End of Life Questions

[Conservative]

I’ve been all around the block - and down the highway - searching for answers. Can anyone direct me to some sites - or where I might ask/get answers to end-of-life issues? I’m staunchly pro-life but was put in the position of making some decisions in recent months. No matter how much I relied on priests’ advice, in the end I was left with additional last-minute questions, and I don’t know if I made mistakes. Now, it’s haunting me.

I’m in a serious emotional dilemma and would appreciate anything you can refer me to. Even Pope John Paul II - though he was known to be dying - was given a nasogastric tube the day before he passed. A friend of mine has said that this was done as an example to countries who were pushing euthanasia. I’d thought the previous Pope didn’t want extraordinary means (although NG tube isn’t considered such ???)

So, how far is too far? How much is too much? And when is it not enough no matter what the doctors say? Medically, religiously, morally? Does anyone have some reference tools or answers for me?

 

[blessedtoo]

It would help to have more specifics but perhaps I can share a personal story with you that might shed some light.

When my brother-in-law was dying from a vicious lung/brain cancer, he weakened severely the last 8 days prior to his death. He had essentially stopped taking all food and water on his own and was slipping in and out of consciousness. We consulted with the doc and the Hospice nurses about feeding him through IV or tube. They told us this: when a patient is dying as he was, the body begins to shut down. The organs are no longer working as they should and hence, do not “need” food. Water could be administered through sponging the lips, but beyond that, watching his urine output through the catheter indicated his kidneys were shutting down. We were told that to attempt to “feed” him would cause more harm than good because his organs would not be able to process nutrition. This was clearly illustrated by the fact that the nurses had to disimpact his bowel, even though he had not been fed for days. Clearly, this was a most uncomfortable and painful condition for him to be in.

So, in this case, a feeding tube or IV would have actually prolonged his pain - not his life. Hope that helps.

 

[StCsDavid]

First of all, I am very sorry for your recent loss.

I would suggest you contact the National Catholic Bioethics Center for your question. This article from NCBC might address some of your questions.

I would also suggest that you give your anxiety over this matter to Christ. No doubt any action you took was done out of love for the person involved using the best information you had at the time.

 

[Scottgun]

First of all, I am very sorry for your recent loss.

I would suggest you contact the National Catholic Bioethics Center for your question. This article from NCBC might address some of your questions.

I would also suggest that you give your anxiety over this matter to Christ. No doubt any action you took was done out of love for the person involved using the best information you had at the time.

Good link and doc. Thanks.

 

[Conservative]

Thank you all - As for feeding tube, that had already become an issue with both patients. I’d consulted with my priest who researched for me, as well. I went with Church teachings and was not sorry about going with a feeding tube (though not NG). It saved two lives and kept them alive for more than a year in one case; less in the second.

As for “Bioethics” - I’d called one bioethics group during one of my sieges - and they gave me opposite advice of Church. I stuck with Holy Mother the Church. Again, I don’t know if Bioethics was the same group. But I thank you all. I wouldn’t wish it on anyone - but I guess we all face something.

 

[vern_humphrey]

I’ve been all around the block - and down the highway - searching for answers. Can anyone direct me to some sites - or where I might ask/get answers to end-of-life issues? I’m staunchly pro-life but was put in the position of making some decisions in recent months. No matter how much I relied on priests’ advice, in the end I was left with additional last-minute questions, and I don’t know if I made mistakes. Now, it’s haunting me.

I’m in a serious emotional dilemma and would appreciate anything you can refer me to. Even Pope John Paul II - though he was known to be dying - was given a nasogastric tube the day before he passed. A friend of mine has said that this was done as an example to countries who were pushing euthanasia. I’d thought the previous Pope didn’t want extraordinary means (although NG tube isn’t considered such ???)

So, how far is too far? How much is too much? And when is it not enough no matter what the doctors say? Medically, religiously, morally? Does anyone have some reference tools or answers for me?

I urge you to go to the Catechism:

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 inability 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 interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers 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 is a special form of disinterested charity. As such it should be encouraged.

If life is maintained solely through machines, and there is no chance of recovery, such treatment can be discontinued.

Food and water are not extraordinary measures and must be provided as long as they can be metabolized.

Pain killers can be administered in large doses to dying patients to permit them to die with dignity.

 

[HashemEchad]

I’ve been all around the block - and down the highway - searching for answers. Can anyone direct me to some sites - or where I might ask/get answers to end-of-life issues? I’m staunchly pro-life but was put in the position of making some decisions in recent months. No matter how much I relied on priests’ advice, in the end I was left with additional last-minute questions, and I don’t know if I made mistakes. Now, it’s haunting me.

I’m in a serious emotional dilemma and would appreciate anything you can refer me to. Even Pope John Paul II - though he was known to be dying - was given a nasogastric tube the day before he passed. A friend of mine has said that this was done as an example to countries who were pushing euthanasia. I’d thought the previous Pope didn’t want extraordinary means (although NG tube isn’t considered such ???)

So, how far is too far? How much is too much? And when is it not enough no matter what the doctors say? Medically, religiously, morally? Does anyone have some reference tools or answers for me?

Hello,

Very recently, I was in the exact same situation as you were.( I am not a Catholic but an observant Jew, so our views on these moral issues are identical for the most part.)

Three years ago when she was still healthy and alert, my mom had a Living Will drawn up. She did it in response to the Terri Schiavo situation, which really infuriated her.

My mom knew of my active involvement in the pro-life movement, and when she showed me her LW and the fact that she’d made me her power of attorney for it, I expressed concern because I knew I could never order that food and water be withheld: to me, that would be tantamount to starvation and murder. She knew of my position, but I filed the papers away and forgot about it, assuming she’d never wind up in such a situation.

Well…a few months ago, she had to go to the hospital. She was having trouble swallowing food, and was in the beginning stages of congestive heart failure.

Gradually she was unable to eat or drink normally, and the doctors told me they would be required by law to put in a feeding tube unless she had a LW that said otherwise. If they tried giving her food normally, it would go into her lungs and cause aspiration, which then would lead to what they called aspiration pneumonia and would bring about a faster, more painful death.

The doctors told me, “If your mom has a living will, we need to know NOW, and we need to have a copy NOW”. I’d been holding out up until then, not letting them know she had one because I was afraid they might use it to euthanize her. I didn’t understand how things worked with the terminally ill (what my mother now was), that the terminally ill do not require food and water, its part of the body’s natural method of shutting ITSELF down. In cases like that, putting in a feeding tube can actually cause more suffering, and can even cause infections that would make death happen faster and more painfully.

I was really scared, but gave the LW to them. I then went home and researched online, to find pro-life groups that could advise me what to do.

I found this really great one, which is affiliated with the American Life League, a Catholic 100% solid pro-life group:

hospicepatients.org

I called them, and they assured me that my mom was not being starved, that when a person is TERMINAL (which Terri Schiavo was NOT, btw), their body does not WANT food/water, the person actually loses desire for it because the body is working to SHUT ITSELF DOWN.

I consulted my rabbi about this; he said Jewish Law requires that a person be given food, water and oxygen, IF their bodies are able to metabolize food/water, but that it cannot be done if by doing so you would speed up their death or cause them great suffering. He said a dying person cannot even be moved if doing so would make their death happen faster. Much of what he said seems to be the Catholic view, too.

I had hospice bring my mother home to us because I wanted to be sure she was not being starved. I offered her food and water while she was here; she was able to drink some water from a lollipop type sponge the hospice provided us with, but I found when she did drink it, it got into her lungs and made her congested. So we had to stop. She stopped asking for it anyway.

We tried feeding her, but the food just sat on her tongue. We had to take it out or she would choke. I began to see that what they told me was true. A DYING person does not want to eat and cannot anyway most of the time.

My mom lived her final week with us, and she died on March 17th at 5 AM. I was by her side when she passed, because I’d been sleeping in the living room next to her hospital bed.

The day before she died, my rabbi came to visit her and assist her in saying Viddui (the Jewish prayer for repentence of sin, said on a person’s deathbed).

But also, because my mother had been raised a Catholic (though converted to Judaism when she was in her 20s), I also then called a Catholic priest to administer to her the Last Rites. I wanted to acknowledge everything she had been in her life. She was unconscious by the time the priest came, but still, I think on some level, she wanted what I did for her.

But I struggled with the same end-of-life issues you have, yet from a different religious viewpoint. If you ever feel the need to discuss this, or need someone to talk to, email me anytime at chana4hashem@yahoo.com

I’ll keep you in my prayers, I know how you feel right now!

 

[blessedtoo]

My mom lived her final week with us, and she died on March 17th at 5 AM. I was by her side when she passed, because I’d been sleeping in the living room next to her hospital bed.

The day before she died, my rabbi came to visit her and assist her in saying Viddui (the Jewish prayer for repentence of sin, said on a person’s deathbed).

But also, because my mother had been raised a Catholic (though converted to Judaism when she was in her 20s), I also then called a Catholic priest to administer to her the Last Rites. I wanted to acknowledge everything she had been in her life. She was unconscious by the time the priest came, but still, I think on some level, she wanted what I did for her.

But I struggled with the same end-of-life issues you have, yet from a different religious viewpoint. If you ever feel the need to discuss this, or need someone to talk to, email me anytime at chana4hashem@yahoo.com

I’ll keep you in my prayers, I know how you feel right now!

I am so sorry for the loss of your mama. You allowed her a dignified and loving departure from this earthly life. For me, it was a privilege to be in the presence of my brother in law as he passed away and the most profound experience of love I’ve ever had. I will keep you and your mama in my prayers. God bless you.

 

[HashemEchad]

I am so sorry for the loss of your mama. You allowed her a dignified and loving departure from this earthly life. For me, it was a privilege to be in the presence of my brother in law as he passed away and the most profound experience of love I’ve ever had. I will keep you and your mama in my prayers. God bless you.

Thank you so much for your words, and I agree, it is a beautiful thing when you can help a loved one (in your case, your brother in law) depart this life in peace ans security, at home, in familiar surroundings, close to family members they knew and loved.

I will be forever grateful that such a thing as hospice care exists. I know that if at all possible, that is how I want to pass into the next life.

 

[blessedtoo]

Thank you so much for your words, and I agree, it is a beautiful thing when you can help a loved one (in your case, your brother in law) depart this life in peace ans security, at home, in familiar surroundings, close to family members they knew and loved.

I will be forever grateful that such a thing as hospice care exists. I know that if at all possible, that is how I want to pass into the next life.

Agreed. After my experience with Hospice, I decided to become a volunteer myself. Unfortunately, although I did the training, I was unable to practice this ministry because of life circumstances getting in the way! But it’s always there when I need it.

 

[Conservative]

Hello,

Very recently, I was in the exact same situation as you were.( I am not a Catholic but an observant Jew, so our views on these moral issues are identical for the most part.)

Three years ago when she was still healthy and alert, my mom had a Living Will drawn up. She did it in response to the Terri Schiavo situation, which really infuriated her.
…
…The day before she died, my rabbi came to visit her and assist her in saying Viddui (the Jewish prayer for repentence of sin, said on a person’s deathbed).

But also, because my mother had been raised a Catholic (though converted to Judaism when she was in her 20s), I also then called a Catholic priest to administer to her the Last Rites. I wanted to acknowledge everything she had been in her life. She was unconscious by the time the priest came, but still, I think on some level, she wanted what I did for her.

But I struggled with the same end-of-life issues you have, yet from a different religious viewpoint. If you ever feel the need to discuss this, or need someone to talk to, email me anytime at chana4hashem@yahoo.com

I’ll keep you in my prayers, I know how you feel right now!

Thank you, Hashem -
And yes, I’ve learned our Faiths share many of the same beliefs in matters of morals.

As regards your experience and for everyone’s info - re Living Wills (LW) and Power-of-Attorney (POA): I’ve read that we are **not bound/not permitted **to carry out any part of LW that goes contrary to moral issues, such as if a LW requests ending a life - we are morally bound not to uphold that request, so I fully sympathize with what you went through. POAs can be rendered helpless, as well - I learned that when a doctor honored my mother’s “patient’s rights” versus the medical POA despite her having dementia. She refused treatment for infection - and was sent home. Two months later, she had sepsis.

My mother remained on feeding tube until the day before or her last day. While she’d been diagnosed with congestive heart failure the year previous, no congestion resulted until the end. When she suddenly rejected the feeding, I myself stopped it - it’s only common sense. Until then, she’d been fine. But the congestion remained, and Hospice had discontinued her earlier that year - so I had no oxygen. Calling a nurse, I was told oxygen wouldn’t help. I had no professionals there. Even her doctor, calling me about my father’s failing condition, didn’t come to see her telling me he was glad I was considering not hospitalizing her - To this day, I’m wondering if I made the wrong decision. I, too, knew she wouldn’t want to be on respirator (or intubation) and feared that might be the case. Making a similar decision upon my father’s passing - I’m left with two guilt trips - six months apart.

I must congratulate you on seeing to your Mother’s religious needs - on both the Judaic and Catholic side. It was a beautiful thing to do.

 

[HashemEchad]

Conservative,

About the LW and what the POA is required to do…I checked into that too.

My personal attorney is a very devout Catholic whom I know from my years of involvement in the pro-life movement. I asked him if I was dutybound by my mother’s LW, as her POA.

After reading her LW, he said she had one of the most specific ones he’d ever seen (it was crafted for her by her lawyer when we all still lived in NJ)…he said he never uses ones like that. He told me that the more specific it is, the harder it is to work around it. He said the vague ones are easiest to work around.

Her LW said that she did not want feeding tubes, etc even if her condition was not terminal! Knowing that, if her condition was NOT terminal and the doctors insisted on having a copy of her LW if she had one, I simply would have kept refusing to let them know she had one. I wouldn’t lie and say she did not have one; I would probably have found a way to use what you Catholics call mental reservation (!) I’m just glad it did not come to that, and since her condition truly WAS terminal, things worked out morally.

My lawyer told me that the LW forms he uses state that feeding tubes are to be avoided ONLY when the condition is terminal.

This is WHY Terri Schivao truly WAS starved to death: her condition was not terminal. If it had been, her own body would have refused food and water on its own.

So much of what you related about your mom fits my own situation too–they both had the same thing too: congestive heart failure.

I never, ever thought I’d be in such a situation, and I know you never thought you’d ever be either. I don’t know why God put us in these situations, but maybe because He knew we would do the moral and right thing, whereas others might not have.

Hold onto that thought, because you did the right thing. I think to help alleviate the guilt you feel, you need to consult a really good priest, one who preferably has done work in hospice care.

If you call a Catholic hospital near you, and ask for the chaplain’s office, they can direct you to a priest who has experience with end-of-life issues.

In addition, you should try to get ahold of Father Frank Pavone of Priests for Life. He is expert on these kinds of issues as they relate to Catholic theology.

I think this is their website: priestsforlife.org

 

[seekerz]

I believe if someone has truly sought to do what is moral and right, even if mistakes are made about end of life care, we should not feel guilty about them.

Those of us presently or in the future facing such situations need to be aware though that the push toward euthanasia is often not by outright suggestion, but by making some immoral decisions seem compassionate and commonplace.

There is nothing wrong in withholding feeding tubes/food in a terminally ill patient, but sometimes the decision regarding who is terminally ill is what is flawed. Terminal illness is being redefined in much the same way that pregnancy was redefined to begin at implantation rather than at fertilization. We need to be aware of this trend and guard against it. Relatives of the seriously ill are often overcome with emotion and fatigue and may more easily fall prey to seemingly merciful suggestions or may fail to question medical opinions.

Again, if a wrong decision is made regarding whether someone is terminally ill, the guilt lies not with the loved ones who are truly striving to do the right thing but with those whose agenda is to take euthanasia into the mainstream.

I have known for example, someone whose living will clearly stated a refusal of respirators. The person, quite healthy at the time, had a serious but easily treatable accident which required *** some hours ***on a respirator and which prevented her from making her wishes known. The wishes in the LW were followed to the letter, rather than the commonsense interpretation that she didn’t want to have her life prolonged artificially in a situation where there was no hope of recovery (this was far from being such a situation). Who knows whether at the time of making her living will, she was even aware that short-term situations such as hers could possibly arise?

Bottom line is, God will judge the intentions of our hearts. He expects us to use commonsense but some confusion (especially with today’s medical advances) is only natural and I don’t believe He will hold that against us.

 

[HashemEchad]

I believe if someone has truly sought to do what is moral and right, even if mistakes are made about end of life care, we should not feel guilty about them.

Those of us presently or in the future facing such situations need to be aware though that the push toward euthanasia is often not by outright suggestion, but by making some immoral decisions seem compassionate and commonplace.

There is nothing wrong in withholding feeding tubes/food in a terminally ill patient, but sometimes the decision regarding who is terminally ill is what is flawed. Terminal illness is being redefined in much the same way that pregnancy was redefined to begin at implantation rather than at fertilization. We need to be aware of this trend and guard against it. Relatives of the seriously ill are often overcome with emotion and fatigue and may more easily fall prey to seemingly merciful suggestions or may fail to question medical opinions.

Again, if a wrong decision is made regarding whether someone is terminally ill, the guilt lies not with the loved ones who are truly striving to do the right thing but with those whose agenda is to take euthanasia into the mainstream.

I have known for example, someone whose living will clearly stated a refusal of respirators. The person, quite healthy at the time, had a serious but easily treatable accident which required *** some hours ***on a respirator and which prevented her from making her wishes known. The wishes in the LW were followed to the letter, rather than the commonsense interpretation that she didn’t want to have her life prolonged artificially in a situation where there was no hope of recovery (this was far from being such a situation). Who knows whether at the time of making her living will, she was even aware that short-term situations such as hers could possibly arise?

Bottom line is, God will judge the intentions of our hearts. He expects us to use commonsense but some confusion (especially with today’s medical advances) is only natural and I don’t believe He will hold that against us.

This is a very vital point to remember, and one I should have mentioned as well, but forgot!

The DEFINITION of “terminal” is in fact being redefined, and we do need to be on guard against this.

When in doubt, always seek to consult with doctors, nurses, priests, rabbis, etc who are LIFE-AFFIRMING. There are organizations for this, such as Aguda Israel (for Orthodox Jews, who offer a free Halachic Living Will that does not violate Jewish Law), and the American Life League (Catholic), which offers a Loving Will, one that does not violate Catholic belief.

There is also an organization for Catholic doctors (I forget the name offhand but I see them mentioned sometimes in my pro-life travels), who would be a good resource to consult for these kinds of questions. I THINK they are called the Catholic Physician’s Guild, something like that.

One thing I do have to warn about, and this is sad for me to admit even though I’m not Catholic: my mother spent the last few weeks of her life (before hospice) in a Catholic hospital, and they often are not much different from the non-Catholic ones, despite what they say.

My mother’s doctor (Catholic) was very quick to sign the DNR for my mother, and to declare her “terminal”…I think she just wanted my mother out of there because her insurance was running out. I got my mom’s regular doctor to examine her as well, and to see if she truly was terminal before I’d let them move her to hospice.

And this same hospital, in 1992, did not want to give me the remains of a baby I’d lost because (they said), “Its just medical waste” (because the baby was “only” 10 weeks along)! I had to use my connections in the pro-life movement to get the Monsignor whose parish that hospital was in, to make them turn the remains over to me for burial! He was infuriated that they referred to my baby as “medical waste” and wanted to just thriow him out like so much garbage…but the rule in medical circles is that its not regarded as a “real” baby until 20 weeks (some states differ.)

You have to be VERY careful, even in hospitals that are called “Catholic”.

 

[Alexandra]

I am quite grateful for this thread. I lost both my mom and dad within 11 months of one another. (And in two weeks will be the second anniversary of her death) As I reflected back at my mom’s last few days, which were in the hospital, I questioned whether she had been given a feeding tube. I was beginning to feel guilty that I had failed her. These posts have helped me realize that I did nothing wrong. That feeding her would have been the wrong thing to do. My father also stopped eating the last week of his life. He agreed to a feeding tube then removed it the next day. I guess he knew best. So once again I thank everyone for their replies to the OP as this has helped me put to rest my fears.

 

[HashemEchad]

I am quite grateful for this thread. I lost both my mom and dad within 11 months of one another. (And in two weeks will be the second anniversary of her death) As I reflected back at my mom’s last few days, which were in the hospital, I questioned whether she had been given a feeding tube. I was beginning to feel guilty that I had failed her. These posts have helped me realize that I did nothing wrong. That feeding her would have been the wrong thing to do. My father also stopped eating the last week of his life. He agreed to a feeding tube then removed it the next day. I guess he knew best. So once again I thank everyone for their replies to the OP as this has helped me put to rest my fears.

Alexandra {{{{{{{HUGS}}}}}}, you have my deepest sympathies, I cannot even imagine how hard it must have been for you to lose both parents so close together like that.

God bless you, I’m glad this thread has helped you! I know it has helped me too.

 

[Conservative]

I am quite grateful for this thread. I lost both my mom and dad within 11 months of one another. (And in two weeks will be the second anniversary of her death) As I reflected back at my mom’s last few days, which were in the hospital, I questioned whether she had been given a feeding tube. I was beginning to feel guilty that I had failed her. These posts have helped me realize that I did nothing wrong. That feeding her would have been the wrong thing to do. My father also stopped eating the last week of his life. He agreed to a feeding tube then removed it the next day. I guess he knew best. So once again I thank everyone for their replies to the OP as this has helped me put to rest my fears.

I’m glad that some found peace through this thread. Hashem, your story re baby was so sad - and sadly, I think, not uncommon. I’m still upset, however - I also lost 2 parents in six months, but I was never given any “terminal” anything. Just suggestions of “do not hospitalize” based on kidney levels but without a specific “terminal” diagnosis. First, being told docs wouldn’t do dialysis based on age - then, in the E.R. I got sort of an option, and I was left dangling on another moral dilemma. Both parents were advanced in age (99 and 95) - and on that, it seems, people considered them “terminal”. I know I was concerned with what would be morally right to do at their ages (and neither would have wanted respirator, etc.). But I’m in agreement that respirators are very much for the purpose of a temporary aide. I even told a doc that they should be more blunt with family members. I was given non-answers or possibilities of things to do - (they’ll do almost any procedure) — but in such a way as to leave me without explanations of outcomes (would they/wouldn’t they come off machines, etc. – would/wouldn’t treatments work?). That’s why I’m left with “should I or shouldn’t I have done more?” In a Catholic hospital, I was once told I “can’t keep bringing her back” after Mom had just bled out at home. ???

Left in limbo over my decisions and God’s opinion of me - perhaps will be for a long time - I wouldn’t have hurt them for the world.
But glad someone received beneficial results from this thread.

 

[HashemEchad]

Conservative,

I’ll be getting back to you ASAP, things have been hectic offline and I have not been able to be online much.

I think it might really do you good in the meantime to consult a really good Catholic priest, preferably one who is both active in pro-life work and hospice work as well.

Maybe he will be able to give you some peace of mind over this?

 

[blessedtoo]

Conservative,

I’ll be getting back to you ASAP, things have been hectic offline and I have not been able to be online much.

I think it might really do you good in the meantime to consult a really good Catholic priest, preferably one who is both active in pro-life work and hospice work as well.

Maybe he will be able to give you some peace of mind over this?

I agree. Conservative, it is SO clear that you did everything to help your mom and dad. Even if there were oversights or unclear decisions, it sounds as though you were seeking to do God’s will, which is all any of us can strive for. Talk to a good priest. You should find comfort there.

 

[saylo]

If a patient is proven to be “brain dead” that is tantamount to death. No artificial life support is necessary or even prolonged.