Over the past two weekends I have tried to communicate to you all the importance of making your own funeral arrangements “in the living years” as a compassionate way of lightening the burden on future survivors. This is as important as drawing up a will, purchasing life insurance or even telling family and friends regularly that you love them while you are still around and able to do so. One other thing that you can do though for both your loved ones and yourselves is to fill out an advanced medical directive. Because we all face the possibility that our own death, by God’s design, might be long and drawn out rather than sudden or in our sleep it would be wise of us to inform our loved ones of the extent of medical care we wish to receive during our final days should that happen. What I am suggesting is not opening the door to physician assisted suicide/euthanasia or in any other way, shape or form trying to take the place of God in determining the timing of our death. God alone is the author of life and God alone has the authority to determine its ending. However, one decision the Church leaves up to each of us as individuals is how much extraordinary medical care we are willing to undergo in our attempt to exercise proper stewardship in preserving the gift of life we have received. Within the limits of medical advancements, financial resources, Christian ethics and the laws of nature we may choose to exhaust all options available to us but we are also allowed to refrain from extraordinary care altogether, if we prefer, in favor of the dignity of a natural death. Advanced medical directives are designed to informed medical professionals of how far we wish to go in extending our life. Here are some things we should consider under this umbrella of Catholic medical ethics around end of life issues:
- We do not consider food and water extraordinary medical care unless the specific medical condition we face as a result of our advanced terminal condition has caused our digestive processes to shut down. Withholding nourishment from patients who can process it is, in my view, a cruel form of euthanasia and a hastening of the dying process that we as Catholics are not allowed to undertake. However, forcing nourishment on a patient who cannot process it is equally cruel and can cause further pain and medical complications. Each medical case must be weighed to make that determination.
- The use of experimental treatments and/or machinery which aids in such bodily functions as breathing or heart function long-term is considered extraordinary care and can be refused with a clear conscience. Pope John Paul II made it clear to those who looked after him that he did not wish to have any extraordinary care in his final battle with Parkinson’s Disease, for example, and he is about to be canonized a saint later this year. Unplugging a respirator for a person in a persistent vegetative state is not killing them in the eyes of the Church but is instead allowing them to die a natural death with dignity
- This brings me to the next point. The so-called “Death with Dignity Act” is anything but that and it is evil. Under no circumstances is a practicing Catholic permitted to make use of this form of legalized, physician-assisted suicide. This law on the books in the state of Oregon states that when a patient is judged by two doctors to be terminally ill with six months or less to live they are legally entitled to purchase from a local pharmacy a lethal pharmaceutical cocktail that, when consumed, will bring about their death. As Oregonians, we may be legally entitled to follow this path but we are never morally entitled to do so. There are so many things wrong with this law that it will require me to address it with a full article of its own in the future. Suffice it to say for now that, as Catholics, we see a value in human suffering. We work to alleviate what we can but with the suffering that remains, we help to complete the sufferings of Christ in our own bodies as St. Paul said. We offer it up as powerful prayer for the salvation of the world and, thereby, more deeply conform ourselves to Christ on the cross.
- When it comes to alleviating the suffering that can be avoided, we are permitted to make use of medications for pain management during or own decline or in the care of other terminally ill patients. We are even permitted their aggressive use in cases of terminal illness where that same pain medication might speed up the dying process, as long as the administering of this pain medication is for the express use of pain reduction and not the specific purpose of the hastening of death.