Advance Directives

[JCPhoenix]

Here is my dilemma:

I am listed on my friend’s Advance Directive. She is not Catholic, and to my knowledge does not believe in Euthanasia. She called me yesterday as she is updating her paperwork and wanted to be sure I was still willing to “stand up” for her. I agreed.

However, I did start thinking after I agreed; I can’t remember what is in the document, although I think it did revolve around dying with dignity. She is a social worker, has worked in different nursing homes and is terrified of “heroic measures” when it is really just her time to go.

Case in point: A woman at a nursing home had simply stopped eating. She had a terminal illness (in addition to age-related issues) and the family was trying to do everything. At the time they had her on IV feedings to sustain her. When my friend met with the family and discussed ongoing treatment, the family really wanted to do everythign to keep this woman alive. Hoewver, my friend suggested that maybe her absolute refusal to eat (she was conscious and willfully refusing food, had expressed readiness to die) was a “sign” that she was ready to go. The family persisted and as there was no Advance Directive, they went on treating her. She had a prolonged death and my friend did not feel right about it. She does not want to be in the same position.

She has family, but does not trust her family for many reasons. Example here: her mother would be the living kin. She related a fairly recent experience in which her mother had come to visit her. En route from poitn A to point B in a snowstorm in the Twin Cities area, my friend and her mother witnessed an accident…a pickup rollover involving what appeared to be at least 4 people total in the vehicle. She knew she could not safely stop in traffic so asked her mother to get her cell from her purse, dial 911 and hand the phone over. Her mother simply looked at her and told her, “You know, H, you can’t save everyone.”

Needless to say, my friend does not have trust for this woman who gave her life. She really needs me.

So! Is it OK for me to be listed on her Advance Directive? I know I need to review it again, but is there any Catholic teaching that suggests that as she is non-Catholic I should not be a part of this? I would hope to be a friend to her and she feels that I would stand up to her family with respect to her wishes, especially given the knowledge I have gained of the healthcare system.

Sorry for the essay, but I want to be sure respondents understand where I am coming from. I am sure others have similar questions in this vein or other aspects of the same question.

 

[jennstall]

I would think refusing to eat when you are capable of feeding yourself is a form of suicide. IV feeding is not considered a heroic measure by the Catholic Church. You should probably talk to your friend to determine the parameters of what she expects from you.

 

[Grayton]

Whether she is Catholic or not, the question is whether or not you are willing to carry out her intentions. If she wants you to direct medical professionals in a way that is incompatable with Catholic teaching and your conscience, then it would be better if you decline.

On the other hand, if she is not asking you to violate the Church’s teaching on end-of-life issues, then it would be an honorable thing to do for your friend.

 

[Listener]

jennstall:

I would think refusing to eat when you are capable of feeding yourself is a form of suicide. IV feeding is not considered a heroic measure by the Catholic Church. You should probably talk to your friend to determine the parameters of what she expects from you.

I think it is different when people are old and ready to go. Refusing to eat is not a form of suicide. I believe that when the body is ready to shut down, the last thing a person wants is food. I watched my parents waste away and slowly die in a nursing home. This was a Catholic nursing home, and they asked my Dad to sign a paper stating whether or not he wanted a feeding tube. He chose not to have one. He was still capable of eating, but he only ate a few bites, and it was impossible to get him to eat more. Water is even a more complicated question. When he got dehydrated, I made the doctor give him water through a tube. A few weeks later, the doctor called and said that he had to remove the tube because his body was getting water-logged, and his kidneys weren’t processing the water. He was still capable of drinking…he just wasn’t doing it. He actually lived another four months after the doctor removed the water tube. I had a friend whose Dad was in a nursing home on a feeding tube for about five years. They actually had to remove the tube and watch him die - it was because his blood vessels were no longer capable of supporting a feeding tube. It is very difficult to make these kind of decisions if you are not trained as a doctor or a nurse. Some of these decisions are medical rather than moral. I realize that the Pope recently stated that a feeding tube is not extraordinary, but I don’t think he meant that we were supposed to force-feed an old person whose body is shutting down. I could be wrong about this, so maybe an apoligist will see this and give us some answers.

 

[JCPhoenix]

I believe that dying with dignity is both understanding that the time is at hand and letting go. Unfortunately, it is very difficult for some people to let others go…especially if they don’t have a belief in God and the afterlife.

My friend is very conflicted when it come to religion so I do ask all of you to pray for her. However, she has seen suffering and I think all she really wants is to have a dignified death without unnecessary prolongment. (that’s not a word, I just made it up).

Anyway, it’s true that the body really does just shut down…and force feeding can prolong a life that is really over…and a person struggling to die. We should allow them to go home to God then rejoice when they finally do so. Of course this is against our emotions, but just the same…well…is it really better to force life when the time has truely come?

I hope to be able to represent her well and consider it an honor that she would literally put her life in my hands. But it is an awesome responsibility, and with it, if I make wrong decisions I won’t be answering to her but to God.

I also realize that I also am in the position in which I may be able to gently influence her if she does have moral issues in her directive…but doing so would be difficult.