Not providing medical treatment when it could help?

[JRKH]

First, let me say, I’m close to this situation, but do not want to get too personal. Here goes:

I’m confused as to what is being done, or not being done in this situation. Patient is a 92 year-old woman. She has Alzheiner’s and has been in a Catholic Nursing home for about 9 years. She doesn’t know when her own family visits. It’s sad, but it is what it is. She has contracted pnuemonia once or twice over this period and was taken to the hospital and treated with Antibiotics and recovered.

She has again been diagnosed with pnuemonia, but one of the adult children, a nun, has decided they will not bring her to the hospital this time. And just let things “take their course.”

I don’t know much about these “end of life” scenarios, but I really have a bad gut reaction to that decision! Isn’t there something wrong in NOT trying some simple medicines? I’m not talking extraordinary measures, just an IV or some pills, like before.

Can someone help me out here?

Wouldn’t the Catholic approach here to try simple treatment? Is it immoral, or worse, to let someone die in this situation?

I would not wish to interfere with the wishes of the family in this case.
We went through this kind of thing with my Dad and, once the AD reaches a certain point, you almost wish for God to come and take your loved one.
Please respect the family’s wishes in this and simply pray for God’s will to be done.

Peace
James

 

[GerardP]

I wasn’t trying to be humorous, I think we often forget that death is a natural part of life, not an enemy to be feared and held at bay as long as possible.

Death is a natural part of a fallen nature. The wages of sin is Death. Death is also not something to be looked forward to because none of us are particularly ready to face judgement (unless of course you are guilty of presumption)

YES, I would withhold the medical care under discussion. In my opinion, medical care wouldn’t “save” her life, it would only prolong her death.

Heck why not suffocate her with a pillow? You’d only be helping her go through “the dying process.”

There is a reason that Pnuemonia was once called the “old person’s friend”. I think it is possible that God gave her the pnuemonia to bring her home.

Maybe God allowed her to catch pneumonia because as helpless as she is, she is a child of God and in her sufferings we are given the opportunity to do as our Lord Jesus Christ did and try to save her. That is how God manifests His Glory in this world.

At any rate, there is nothing in Catholic theology or teaching that demands that we must avail ourselves (or those we are responsible for) of medical care.

There is this thing called virtue and it’s called Charity.

Every person has to make the decision about what level of care is appropriate for them self and those they are responsible for.

Subjectivism. People can and do abuse themselves and abuse others through direct abuse and neglect.

And every person would, I suspect, draw that live in a slightly different place.

And God will make an accounting of that.

I personally wouldn’t treat the Pnuemonia if I were in that position. Patently you would. So I would ask, where would you draw the line in this case?

The Church has laid down guidelines and it’s absurd to stretch them to include neglect.

Would you give her, say a heart or liver transplant?

Heart transplants require more often than not that the heart be stopped by the surgeon. They are more often than not morally illicit. Livers may be a different case.

But essentially, you are asking how much trouble is a life worth?

 

[GerardP]

I would not wish to interfere with the wishes of the family in this case. We went through this kind of thing with my Dad and, once the AD reaches a certain point, you almost wish for God to come and take your loved one.
Please respect the family’s wishes in this and simply pray for God’s will to be done.

Peace
James

He IS part of this family. It’s his mother-in-law. It’s his wife’s mother.

Praying that God takes her is one thing.

Neglecting to give someone the ordinary means of help is not right.

 

[NaturalEnquirer]

He IS part of this family. It’s his mother-in-law. It’s his wife’s mother.

Praying that God takes her is one thing.

Neglecting to give someone the ordinary means of help is not right.

Who decides what is “ordinary”, if not the family? Not long ago, it would have been absolutely extraordinary for a woman to live into her 90s. At some point in the future, science may develop techniques to keep people alive for decades or even centuries longer. Is that ordinary?

Doesn’t there come a point where more and more medical interventions are an exercise in human pride, rather than charity?

Anyone who saw a child with an infection and said they were going to “let it run its course” would be hauled off to jail.

Of course that’s not true. Parents are never obligated to pursue medical treatment. That is a fundamental aspect of certain religious groups.

 

[Eilish_Maura]

Thanks Matthew.

The person who has power of attorney did not make this decision, and that person is my wife, so it is at least family-in-law.

So you wife should be taking up this or making appropriate changes to the plan not to treat.

 

[BillP]

Heart transplants require more often than not that the heart be stopped by the surgeon. They are more often than not morally illicit. Livers may be a different case.

I am unsure of your religious beliefs, but the Catholic church does not consider heart transplants “not morally licit”. I believe we were discussing the perspective of the Catholic Church on this issue although I do appreciate you enlightening us about your religious tradition.

But essentially, you are asking how much trouble is a life worth?

No, I am asking whether or not you would procure a heart or liver transplant for this poor women if it would keep her alive for some further period of time?

 

[BillP]

The Church has laid down guidelines and it’s absurd to stretch them to include neglect.

Those guidelines do not require proactive medical treatment. The only require ordinary measures (food and water for example) to sustain life.

 

[JRKH]

He IS part of this family. It’s his mother-in-law. It’s his wife’s mother.

Praying that God takes her is one thing.

Neglecting to give someone the ordinary means of help is not right.

I hope that the people posting on this thread are people who have been through this. Only those who have “been there” can really understand.

I do not wish to get into a morality debate on this thread. The OP asked for our help/opinion and I gave mine based my personal experience with my dad.

However I will expound a bit on our experience.
My parents are both very devout catholics.
My Dad, who was in generally good health, developed AD after prostate surgery. Most likely the anestetic(sp) set it off.
My mother kept him at home and cared for him until the day he died. The entire family watched him deteriorate from a vibrant, loving, happy man into a bedridden, incoherent, incontinant, vegatable. Never, in all of that, did we stop loving him, or caring for him, or supporting our mother, or praying for God’s will to be done.
Once it reached a point where Dad was bedridden, and unable to communicate, mom wrestled with the idea of how much care to give him. Especially once the inevitable happened and he stopped eating. Ultimately she did exactly what she knew he would want. She did nothing. Her pastor knew what she was going through and supported her decisions.
I was there with her when he passed quietly into God’s hands. We could have put him on feeding tubes but we didn’t.

Watching my dad die was one of the toughest experiences of my life. Yet I knew that he was OK. He was with God.

There comes a point at which the family must Let Go And Let God. If God wishes to take this person by pneumonia, or by starvation, or whatever it is up to God.

I am now watching my DW go down the same road. We discussed things early on and she doesn’t want any kind of medical intervention to prolong her life if some other disease takes her that is what will be.
Once in prayer, God spoke to me and said, “She’s mine, I’ll take care of her”.
Since then I view myself as only the caretaker as long as God wishes me to be. Then He will take her home to be with Him.

Peace
James

 

[system]

So you wife should be taking up this or making appropriate changes to the plan not to treat.

YES. And I, as her spouse, should get as much information on my church’s stance on this as possible, hence, my asking for help on this bulletin board.

As I said in the earlier posts, my gut reaction was that not treating the illness was wrong. Most often, my gut reaction comes from God-Given conscience and I should pay attention to it. But, since it is in no way a perfect conscience, I came here to ask the help of fellow Catholics, and I must say, I am am amazed and disheartened by most of the responses telling me to butt out of this family’s business (I’ve been a member of this family for 15 years, but I guess I wasn’t clear about it); and those reponses more or less saying, “let her die, she’s old.”

This troubles me on a board where I have seen pro-lifers on the verge of jumping through the computer screen when it’s a baby, but few or none feel the same when it’s an older person.

I would equate her condition right now to a baby with breathing troubles in a neo-natal intensive care unit - totally dependent on the kindness of those around her.

Would the same people saying “let her die” say that about the baby in the NICU? If so, just please come out and say that, I wouldn’t like you, but I would respect your strength of convictions.

So go ahead, tough-guys

 

[system]

Those guidelines do not require proactive medical treatment. The only require ordinary measures (food and water for example) to sustain life.

I’m not a doctor, but wouldn’t “proactive” mean BEFORE the pneumonia?

And isn’t the use of anti-biotics against pneumonia considered “ordinary” in 2008?

 

[system]

Doesn’t there come a point where more and more medical interventions are an exercise in human pride, rather than charity?

YES! This is my reason for being here. The one person who made this decision must be at the point you just described. But not everyone is on the same page.

Hearing this plan of non-treatment hit me like a ton of bricks, like it was euthanasia and I’m here seeking counsel and the wisdom of the church.

**She doesn’t have a great life, but she is in a far, far better state than Terry Schiavo, and half the country was trying to help her! **

 

[Eilish_Maura]

YES. And I, as her spouse, should get as much information on my church’s stance on this as possible, hence, my asking for help on this bulletin board.

As I said in the earlier posts, my gut reaction was that not treating the illness was wrong. Most often, my gut reaction comes from God-Given conscience and I should pay attention to it. But, since it is in no way a perfect conscience, I came here to ask the help of fellow Catholics, and I must say, I am am amazed and disheartened by most of the responses telling me to butt out of this family’s business (I’ve been a member of this family for 15 years, but I guess I wasn’t clear about it); and those reponses more or less saying, “let her die, she’s old.”

This troubles me on a board where I have seen pro-lifers on the verge of jumping through the computer screen when it’s a baby, but few or none feel the same when it’s an older person.

I would equate her condition right now to a baby with breathing troubles in a neo-natal intensive care unit - totally dependent on the kindness of those around her.

Would the same people saying “let her die” say that about the baby in the NICU? If so, just please come out and say that, I wouldn’t like you, but I would respect your strength of convictions.

So go ahead, tough-guys

As an inlaw you don’t share the same kind of connection to the woman as the children do.

Sometimes we are gifted with the knowledge it is someone’s time and act on it.

There are times some fight the message and cling to the ‘do everything possible so we can have a little more time’.

Your wife and her siblings may, on some level, know what is the right choice to make. Your wife is in a position to effect change of treatment. If she is not doing that she may know more than you do about God’s will in this.

 

[BillP]

I would equate her condition right now to a baby with breathing troubles in a neo-natal intensive care unit - totally dependent on the kindness of those around her.

Would the same people saying “let her die” say that about the baby in the NICU? If so, just please come out and say that, I wouldn’t like you, but I would respect your strength of convictions.

So go ahead, tough-guys

First of all, lets not call people names because we don’t like their perspective, okay?

Second of all, a child in a NNICU has their entire life before them. If heroic intervention can just get them through their crisis then they have an opportunity to go on to live a beautiful, vibrant life (ALL lives are beautiful and vibrant!). But even with babies in NNICUs there is a limit to appropriate levels of medical care. There comes a time in each person’s life when it it time to let go. And each person is entitled to make that decision for them self (or appoint someone they trust to make that decision in event of their incapacity). The Church teaches us that we must, in human decency, provide ordinary care. We can’t withhold food or water (or smother them with a pillow). But we aren’t required to bring all the forces of technology to bear in each and every case. We can make our own decision.

I believe if I were in your MIL’s position I would believe that I have had my beautiful and vibrant life and what I now needed would be a dignified and peaceful death.

 

[system]

First of all, lets not call people names because we don’t like their perspective, okay?

Ha! Like your first post to me was charitable? Look in the mirror

 

[BillP]

Ha! Like your first post to me was charitable? Look in the mirror

I’m sorry that you were offended by my post. It certainly wasn’t my intent to be sarcastic or uncharitable, as I attempted to clarify in a later post.

Since you claim to be looking for the Church’s position, here is something from the Conference of Catholic Bishops that is, I believe on point:

1. 
   *]A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community.40
   *]A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.41
   *]There should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient.
   *]The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.
   *]Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.42
   *]Patients should be kept as free of pain as possible so that they may die comfortably and with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason. Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person’s life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.

1. 
   usccb.org/bishops/directives.shtml#partfive

 

[system]

As an inlaw you don’t share the same kind of connection to the woman as the children do.

You’re right. But as a husband I have a duty to help her and support in this very vulnerable time.

Sometimes we are gifted with the knowledge it is someone’s time and act on it.

Wow! I know that works great with “new age people” but can you point me to that in Christ’s words, or at least a Pope’s?

There are times some fight the message and cling to the ‘do everything possible so we can have a little more time’.

I never said do anything possible, just the obvious. 4 cipros a day and she lives, do nothing and she dies.

Your wife and her siblings may, on some level, know what is the right choice to make. Your wife is in a position to effect change of treatment. If she is not doing that she may know more than you do about God’s will in this.

Or she may be too afraid to confront her sister the nun.

Maybe I’m in a position to know my wife better than you.

 

[Eilish_Maura]

Wow! I know that works great with “new age people” but can you point me to that in Christ’s words, or at least a Pope’s?

This is not new age anything – this is how it has always been - it is how God has made us.

Or she may be too afraid to confront her sister the nun.

Maybe I’m in a position to know my wife better than you.

If she is unwilling or unable to do the job you may be best help to her by getting her to turn the authority over to one of the others who is willing and able.

As for your statement regarding ‘knowing’ her better than any of us here you have not stated that she shares your ‘gut reaction’ or objects in any way to her sister’s recommended course of action.

 

[BillP]

I’m not a doctor, but wouldn’t “proactive” mean BEFORE the pneumonia?

And isn’t the use of anti-biotics against pneumonia considered “ordinary” in 2008?

Not always: Form the USCCB

extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community

So use of antibiotics could be extraordinary on several of the criteria, “reasonable hope of benefit”, or “excessive burden”.

 

[GerardP]

Who decides what is “ordinary”, if not the family? Not long ago, it would have been absolutely extraordinary for a woman to live into her 90s. At some point in the future, science may develop techniques to keep people alive for decades or even centuries longer. Is that ordinary?

You’re not making sense. You say “the family” decides what is “ordinary” and then you post how not too long ago it would have been “extraordinary” from someone to live into their 90s. So, how does a family decide that it is ordinary to live into a certain decade of life?

Is it extraordinary to give some medicine to someone who has pneumonia? No, it is the ordinary care for pneumonia.

Doesn’t there come a point where more and more medical interventions are an exercise in human pride, rather than charity?

No. And exercise of pride is disregarding ordinary means of care in order to play God and decide that “it’s time” for a human being to die.

Of course that’s not true. Parents are never obligated to pursue medical treatment. That is a fundamental aspect of certain religious groups.

Frankly that is true. Parents will be guilty of neglect if they don’t seek proper treatment for their children. Broken bones need to be set, Cuts need to be treated. Medicines are ordinary means and the responsibility of parents. (And children who care for their parents)

 

[GerardP]

I’m sorry that you were offended by my post. It certainly wasn’t my intent to be sarcastic or uncharitable, as I attempted to clarify in a later post.

Since you claim to be looking for the Church’s position, here is something from the Conference of Catholic Bishops that is, I believe on point:

usccb.org/bishops/directives.shtml#partfive

The answer is right there in the bishops usual cryptic language, but at least they got it right.

*"Euthanasia is an action **or omission **that **of itself *or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.42"