By Father Gerald D. Coleman P.S.S., Pd.D
Graduate Department of Pastoral Ministries, Santa Clara University
Just shy of his second birthday, Alfie Evans died on April 28 in Liverpool, England. He had become the focus of international attention. Due to an unidentified degenerative condition, he had been hospitalized since December 2016 at Alder Hey Children’s Hospital in Liverpool. His physicians described him in a “minimally conscious state” with a “catastrophic and untreatable neurodegenerative condition” that led to his brain being “corrupted” by this disease. They unanimously believed that all further medical treatment would not benefit him. Since his brain had almost entirely eroded “leaving only water and spinal fluid,” compromised further by frequent seizures, a urine infection, and compromised lung functioning, they recommended that he be removed from his ventilator and allowed to die comfortably with palliative care.
His young parents vehemently disagreed and wanted their son to be transferred to another hospital for further diagnosis and treatment. His father saw him as “my healthy young boy, who is undiagnosed and certainly not dying.” As typical of such cases in the United Kingdom (UK), and very different from the way these cases are dealt with in the United States, Alfie’s case was referred to the courts. The family lost their appeals at all levels including the Court of Appeals, the Supreme Court, and the European Court of Human Rights.
Hospitals in Milan, Munich, Poland and Rome offered to take Alfie. Rome’s Babino Gesu Pediatric Hospital went to extraordinary lengths to offer its assistance, especially through the interventions of the Italian Ambassador and Pope Francis himself. The Courts would not permit a transfer as “there was virtually nothing left of his brain” and he deserved to die “with comfort, dignity, and privacy.” His ventilator was removed on April 23 and he died five days later in Liverpool’s Children’s Hospital.
Father Ron Rolheiser once wrote, “Moral outrage is the antithesis of morality.” Indignation and rage flared up against the hospital. Alfie’s father had early on encouraged supporters to publicly dissent and call themselves “Alfie’s Army.” Some protesters swept into the hospital’s Pediatric Intensive Care Unity causing, as the Chief Nurse said, “disruption, stress and anxiety.”
Acrimonious slurs were made. Many called Alfie’s death “murder” while others named it “legalized killing and euthanasia.” One conservative blog claimed that the hospital’s statements about Alfie were “diabolical” and “lunacy.” Priests for Life in the U.S. issued a prayer judging Alfie’s doctors as “blind and misguided,” even “pretending to be God.” These outrageous opinions demonstrate a remarkable and woeful ignorance of the Catholic moral tradition.
Saint John Paul II’s encyclical Evangelium Vitae (1995) states that “to forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia.” (no. 65) The Catechism of the Catholic Church explicitly summarizes the Church’s century’s old moral teaching: “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted.” (no. 2278) Catholic teaching places limits on what medical treatments must be provided to patients for whom there is no realistic medical expectation of benefit. The Bishops of England and Wales stated the point precisely: “We do, sometimes, however, have to recognize the limitations of what can be done.”
The President of the Vatican’s Academy for Life was quite clear and accurate: “The proper question is raised in this and any other unfortunate similar case – what are the best interests of the patient? We must do what advances the health of the patient, but we must also accept the limits of medicine and … avoid aggressive medical procedures that are disproportionate to any accepted results or excessively burdensome to the patient or family.”
Three days before Alfie’s death, his parents expressed appreciation for all the encouragement they received from around the world. They asked their supporters to return home and allow them to spend time with Alfie’s physicians to “built a bridge and walk across it.” They thanked the hospital’s staff for their professionalism and the way they treated Alfie with dignity and respect.
A British member of the European Parliament promised to initiate changes in UK law to help parents in the future from being sidelined in their rights to make decisions for their children. It is now time, he said, for Alfie’s Law.
It is also time for Catholics to properly understand the Church’s moral tradition about death and dying, comprehend accurately its teaching on non-beneficial, extraordinary medical treatment, and refrain from hurling wrong-headed accusations such as murder, euthanasia and misguided physicians.