Living wills, resuscitation, honoring wishes, and church position

[stringbeanduck]

Hello every one. I’ve been instructed to find out everything about what I described in the title and would like some help and advice. My questions are:

If a friend or relatives requests not to be resuscitated or given any medical help in case where they are unable to make any of these decisions, should we honor these requests? For example if my friend or relative says, “If I my heart stops or breathing ceases DO NOT revive me,” where does the church say our moral obligation lies? If I see him/her passed out and not breathing and/or heart stopped, do I let them die? Personally I would probably help them. Naturally it would seem wrong not to.

What about us? If I were to (God forbid) come down with cancer and didn’t want chemo, radiation therapy because I didn’t want to suffer the affects of it, would be considered suicide if I were to die? Are we required to take every means necessary to prolong our life?

So where does the church stand in all this? What is our moral obligation when it comes to peoples wishes? Thank you very much.

 

[Toribus]

The Church has long drawn the (very basic) distinction between [1] actively causing death and [2] allowing death to follow its natural course.

With this in mind, let me say simply that no, we are not by any means obligated by divine law to find any means necessary to prolong our life. After all, we were not made for this world but the next!

Allowing a positively terminal illness to take its course (rather than undergoing the added suffering of treatment which would only prolong the time spent waiting for death) is not a moral imperative. However, it cannot be stressed enough that the choice lies squarely with the suffering individual.

If (God forbid) you were to develop terminal cancer and wished to accept death sooner rather than undergo long and debilitating treatment, the choice is yours. If you wished to suffer the treatment for the sake of a few more weeks, months, years with your family, the choice is again yours.

 

[arussell17]

Toribus, where are you getting your information on the church’s distinction between active and passive death ? I agree with you but our Pastor has said you must never go to what promotes death and applies this to do not resusitate too. It is very confusing and I, for one, do not want to choose not to be revived if it is sinful nor do I want to put that burden on my children,. However, is it necessary to be brought back when we are very old and /or very ill?

 

[Doc2be]

Hello every one. I’ve been instructed to find out everything about what I described in the title and would like some help and advice. My questions are:

If a friend or relatives requests not to be resuscitated or given any medical help in case where they are unable to make any of these decisions, should we honor these requests? For example if my friend or relative says, “If I my heart stops or breathing ceases DO NOT revive me,” where does the church say our moral obligation lies? If I see him/her passed out and not breathing and/or heart stopped, do I let them die? Personally I would probably help them. Naturally it would seem wrong not to.

What about us? If I were to (God forbid) come down with cancer and didn’t want chemo, radiation therapy because I didn’t want to suffer the affects of it, would be considered suicide if I were to die? Are we required to take every means necessary to prolong our life?

So where does the church stand in all this? What is our moral obligation when it comes to peoples wishes? Thank you very much.

Hello,

This is from what I have learned in my medical moral theology class…

I am sorry I don’t have time for sources…I will try to come back later and add them, but here is something to get you started… ewtn.com/expert/answers/end_of_life_decisions.htm

The church defines ordinary and extraordinary means when someone’s health is concerned. The best way to explain these is as follows:

Ordinary means are actions which a healthy person can do for themselves. These include eating/feeding themselves (thus the church teaches that nutrition and hydration are ordinary means), Bathing oneself (we should always make sure that the terminally ill are comfortable and well groomed). There are others but I can’t think of them off of the top of my head.

Extraordinary means are things which only science can achieve, like radiation therapy or chemotherapy. These are options available to us to extend our life only to put our life in order to finally accept the death of this body and accept eternal life with God. This also includes surgeries and things of that nature.

We are not required by the use of extraordinary means to prolong our life. These are available but not forced upon us. Ordinary means are required for each and every person; this flows from the innate law which God wrote into each soul, Natural law.

The natural law and the Fifth Commandment1 requires that all ordinary means be used to preserve life, such as food, water, exercise, and medical care. Since the middle ages, however, Catholic theologians have recognized that human beings are not morally obligated to undergo every possible medical treatment to save their lives. Treatments that are unduly burdensome or sorrowful, such as amputation, or beyond the economic means of the person, or which only prolong the suffering of a dying person, are morally extraordinary, meaning they are not obligatory.

The Catechism of the Catholic Church states,

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.

The key principle in this statement is that one does not will to cause death. When a person has an underlying terminal disease, or their heart, or some other organ, cannot work without mechanical assistance, or a therapy being proposed is dangerous, or has little chance of success, then not using that machine or that therapy results in the person dying from the disease or organ failure they already have. The omission allows nature to takes its course. It does not directly kill the person, even though it may contribute to the person dying earlier than if aggressive treatment had been done.

So to apply this to your questions…

CPR…you are not causing their death but allowing death to take its course. CPR is an extraordinary means. While it is hard to know that you could save their life…you could just be increasing their suffering against their will which you can only pray they have developed through prayer and with God.

The Cancer question is much the same. The use of chemo and radiation are not ordinary means of staying alive. Yes, they can relieve suffering, yes they can cure cancer (sometimes), but if a person doe not want to go through the hour long procedures or the pain of chemo, then it is their decision. The doctor can disagree with the patients decision, but in the end patient autonomy wins out, and the doctors role is to give options/facts/recommendations…not orders. The old paternal model of medicine has mostly died away.

Anyways, I hope this helps you out.

God Bless.

 

[joandarc2008]

Euthanasia

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

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.

I hope this clarifies it.

God bless,

 

[DominicVobiscum]

I have a “Five Wishes” document, which basically outlines the medical care that I want (and do not want) in the event I am unable to articulate my wishes.

As I understand it, the Church draws the line in extending or sustaining life with natural means (i.e. nutrients and hydration) versus extraordinary means (i.e. medicines, oxygen treatment, raditation, etc.). We should never call for the suspension of natural means in which to sustain our life.

There is an excellent document in which the late Pope John Paul II articulates the Church’s position.

vatican.va/holy_father/john_paul_ii/speeches/2004/march/documents/hf_jp-ii_spe_20040320_congress-fiamc_en.html

I would offer that when making plans for such a “will” or durable power of attorney, you discuss this matter with your priest.

God bless.

 

[Newbie2]

Perhaps it helps to make a distinction between DNR requests and other types of medical intervention.

DNR requests pretty much deal with immediate cardiac or respiratory failure and imminant death without intervention. Such resusitation techniques unquestionably qualify as extrordinary.

However, there can be grey area here. For example, if an otherwise healthy man, let’s say in his early 30’s is a wuss about pain (like me ) wants to put a DNR request on file, in the event that he gets into a car accident or suffers another sort of trauma, would rather die than experience any sort of pain of recovery, even though for the purposes of this example he would be expected to make a full recovery, this would seem to be extraordinary (let’s say he just needed to get his heart restarted and needed a few days bed rest)…but at the same time contrary to preserving his own life.

In other situations, such as cancer, advanced heart disease, age-related organ failure, etc., it becomes more complicated. Chances of expected recovery, the person’s own will to live and the complexity and side effects associated with treatment must all be considered.

It would be much easier if we all had some sort of “life remaining” meter, like the oil life remaining indicator that many cars have nowadays.

 

[joandarc2008]

I think that’s why in the end we all have to answer to the one that knows about that “life meter” anyway. He is the only one other than the person making the decision that knows what our true intent was and that is probably why it should be the person who is making the decision according to CCC.

God Bless,

 

[arussell17]

Thanks Newbie2. In fact, the two scenarios you present (except for the pain wuss part) were exactly the issues that arose at this End of Life Seminar. The priest unequivocally stated that you must never chose death.

 

[joandarc2008]

arussul this is going to sound like semantics but the priest is right you must never choose death - you may choose not to have extraordinary measures even if it means death. The difference in this is simple intent. It is why human beings cannot judge one another.

God bless,

 

[stringbeanduck]

Perhaps it helps to make a distinction between DNR requests and other types of medical intervention.

DNR requests pretty much deal with immediate cardiac or respiratory failure and imminant death without intervention. Such resusitation techniques unquestionably qualify as extrordinary.

However, there can be grey area here. For example, if an otherwise healthy man, let’s say in his early 30’s is a wuss about pain (like me ) wants to put a DNR request on file, in the event that he gets into a car accident or suffers another sort of trauma, would rather die than experience any sort of pain of recovery, even though for the purposes of this example he would be expected to make a full recovery, this would seem to be extraordinary (let’s say he just needed to get his heart restarted and needed a few days bed rest)…but at the same time contrary to preserving his own life.

:

That’s what I need to clarify still. If I see you with your heart stopped, am I morally obligated to honor your DNR request given that CPR is a use of extraordinary means, even though you are young and should make a full recover if revived? And what about those who haven’t specified; do we automatically assume that they would want to be resuscitated? I mean that’s why folks take CPR classes in the first place.