenario, for it gives such actions the official stamp of approval of a respected medical organization.

Wednesday, August 5, 2009

American Academy of Pediatrics recommends when children can be killed

The American Academy of Pediatrics (AAP), a respected and influential medical organization of some 60,000 members (ostensibly "Dedicated to the Health of all Children"), has recently published something which any morally sane American should consider highly disturbing, to say the least.

In the August, 2009 (Vol. 124, No. 2, pp. 813-822), issue of their monthly scientific journal, Pediatrics, the AAP published an article--a "clinical report"--titled, "Forgoing Medically Provided Nutrition and Hydration in Children." [available online here; pdf here] The two authors of this article (both medical doctors) are the present and immediate past chairpersons (their term; I prefer 'chairmen') of the AAP's Committee on Bioethics. And so this article represents the current point of view of the bioethics experts of the American Academy of Pediatrics on the subject of withholding food and water (i.e. nutrition and hydration) from living children. From what I can gather from their web site (their "Clinical Reports" index, here, which includes this article, is listed under the heading of "AAP Policy"), this represents official policy of the AAP. At the very least, this will be influential among pediatric medical professionals. To some degree it may represent already established opinion among them.

In the conclusions section of the article is the following: "The primary focus in decision-making should be the interests of the child." What does the AAP consider in the interests of the child? When do they say a physician may withhold food and water?

Medically provided fluids and nutrition may be withdrawn from a child who permanently lacks awareness and the ability to interact with the environment. Examples of such children include children in a persistent vegetative state or children with anencephaly. [conclusions, no. 6]
I stress loudly that such children are not necessarily dying! A persistent vegetative state, especially, is not a lethal condition--imminent death is not in the prognosis for PVS by itself. The AAP thinks it is morally permissible to kill children who are not dying, but severely injured, by withholding nutrition and hydration. They do not call this killing. But in a sound moral analysis, it certainly is.

Further, the article states, "Because individuals in a persistent vegetative state are unaware of themselves and their environment, the provision of medically provided fluids and nutrition does not confer them benefit and may be withdrawn." This position is essentially utilitarian. It does not assume that human life and human existence is, in itself, essentially good and valuable. It reduces the value of human life to something dependent upon the awareness of the individual. This is an extremely dangerous and morally bankrupt position to take. The AAP now holds that if life isn't worth living according to its understanding of a worthy, beneficial life, then it is a legitimate option to end the patient's life by not giving them nutrition and hydration. Such is the state of bioethics among the leadership of mainstream medical organizations.

It is helpful to have the following background information: the AAP considers providing nutrition and hydration (food and water), by feeding tube (a tube going into the stomach or small intestine) or intravenously, to be "life sustaining medical treatment" (LSMT). Here is a quote from AAP official policy:

Life-sustaining medical treatment encompasses all interventions that may prolong the life of patients. Although LSMT includes the dramatic measures of contemporary practice such as organ transplantation, respirators, kidney (dialysis) machines, and vasoactive drugs, it also includes less technically demanding measures such as antibiotics, insulin, chemotherapy, and nutrition and hydration provided intravenously or by tube.
[Guidelines on Forgoing Life-Sustaining Medical Treatment]
Thus, leaders among our pediatric specialists officially consider antibiotics, insulin, and food and water (given by tube into the stomach or by a smaller tube into a vein) to be "Life Sustaining Medical Treatment." In other words, these are considered interventions that may, under some circumstances (some not life threatening), be forgone. A very serious question must be asked: Do they approve forgoing such treatments for the sake of bringing about death--where it would be understood (even if not stated explicitly) that death would be a direct result (as contrasted with allowing an already inevitable death to take place by forgoing treatment)? The answer, clearly, is yes (see above).

Why is this a huge concern? Because the medical community does not seem to recognize the moral difference between allowing certainly impending death to happen, death which will come as a direct result of an incurable lethal disease or injury, vs. deliberately killing the patient by keeping food and water from him or by omitting other routine and probably effective antibiotic or insulin treatments for secondary and not-necessarily lethal conditions. We are in serious trouble when our doctors do not recognize the difference between choosing to stop fighting against imminent death and choosing to kill.

The official AAP web site states [see AAP Fact Sheet] that their mission is "to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults." How do they pursue this mission? "One of the AAP’s major activities is to further the professional education of its members. Continuing education courses, annual scientific meetings, seminars, publications and statements from committees, councils, and sections form the basis of a continuing postgraduate educational program." [Fact Sheet]. In other words, they educate and influence pediatric medical professionals, in part, according to the considered positions formed by their various national appointed committees. One of these is the Committee on Bioethics whose chairperson and immediate past chairperson wrote this article.

Should this matter to Catholics (and to any Christian)? Absolutely! Euthanasia, however well-intentioned (i.e. killing so as to end suffering), is never permissible. Killing the innocent is killing the innocent--and never OK. There is a commandment (you know, the Ten Commandments) against it. Here is the definition of euthanasia used by the Catholic Church: "an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated." [Declaration on Euthanasia]. Choosing not to give nutrition and hydration in the case of a non-lethal situation where food and water can still be assimilated by the body is an omission; it is a choice made for a specific purpose--to cause death. Likewise for antibiotics and insulin.

Christians do not do this. It is never permissible under any circumstances. Our calling is never to take another person's life, but rather to provide a self-giving, person-oriented service of love and compassion. We are to do all we can to comfort others, lessen their suffering, and to accompany them in their suffering--to suffer with others in solidarity as best we can. We are to show those who suffer by our caring presence that we love them, and that they are worth being with no matter what is happening to them. To do this well, we need grace. May we pray for it, and may God grant it to us.