Seeking new and effective ways to alleviate suffering is a valid quest, but suffering nevertheless remains a fundamental fact of human life. In a way it is as deep as man himself and touches upon his very essence (cf. Salvifici Doloris, 3). Medical research and treatment neither wholly explain nor fully overcome suffering. In its depth and its many forms it needs to be considered from a perspective which transcends the merely physical.

The various religions of humanity have always sought to answer the question of the meaning of suffering, and they recognize the need to show compassion and kindness towards all who are suffering. Thus religious convictions have given rise to systems of medicine to treat and cure diseases, and the history of various religions tells of organized health care of the sick practiced from very ancient times. Even though the Church finds much that is valid and noble in non-Christian interpretations of suffering, her own understanding of this great human mystery is unique. In order to discover the fundamental and definitive meaning of suffering "we must look to the revelation of divine love, the ultimate source of the meaning of everything that exists" (Salvifici Doloris, 13).

The answer to the question of the meaning of suffering has been "given by God to man in the Cross of Jesus Christ" (ibid., 13). Suffering, a consequence of original sin, takes on a new meaning; it becomes a sharing in the saving work of Jesus Christ (cf. Catechism of the Catholic Church, 1521). Through His suffering on the Cross, Christ has prevailed over evil and enables us too to overcome it. Our sufferings become meaningful and precious when united with His. As God and man, Christ has taken upon Himself the sufferings of humanity, and in Him human suffering itself takes on a redemptive meaning. In this union between the human and the divine, suffering brings forth good and overcomes evil.

Faith teaches us to seek the ultimate meaning of suffering in Christ's Passion, Death and Resurrection. The Christian response to pain and suffering is never one of passivity. [Pope John Paul II - The Christian Response to Suffering ,Women for Faith & Family, online, http://www.wf-f.org/02-1-ChristianSuffering.html, 2008]

The words or message, "quality of life", which first appeared in a political document (a speech by United States President Johnson, who succeeded John Kennedy as President), permeated Western cultures as a political and financial ideal deemed sound for peaceful, powerful societies, capable of producing the means not only to satisfy their basic needs but also those that aspired to "well-being": social security, health care, the enjoyment of their wealth, the improvement of the ecological environment and the satisfaction of a certain number of desires. After satisfying their needs, people affirmed the urge to satisfy their desires; however, these have no predetermined limit.

This change gave rise in turn to a corollary: the human being who does not possess the desired minimal "quality" does not deserve to be kept alive, hence, the proposal of eugenic parameters for the purpose of selecting those who do deserve to be accepted or kept alive and those who are to be abandoned or suppressed via euthanasia.

Self-awareness and the capacity for relating, that is, the "signa personae", without which the person himself would not exist, have often been proposed among the features that connote the minimum quality of a life held to be worth living. This is how it is, for example, in neo-contractual thought.
Such an ideal conception of "quality of life" thus inevitably challenges the more traditional concept of the "sanctity of life", misinterpreted as biological vitalism. This has also given rise to contraceptive programs: happiness means few, for quantity is the enemy of quality. [H.E. Mons. Elio Sgreccia, Quality of Life and the Ethics of Health, Women for Faith & Family, online, http://www.wf-f.org/PAL_QualityLife.html, 2008]

It is necessary first of all to recognize the essential quality that distinguishes every human creature as that of being made in the image and likeness of the Creator himself. The human person, constituted of body and soul in the unity of the person - corpore et anima unus, as the Constitution Gaudium et Spes says (n. 14) -, is called to enter into a personal dialogue with the Creator. Man therefore possesses a dignity essentially superior to other visible creatures, living and inanimate. As such he is called to collaborate with God in the task of subduing the earth (cf. Gn 1: 28), and is destined in the plan of redemption to be clothed in the dignity of a child of God.

This level of dignity and quality belongs to the ontological order and is a constitutive part of the human being; it endures through every moment of life, from the very moment of conception until natural death, and is brought to complete fulfillment in the dimension of eternal life. Consequently, the human person should be recognized and respected in any condition of health, infirmity or disability.

Consistent with this first, essential level of dignity, a second, complementary level of quality of life should be recognized and promoted: starting with the recognition of the right to life and the special dignity of every human person, society must promote, in collaboration with the family and other intermediate bodies, the practical conditions required for the development of each individual's personality, harmoniously and in accordance with his or her natural abilities.

All the dimensions of the person, physical, psychological, spiritual and moral, should be promoted in harmony with one another. This implies the existence of suitable social and environmental conditions to encourage this harmonious development. The social-environmental context, therefore, characterizes this second level of the quality of human life which must be recognized by all people, including those who live in developing countries. Indeed, human beings are equal in dignity, whatever the society to which they may belong.

It is certainly not easy to define in logical or precise terms a concept as complex and anthropologically rich as that of health. Yet it is certain that this word is intended to refer to all the dimensions of the person, in their harmony and reciprocal unity: the physical, the psychological, and the spiritual and moral dimensions.

The latter, the moral dimension, cannot be ignored. Every person is responsible for his or her own health and for the health of those who have not yet reached adulthood or can no longer look after themselves. Indeed, the person is also duty bound to treat the environment responsibly, in such a way as to keep it "healthy".

Health is not, of course, an absolute good. It is not such especially when it is taken to be merely physical well-being, mythicized to the point of coercing or neglecting superior goods, claiming health reasons even for the rejection of unborn life: this is what happens with the so-called "reproductive health". How can people fail to recognize that this is a reductive and distorted vision of health?

Properly understood, health nevertheless continues to be one of the most important goods for which we all have a precise responsibility, to the point that it can be sacrificed only in order to attain superior goods, as is sometimes demanded in the service of God, one's family, one's neighbor and the whole of society.

Health should therefore be safeguarded and looked after as the physical-psychological and spiritual balance of the human being. The squandering of health as a result of various disorders is a serious ethical and social responsibility which, moreover, is linked to the person's moral degeneration. [Pope JOHN PAUL II, ON "QUALITY OF LIFE AND ETHICS OF HEALTH" 3,4,6,7, Women for Faith & Family, online, http://www.wf-f.org/JPII_QualityLife.html, 2008]

With deep esteem and sincere hope, the Church encourages the efforts of men and women of science who, sometimes at great sacrifice, daily dedicate their task of study and research to the improvement of the diagnostic, therapeutic, prognostic and rehabilitative possibilities confronting those patients who rely completely on those who care for and assist them. The person in a vegetative state, in fact, shows no evident sign of self-awareness or of awareness of the environment, and seems unable to interact with others or to react to specific stimuli.

Scientists and researchers realize that one must, first of all, arrive at a correct diagnosis, which usually requires prolonged and careful observation in specialized centers, given also the high number of diagnostic errors reported in the literature. Moreover, not a few of these persons, with appropriate treatment and with specific rehabilitation programs, have been able to emerge from a vegetative state. On the contrary, many others unfortunately remain prisoners of their condition even for long stretches of time and without needing technological support.

In particular, the term permanent vegetative state has been coined to indicate the condition of those patients whose "vegetative state" continues for over a year. Actually, there is no different diagnosis that corresponds to such a definition, but only a conventional prognostic judgment, relative to the fact that the recovery of patients, statistically speaking, is ever more difficult as the condition of vegetative state is prolonged in time.

However, we must neither forget nor underestimate that there are well-documented cases of at least partial recovery even after many years; we can thus state that medical science, up until now, is still unable to predict with certainty who among patients in this condition will recover and who will not.

Faced with patients in similar clinical conditions, there are some who cast doubt on the persistence of the "human quality" itself, almost as if the adjective "vegetative" (whose use is now solidly established), which symbolically describes a clinical state, could or should be instead applied to the sick as such, actually demeaning their value and personal dignity. In this sense, it must be noted that this term, even when confined to the clinical context, is certainly not the most felicitous when applied to human beings.

In opposition to such trends of thought, I feel the duty to reaffirm strongly that the intrinsic value and personal dignity of every human being do not change, no matter what the concrete circumstances of his or her life. A man, even if seriously ill or disabled in the exercise of his highest functions, is and always will be a man, and he will never become a "vegetable" or an "animal".

Even our brothers and sisters who find themselves in the clinical condition of a "vegetative state" retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as His sons and daughters, especially in need of help.

Medical doctors and health-care personnel, society and the Church have moral duties toward these persons from which they cannot exempt themselves without lessening the demands both of professional ethics and human and Christian solidarity.

The sick person in a vegetative state, awaiting recovery or a natural end, still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention of complications related to his confinement to bed. He also has the right to appropriate rehabilitative care and to be monitored for clinical signs of eventual recovery.

I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.

Considerations about the "quality of life", often actually dictated by psychological, social and economic pressures, cannot take precedence over general principles.

First of all, no evaluation of costs can outweigh the value of the fundamental good which we are trying to protect, that of human life. Moreover, to admit that decisions regarding man's life can be based on the external acknowledgment of its quality, is the same as acknowledging that increasing and decreasing levels of quality of life, and therefore of human dignity, can be attributed from an external perspective to any subject, thus introducing into social relations a discriminatory and eugenic principle.
Moreover, it is not possible to rule out a priori that the withdrawal of nutrition and hydration, as reported by authoritative studies, is the source of considerable suffering for the sick person, even if we can see only the reactions at the level of the autonomic nervous system or of gestures. Modern clinical neurophysiology and neuro-imaging techniques, in fact, seem to point to the lasting quality in these patients of elementary forms of communication and analysis of stimuli.

[Pope John Paul II, ON "LIFE-SUSTAINING TREATMENTS AND VEGETATIVE STATE:SCIENTIFIC ADVANCES AND ETHICAL DILEMMAS" 3, 4, 5, Women for Faith & Family, online, http://www.wf-f.org/JPIILifeSustaining0304.html, 2008]