I just received a question from a family who is keeping watch over a loved one dying of cancer. After repeated efforts at chemo and radiation therapy, the doctors have told the patient and the family that there is nothing further which they can do for her therapeutically. Each day, their loved one advances closer and closer to the moment of death.
As is the common practice today, the hospital and the doctors have presented the patient and the family with alternatives related to end of life decisions which may have to be made in the very near future.
A life ending and painful illness is indeed an emotionally stressful time for the person who is dying and for the family members who wish to provide support, comfort and care.
In considering the Church's moral teaching regarding such issues, we need always remember that the dying person has a grace-filled opportunity to join his or her suffering to those of Christ Himself for the salvation of the world. Always and ever, the Christian person should consider and accept this redemptive value of suffering.
There come a moment, however, when the critically ill patient and the family may be faced with having to make a decision which will result in the death of their loved one. The Catholic Church makes clear distinctions between morally obligatory and morally optional means of preserving life.
Generally, one is obliged to receive and provide care which is considered routine and common practice with regard to one's medical condition. This is often referred to as the "ordinary means" of preserving life.
Again, generally speaking, medical treatments or procedures which offer little medical benefit or are excessively burdensome are not morally obligatory. These are commonly referred to as the "extraordinary means" of preserving life.
There remains a presumption, however, in favor of providing food and water to dying patients. Even so, there may come a time when even these are no longer obligatory since they will provide no benefit or become practically impossible to administer to the dying person.
In making such profound decisions about preserving life or hastening the moment of death, the patient and the family are to be provided with all the relevant information regarding one's medical condition as well as the predictable course of a treatment or procedure, its risks, its cost and any additional care requirements the treatment may necessitate.
When death is imminent, the patient or family in consultation with physicians, may morally refuse treatment which would only result in the painful prolongation of life. In these moments, it is advisable for the patient and the family to seek the counsel of their Pastor or a chaplain to help them in making an informed and morally acceptable decision.
Advanced Medical Directives and Durable Power of Attorney for Health Care documents can be of tremendous benefit when the patient can no longer direct the course of his or her treatment. The Durable Power of Attorney for Health Care is preferable to the Advanced Medical Directive since it leaves decisions to a person who knows what the patient would have wanted. Hospitals and doctors give great weight to these documents. Catholic hospitals should not enforce directives which are contrary to the moral teachings of the Church.
Certainly, the death of a loved one is the saddest and darkest of life's experiences. Yet, as Christians, we see death not as an end, but as a change, a passage to a new life. For those who die trusting in the loving mercy of God, that new life is in the eternal presence of Lord. We rejoice in our Catholic Faith as we pray for the dying and their families who may be faced with such terrible and challenging end of life decisions.
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