Living Will

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mary_bobo

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I am not sure this is the right forum, but I would like to invite discussion on something that occurred today. I was attending an “inservice” at the hospice where I do volunteer work, and the breavement counsellor was on the agenda. She started out by handing out a living will (a jesting one) and related that last week she had spoken to a group at one of the Catholic churches in our city.

She said that she kind of expected some hard questions as the discussion was on living wills and that “this is one of the more conservative Catholic churches in town”. That description disturbed me. In moral theology, how can there be a conservative Catholic church and a liberal Catholic church?

I am sure that the discussion centered around end of life issues, and some of the practices in this area, almost euthanasia if you will, but I would like to discuss and center on the idea of a conservative Catholic church and a liberal Catholic church. Somewhere along the line we have fallen into heresy about some of the issues in the church. This brings to mind the discussion we are having elsewhere as to whether liberal Catholics should be driven from the church, or castigated in some way. And do you think these kinds of Catholics bring disfavor on the church?

How did we get in this dilemma?
 
In many cases, if not all, a parish is likely to be regarded as ‘liberal’ or ‘conservative’ depending on the attitudes and beliefs Parish Priest.

The reason for this is that many parishioners will vote with their feet and attend Mass in a different parish if what the priest is doing or saying is radically different to their own views.

Like draws to like, and until more of our bishops make a stand and require that their priests adhere to the teachings of the Church and the Magisterium, there is little we can do.

I have personally come up against a parishioner who was outspoken in her opinion that abortion was necessary in some cases and where the priest supported her to the point where he stopped advertising pro-life prayer vigils outside an abortion clinic.

It is a scandal.
 
I failed to mention that this hospice is owned by the Catholic hospital in my city. The bereavement coordinator at hospice was asked to speak about hospice and what it is and what it does. This is where the unpleasantness began–and while I agree with the comments of those who were opposed to hospice policy, I think the rude attacking of the speaker was not necessary to get the point across. This is some of what gives the church a bad name and I hate that.

I think that there was much discussion about how far to offer care to a dying patient and I agree with church teaching, however most of the patients who come to this particular hospice are Baptists who may or may not look at end of life issues the same way Catholics do. This is the dilemma that I am thinking about.
 
mary bobo:
In moral theology, how can there be a conservative Catholic church and a liberal Catholic church?

I am sure that the discussion centered around end of life issues, and some of the practices in this area, almost euthanasia if you will, but I would like to discuss and center on the idea of a conservative Catholic church and a liberal Catholic church. Somewhere along the line we have fallen into heresy about some of the issues in the church. This brings to mind the discussion we are having elsewhere as to whether liberal Catholics should be driven from the church, or castigated in some way. And do you think these kinds of Catholics bring disfavor on the church?

How did we get in this dilemma?
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rkberlin:
ok, don’t call me stupid, but we’re not supposed to have Living Wills?
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It’s probably better to give a health care power of attorney to someone you trust. Every medical situation is different. It’s not really possible to anticipate and give specific directions for everything that might come up. I’d much rather have a trusted individual make those decision based on the situation at the time.
 
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JimG:
It’s probably better to give a health care power of attorney to someone you trust. Every medical situation is different. It’s not really possible to anticipate and give specific directions for everything that might come up. I’d much rather have a trusted individual make those decision based on the situation at the time.
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I think you are generally better off with both a Living Will and a HCPA. The Church is very clear that it is morally Ok to refuse extraordinary measures to preserve life. The Church is also very clear that hydration and feeding are always ordinary measures. Beyond that, living wills are usually very useful to both the family and medical staff to record the wishes of the individual. Even with a HCPA a Living Will helps relieve some of the burden of deciding to “let Dad die.” The weird and unusual cases are just that - weird and unusual. The vast majority of cases they are a blessing to everyone involved. BTW in a dispute/difference between a LW and family members the usual response of the medical team is to take the course for life - or to go to court for an answer.
 
mary bobo:
I failed to mention that this hospice is owned by the Catholic hospital in my city. The bereavement coordinator at hospice was asked to speak about hospice and what it is and what it does. This is where the unpleasantness began–and while I agree with the comments of those who were opposed to hospice policy, I think the rude attacking of the speaker was not necessary to get the point across. This is some of what gives the church a bad name and I hate that.

I think that there was much discussion about how far to offer care to a dying patient and I agree with church teaching, however most of the patients who come to this particular hospice are Baptists who may or may not look at end of life issues the same way Catholics do. This is the dilemma that I am thinking about.
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A little bit off thread, but in what ways are people against the hospice concept?
 
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johnnykins:
I think you are generally better off with both a Living Will and a HCPA. The Church is very clear that it is morally Ok to refuse extraordinary measures to preserve life. The Church is also very clear that hydration and feeding are always ordinary measures.
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You just have to be careful what is in those forms. Many of the standard printed Living Wills made available do not make the distinction that food and water are always ordinary means.
 
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JimG:
You just have to be careful what is in those forms. Many of the standard printed Living Wills made available do not make the distinction that food and water are always ordinary means.
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Exactly. Once they are given ‘artificially’ through IV or a PEG, they are regarded as medical treatment which many feel can be withdrawn at the discretion of the doctors or the Court.

That’s what happened to Terri Schiavo, and why her husband fought so strenuously against having her helped to be fed by mouth.
 
Eileen T:
That’s what happened to Terri Schiavo, and why her husband fought so strenuously against having her helped to be fed by mouth.
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I’m still angry over what happened to her!! When did it become humane to deny food and water to a human (allowed in the highest court) and cruel (in most states and provinces of Canada punishable by law) to deny food and water to an animal!!!

I don’t think there’s anything wrong with having a Living Will provided it doesn’t allow any thing that goes against God.
 
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mikew262:
A little bit off thread, but in what ways are people against the hospice concept?
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Hospice is a facility for palliative care only. Many patients come in, days from death, and have nourishment and water withheld. I know that is against church teaching. But if the water and nourishment are done by IV, is that an extraordinary effort?

The thing that started this post, and my dilemma is that people outside the church refer to the conservative or liberal church. In other words, they believe that you can church shop and find one that will tell you what you want to hear. My opinion is that the church has doctrine and it is true. There is no conservative or liberal facets. Either it is a sin or it is not.
 
mary bobo:
Hospice is a facility for palliative care only. Many patients come in, days from death, and have nourishment and water withheld. I know that is against church teaching. But if the water and nourishment are done by IV, is that an extraordinary effort?

The thing that started this post, and my dilemma is that people outside the church refer to the conservative or liberal church. In other words, they believe that you can church shop and find one that will tell you what you want to hear. My opinion is that the church has doctrine and it is true. There is no conservative or liberal facets. Either it is a sin or it is not.
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I had a comment, but apparently it never made it through; you had asked how we got to the point of liberal and conservative.

However, to answer your question above, the answer is sort of yes and no; Church doctrine is a broad sweep, and often what we want and need is not a broad sweep, but a specific answer to a specific question.

Actually, without getting into an arguement of whether or not Moral Theology is under the area of doctrine, the answer is still the same; what people want is not a broad sweeping answer from Moral Theology, but a specific answer to a specific question. Sometimes Moral Theology has a specific answer, and sometimes it does not. This is especially true in some of the questions concerning medicine; the Church often has not reached a definitive answer.

That is where there may be a variance of opinion among theologians, and it is all too easy to paint the responses as “liberal” and “conservative” in the heat of battle, or the emotional upheaval of trying to find appropriate answers to serious, and often life and death, issues.

There is a medical ethics group, whose name escapes me at the moment, which is widely recognized as being true to the Magisterium, and can be turned to for answers. What must be kept in mind is that often people in the pew have the idea that everything is cut and dried in Moral Theology; that is simply not the case. More than occasionally, we have to find what may be an acceptable range of options that appear to be within the bounds of accepted Moral Theology, and then weigh and choose what option we feel is the correct one for us to make.

There is a tendency to want someone to make the tough decisions for us (and that is not to say that is an illegitimate desire), and a tendency to feel that the Church somehow has the answer to all our questions: if we just ask the question the right way, we will be told what we need. Many, if not most, are uncomfortable in areas that appear more grey than black and white. However, for whatever comfort there may be in the answer, a careful reading of the Gospels shows that Christ Himself tended to answer in some broad sweeps; in addition, He lived in a time and society (Judaism) that had very specific answers to a whole lot of living, and He was not above ignoring or violating some of those laws for a greater good. A prime example is the Gospel reading this last week for RCIA; John 4 shows Him first, going through Samaria, which most good Jews would avoid; second, He spoke to a woman in public who was not his kin, which no good Jew would do; third, he asked her for a drink; no good Jew would share a drinking vessel with a Samaritan woman, for they would then be ritually unclean.

None of that obviously rises to the level of a life and death issue; I only use it to show an example that Moral Theology is not as cut and dried as we may want.

So, to say there are no liberal or conservative facets is not exactly correct. A prime example is the issue of what is any longer an extraordinary intervention and what is an ordinary intervention. There are some areas that the Church has spoken on, but it is an area that can quickly become grey and foggy, as opposed to clear and black and white.
 
mary bobo:
Hospice is a facility for palliative care only. Many patients come in, days from death, and have nourishment and water withheld. I know that is against church teaching. But if the water and nourishment are done by IV, is that an extraordinary effort?
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Maybe a another thread should be started on this. However, I felt some clarification was needed, so people wouldn’t get the wrong idea about the hospice concept.

My wife was a hospice nurse for a couple of years, and I can tell you many a family personally thanked my wife and her hospice organization for making the transition to death as peaceful and painfree as possible for their loved one. There is nothing worse than watching somebody die in agony; a hospice can prevent this.

It is compassionate, comfort-oriented care for the dying with an emphasis on pain management, symptom control and emotional support for the patient and family. Hospice does nothing to speed up or slow down the death process.

As far as withholding food and water, that is only done at the patient’s wishes either directly or through a living will. The hospice does not make that call.
 
Hospice care is good. It is also helpful to the patient and family in obtaining pain medication for dying patients. Docs in ordinary practice may be reluctant to prescribe the dosage required for pain relief, but when hospice is involved, that is less of a problem. While no one desire to cause death through overmedication, it is permissible to prescribe the amounts needed for pain relief for dying patients.
 
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