A Traditional Roman Catholic
The Roman Catholic moral tradition has had much to say about withholding and otherwise limiting medical treatments, including those needed to keep a person alive. Many both within and outside the Roman Catholic community have found the discussion of these matters by Catholic authorities and scholars to be helpful. This is true even when the tradition fails to generate responses that are fully determinate or completely compelling, as is clear from the enduring interest in the Catholic discussion of ordinary and extraordinary ways of treating patients. Most Catholic teaching and scholarship concerning withholding treatment have focused on the scope of health care decisions by individuals and their families, as well as on the corresponding rights and duties of health care professionals. As in other areas of moral perplexity, the tradition has been concerned to identify correctly those participants in various kinds of health care decisions who rightly have the final say. Of course, all decisions by authorities should be shaped by general moral principles and precepts. The framework for these particular authoritative decisions is set by the implications of the Fifth Commandment (Thou shalt not kill), so that decisions to limit life-sustaining treatment that are morally identical to choices to end life are excluded from the range of choices authorities may make.
Traditional Roman Catholic views on withholding medical treatment certainly seem able to deal with the questions raised by the apparent need to limit the care that health care professionals and institutions make available to patients, and in particular the need to limit some patients' access to intensive care units. This is a new question about limiting medical treatment; its answer, as I hope to show below, is not simply an implication of the traditional doctrine on withholding treatment. To answer that new question, the resources of the traditional doctrine must be supplemented by the theory of public authority and of human rights embedded in Catholic social teaching.
Therefore, in my contribution to this volume, I will seek in the first section to summarize the Catholic teaching on withholding treatments, so as to bring its light to bear on the aspects of the new question that it can readily illuminate. Although this teaching does not by itself settle the new question about limiting access to treatments such as intensive