Pope’s Death Is Drawn Into Euthanasia Debate

Vatican City - The debate over the Vatican’s opposition to euthanasia is being played out here over an especially public and delicate case: the death of Pope John Paul II.

Over the past week, the Vatican and an Italian doctor have sparred over the doctor’s accusation that John Paul should have been fitted earlier with a feeding tube. The doctor, Lina Pavanelli, an anesthesiologist, argued in a magazine article, then again this week in public, that the failure to do so before March 30, 2005, when the Vatican announced that John Paul had been fitted with a nasal feeding tube, deprived him of necessary care and thus violated church teachings on euthanasia. He died, at 84, on April 2 that year.

In an article in the magazine, Micromega, Dr. Pavanelli argued, “When the patient knowingly refuses a life-saving therapy, his action together with the remissive or omissive behavior of doctors, must be considered euthanasia, or more precisely, assisted suicide.”

She did not examine the pope or have access to his medical records.

So far, the Vatican has not presented a detailed response, but on Wednesday church officials quietly acknowledged that John Paul actually had the tube inserted several days before the March 30 announcement. His doctor, Renato Buzzonetti, told the newspaper La Repubblica last week that “his treatment was never interrupted,” though Dr. Pavanelli countered that John Paul should have been fitted with a more efficient abdominal feeding tube.

The pope suffered for many years from Parkinson’s disease, which can cause trouble with swallowing.

The accusation came as the Vatican restated its position on feeding tubes. Last week, a Vatican office described them as “an ordinary means of preserving life” that should be used even in cases of long-term deep coma where there is little hope for recovery. The Vatican does not approve of means it considers “disproportionate,” those involving a heavy burden and unlikely to save the patient.

That often means artificial respiration, but even that case is complicated. At a news conference on Wednesday, Dr. Pavanelli appeared by the side of the widow of Piergiorgio Welby, a writer who died last year after deciding to be removed from a ventilator that had kept him alive for nine years.

At the time, several church officials said that act amounted to euthanasia, and Mr. Welby was denied a church burial.