As Terry Schiavo was clinging to life in a Pinellas Park hospice, two Florida bishops have written to their dioceses offering moral guidance and presenting questions about ethics and the law at the end of life.

In an Easter pastoral to the Diocese of Southeast Florida, the Rt. Rev. Leo Frade wrote Floridians were “challenged by the reality of death in the suffering of a family facing the death of their spouse, daughter and sister. Terri Schiavo is our neighbor, a fellow-Floridian, and our sister in Christ.”

Recounting the medical and legal rationale that led to the court-ordered withdrawal of food and water from Mrs. Schiavo, Bishop Frade expressed his sympathies, writing he had “encountered such a tragic and painful moment myself, at the deathbed of my comatose mother, when my sister and I were forced to decide whether to continue care or to accept our mother’s condition as irreparable.”

Christians, he wrote, must hold firm to the “belief in the sanctity of each human life as a cherished creation of God, but we must reject an attitude that disregards the inevitability of physical death. Our Easter faith assures us that the death of the body is not the end of life.”

Endorsing the decisions of the 1991 General Convention on euthanasia (AO93), he rejected the practice as being contrary to Christian teaching, but noted “there is a difference between allowing a terminally ill person to die of natural causes, even by withholding or withdrawing of heroic and extraordinary life-sustaining treatments, and the initiating of actions that will cause someone’s death. I believe that allowing death to take its course is morally appropriate when death is inevitable and will obviously be the natural outcome.”

Bishop Frade criticized the intervention of the United States Congress in the Schiavo case, saying, “the family should be the proper context for decision-making in this type of determination, and that the government should not intrude in even a surrogate role.”

The courts and not the legislature, he argued was the “proper vehicle” to safeguard individual rights as “the intrusion by politicians is extremely inappropriate.”

Bishop Frade urged the clergy to encourage their parishioners “to provide for advance written directives concerning medical treatment and durable powers of attorney, setting forth medical declarations that make known a person’s wishes concerning the continuation or withholding or removing of life sustaining systems.”

In a letter to his clergy written on Good Friday, the Rt. Rev. John W. Howe wrote that he had been criticized for not having commented previously on this current American tragedy. “I have been damned and threatened with hell-fire,” he wrote, “because I have not spoken out on behalf of ‘saving Terri’s life.’”

Noting “the vast majority of Americans say they would not want their lives prolonged if they faced the circumstances Terri faces,” Bishop Howe, a past president and chairman of the board of NOEL, the National Organization of Episcopalians for Life, stated “my sympathies are overwhelmingly on the side of life — for the very young, the very old, and those who at every stage of life cannot defend themselves.”

The courts, he wrote, “have declined to intervene or command the reinsertion of her feeding tube. This is not because of an ethical consideration on their parts but because of legal considerations.”

“Terri’s gift to this nation could be,” Bishop Howe wrote, “that we explore in the fullest detail the numerous ethical and legal questions that her case, and thousands of cases like it, raise.”

Noting his unease with the roll of Mrs. Schiavo’s husband and the conflict within her family, Bishop Howe asked, “how do we decide who makes life-and- death decisions for a deeply disabled person? If there is the kind of ambiguity we see in Terri’s case, shouldn’t we always come down on the side of life?”

Absent a living will, how do we determine a person’s wishes regarding end-of-life issues?” Bishop Howe asked. And “if the decision becomes not to sustain (artificially) life, how do we best ensure that death will be as painless as possible?”

The 1998 Lambeth Conference addressed several of the issues raised by the Schiavo affair. Conference Resolution 1.14 defined “euthanasia” as “the act by which one person intentionally causes or assists in causing the death of another who is terminally or seriously ill in order to end the other’s pain and suffering.”

“Euthanasia”, the bishops noted, “is neither compatible with the Christian faith nor should be permitted in civil litigation.”

In subsection D of the resolution they wrote the conference “distinguishes between euthanasia and withholding, withdrawing, declining, terminating excessive medical treatment and intervention, all of which may be consistent with Christian faith in enabling a person to die with dignity. When a person is in a permanent vegetative state, to sustain him or her with artificial nutrition and hydration may be seen as constituting medical intervention.”

In a bow to the rapid increases in medical knowledge the bishops chose not to define what a “permanent vegetative state” was.