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Food for
thought
PRAISED BE JESUS
CHRIST!
(Now and Forever)
Many of my readers will remember the sad case of Terri Schiavo, who died
in 2005. She was a severely brain-damaged woman who could breathe on her
own, but who had been kept alive 15 years by a feeding tube. Her
estranged husband wanted the tube removed. Her parents did not. A legal
battle ensued. Eventually the tube was removed and she died.
The Schiavo case focused attention on hydration and nutrition.
Palliative care is the broader issue, that is, the broad range of
end-of-life challenges.
The position of the Catholic Church is explicated in its catechism.
Number 2278: “Discontinuing medical procedures that are burdensome,
dangerous, extraordinary or disproportionate to the expected outcome can
be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one
does not will to cause death; one’s ability to impede it is merely
accepted. The decisions should be made by the patient if he is competent
and able or, if not, by those legally entitled to act for the patient,
whose reasonable will and legitimate interest must always be respected.”
Number 2279 reads: “Even if death is thought imminent, the ordinary care
owed to a sick person cannot be legitimately interrupted. The use of
pain-killers to alleviate the sufferings of the dying, even at the risk
of shortening their days, can be morally in conformity with human
dignity if death is not willed as either an end or a means, but only
foreseen and tolerated as inevitable. Palliative care … should be
encouraged.”
If you or a member of your family has been admitted to a hospital
recently, you probably are aware that the issue of health-care
directives is raised upon admittance. Do you have a living will? Have
you appointed a health-care representative? Does anyone have durable
power of attorney? To whom do you wish medical information to be
released?
Because I have been hospitalized several times in recent years, these
questions have been put to me. Having encouraged others to execute
health-care directives, I have had to admit I had not done that myself.
It’s one of those details we let slip quite easily. Nonetheless, in this
day and age, legal documents that give instruction for future
health-care decisions are important.
The Aug. 19 issue of The Catholic Moment reported an Indiana
Catholic Conference initiative on health-care directives. Perhaps you
took note.
The Indiana Catholic Conference serves as the voice of the five dioceses
of the state of Indiana at the Statehouse on matters of public policy.
Glenn Tebbe is its executive director. The board is composed of the five
diocesan bishops of the state, plus a lay representative from each
diocese. Joseph Rice, a member of St. John the Baptist Parish in Tipton,
is the lay representative from this diocese.
Because health-care directives are an important issue, the Indiana
Catholic Conference researched and has now issued a guide which it hopes
will push people like me to execute appropriate documents. This
health-care guide has been sent to each of our parishes and can be
viewed and downloaded for personal use or parish discussion from the
ICC’s Web page: www.indianacc.org. Click the “Resources” button on the
left to view the statement.
The 10-page booklet has a question-and-answer section. For example:
“What is a ‘health-care directive’ or an ‘advance directive’?” “Why
would I want a health-care directive?” “What happens if I don’t have a
health-care directive?” “Do I need to use a special form?” “Do I need a
lawyer?” etc.
It then presents ethical principles. This section is most helpful, in my
judgment. It outlines the fundamental principles that should guide a
Catholic faced with end-of-life decisions. For example, there should be
a presumption in favor of providing nutrition (food) and hydration
(water). Providing nutrition and hydration is considered ordinary care,
as long as the means of supplying food and water are relatively simple
and, barring complications, without pain and of benefit to the
individual.
Sometimes this may not be the case, so nutrition and hydration are not
required in all situations, for example, when a person is no longer able
to assimilate nourishment.
In my living will declaration, I have directed that “I do wish to
receive artificial nutrition and hydration unless these cannot be
assimilated by my body or cannot be administered without causing
significant physical discomfort.” In doing so, I acknowledge that the
cause of death should be the pathology or illness from which I am
suffering and should not be due to a lack of nutrition or hydration.
This conforms with the recent Vatican declaration (Aug. 1, 2007) on
nutrition and hydration.
The ethical principle section of the ICC guide explains the difference
between ordinary or proportionate means of preserving life and
extraordinary or disproportionate means. Medical personnel and ethicists
often use these terms.
The ethical section of the guide urges the appointment of a health-care
representative for the future patient who shares his beliefs or, at
least, who sincerely intends to respect those wishes. The burden on the
future patient is to spend time with that person discussing basic values
and attitudes and any specific wishes. Family members also need to
understand that a health-care representative has been named and why that
person has been chosen.
The guide also provides a helpful suggestion relative to spiritual
needs. It urges that when individuals enter a health-care facility or
hospital, that they state that they are Catholic and want to have a
priest or lay minister care for their spiritual needs. If the patient is
not able to communicate that information personally, it should be
provided by the health-care representative.
It is also important that a person’s parish be informed of the patient’s
wishes. For example, a person can request within their health-care
directive that the sacraments of reconciliation, anointing and Eucharist
as Viaticum be made available to them.
Finally, a tear-out sample of an Indiana Catholic health-care directive
is included in the guide. While a person might wish to discuss their
directives with legal counsel, the tear-out itself can be used as a
legal, Catholic faith-based advance directive.
All this is intended to be informative and, at the same time, to be a
practical help for Catholics who, like me, have been dragging their feet
when it comes to executing health-care directives.
It’s worth your consideration. |
