John Paul's doctor rejects charge that pope's death was euthanasia

By JOHN L. ALLEN JR.
New York

G.K. Chesterton once observed that smart newspaper editors know they can entice people to write half their paper for them for free, if only they keep them angry enough. That’s an insight that certainly applies to the most recent issue of Micromega, a popular Italian journal, which carries an essay charging that the death of Pope John Paul II in April 2005 amounted to a form of euthanasia.

It’s a suggestion that sources close to the late pope, including his personal physician, have strenuously rejected.

Written by an Italian physician named Lina Pavanelli, who was not involved in the treatment of John Paul II, the essay argues that because the pope was not given a stable feeding tube until the final stages of his illness, he was denied essential nutrients that might have prolonged his life. She suggests that the practice followed in John Paul’s case contradicts the official teaching of the Catholic church, which regards the provision of food and water, even through artificial means, as an ordinary form of basic care and therefore obligatory.

In effect, Pavanelli argues, John Paul was allowed to become steadily more underweight rather than subjecting him to invasive procedures -- creating a contrast, she wrote, between the actual decisions made in his case and the general rules promulgated by the church.

That claim has set off a furious round of discussion in Italy, as well as in other parts of the Catholic world. (I was called today by Poland’s leading daily, for example, to comment on whether the report might affect John Paul’s candidacy for sainthood.)

Pavanelli’s essay appeared just days after the Congregation for the Doctrine of the Faith released a response to two questions from the U.S. bishops about artificial nutrition and hydration for patients in a persistent vegetative state. In general, the congregation held, food and water may not be withdrawn, since to do so would be to cause the patient’s death.

In the wake of the Micromega essay, one of Italy’s leading Vaticanisti, Luigi Accattoli of Corriere della Sera, published a reconstruction of the pope’s final days based on interviews with unnamed papal intimates. Accattoli reported that while the Vatican first confirmed that the pope was using a nasal feeding tube on March 30, in fact he had begun using it much earlier. Accattoli said a tube had been inserted and removed several times during the final days of the pope’s second stay at Rome’s Gemelli Hospital, which lasted from Feb. 24 to March 13.

Accattoli also reported that beginning on the Monday of Holy Week, meaning March 21, the nasal feeding tube was left in place more or less permanently, removed only for the pope’s fleeting public appearances. In fact, Accattoli said, the reason TV cameras only showed John Paul from behind as he watched the Good Friday procession from his bedroom on March 25 was to avoid showing him with the tube in place.

The late pope’s personal physician, Renato Buzzonetti, also gave an interview to the Italian paper La Repubblica, breaking two years of self-imposed silence on John Paul’s final days.

La Repubblica asked Buzzonetti about reports that at around 3:30 in the afternoon of April 2, 2005, the day he died, John Paul had whispered “let me go to the Lord” to one of the Polish nuns in his household, asking if that meant he had expressed a desire, in essence, to give up.

Buzzonetti insisted that the phrase “let me go to the Lord” was a spiritual and ascetic utterance on the part of the pope, and that his medical treatment was never interrupted. His intravenous drip, for example, remained in the place to the very end, Buzzonetti said. When the pope experienced septic shock on March 31, he was given all the appropriate treatment to help with his heart and lungs.

Both Buzzonetti and other papal intimates strongly rejected the suggestion that what happened to John Paul could be characterized as euthanasia. On the other hand, experts also point out that nothing in Catholic teaching requires applying extraordinary measures when death is imminent and inevitable. The recent Vatican declaration on artificial nutrition and hydration, they observe, concerns patients in a persistent vegetative state who are otherwise stable. That analysis would not apply to the pope, who was in the final stages of a terminal illness.

In a response published on the Micromedia web site, Pavanelli defended her core thesis, which is that during the two months prior to his death, John Paul II did not receive sufficient nourishment and did not employ the therapeutic tools normally applied to patients in his condition. Failure to do so, Pavanelli wrote, “cannot be explained by clinical motives.”

Some experts on the Italian scene believe Pavanelli’s article should be read against the backdrop of a burgeoning national debate in Italy over euthanasia, with the Catholic church playing the lead role among opponents of liberalization.

The most recent focal point for that debate was the case of Piergiorgio Welby, an advanced muscular dystrophy patient who became a national cause célèbre in 2006 when his agonized pleas to be removed from a respirator and allowed to die triggered a national examination of conscience. Welby died in December 2006, and the anesthesiologist who helped him disconnect the respirator was eventually acquitted of any criminal wrong-doing.

Welby’s case split Italy, and inevitably that means it split the Catholic Church. Some influential Catholics argued that Church teaching defends the right to life, but not always an absolute obligation to live, and that Welby should be allowed to make his own choice; on the other side were Catholics who believed that assistance with something as basic as breathing can never be considered “extraordinary,” and however much they respected Welby’s motives, they said he shouldn’t be allowed to kill himself. Moreover, they argued, Welby’s desires were not the only consideration. Society has an obligation, they said, not to promote death as a solution to difficult situations.

The latter camp included the powerful Cardinal Camillo Ruini, at the time the pope’s vicar for the Diocese of Rome and president of the Italian bishops’ conference. Ruini’s disapproval continued even after Welby’s death. When a Rome parish made plans for a funeral Mass for Welby, Ruini stepped in and refused permission. An outdoor secular ceremony was staged instead on Dec. 24, in a spot adjacent to the parish where the funeral was to have taken place, with some in the crowd of several thousand chanting “shame, shame!” at the Church. Welby’s 91-year-old mother declared: “They continue to insult him after his death.”

Suspicions that the Micromedia article had this Italian debate in mind were bolstered by the fact that the journal held a press conference today in Rome, featuring Pavanelli and Welby’s widow. Also present was Giovanni Franzoni, a former Benedictine priest and abbot of St. Paul Outside the Walls, who is a prominent progressive critic of Vatican positions.