Question on extraordinary measures concerning life support issues

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My roommate has been in the hospital since Friday. They now say that she has no brain function, but that she has some activity in the central cortex because she is moving her arms and legs some. This is a very recent development. She is currently on life support. This was drug overdose case.

Now here is my question according to the ethics and morals of the Church: If they remove the life support and she can breath on her own without the support then should a feeding tube be inserted and kept alive. I need to advise her son as to what the Church says about this. They want to take her organs as she is a donor, but she has been my friend for 30 years and I want to see the proper moral and ethical thing done. I am assuming that if she can breath on her own when they remove the support then she is alive? If so, then she should not be starved or anything else to end her life, although, she may be in a vegetative state as far as her brain functioning.

Anyone out there that knows, please help me to understand
 
Here is some earlier info on CAF.

forums.catholic-questions.org/showthread.php?t=731151
Catechism says:
Quote:
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 the only thing keeping someone alive is a ventilator, it is permissible to let life run its inevitable course. You may not starve or dehydrate someone to death - food and water are not extraordinary procedures.​

I think it would be okay and I know I personally would not want to be kept alive under those circumstances. If I can’t be alive and fully living and conscious, then keeping me alive like that is just keeping me from heaven is how I feel. Plus I wouldn’t want to be a burden on anyone and would want to be remembered the way I am now, not as a vegetable.​

Is the breathing tube the only thing keeping this person alive? If so then removing it and letting life run its course is permissible.

If you change the scenario so that everything is identical but the person in question could breathe on their own, even if a feeding tube is needed, you CANNOT remove the breathing tube and let the person eventually starve to death.​

Purposefully, no. There are very difficult scenarios where a person is just conscious enough to make a feeding tube and or IV impossible to keep in, and the choice is to keep them heavily sedated to the point of unconsciousness or keep them bound in restraints in order to get them nutrition.

But yes, purposefully witholding hydration and nutrition in order to hasten or cause death is immoral.​

You are right. Purposefully doing anything with the intention of hastening or causing death is murder. Period.

However, no one is required to begin, or to continue the use of extraordinary means to prolong life, even if those extraordinary means have a high likelihood of success.

Just what constitutes “extraordinary means” can vary from circumstance to circumstance, but nutrition and hydration are clearly ordinary means and must be continued at least until death is imminent (ie within hours).

It is also important to understand that it is morally acceptable to give treatments that may have the side effect of hastening death, as long as there is no intent to hasten death and the treatment is intended to help the patient in some way. A good example is giving morphine to ease pain even though it is certain that the morphine will compromise the patient’s ability to breathe, thereby hastening their death​

ncbcenter.org/page.aspx?pid=1204

these are the goto persons on this subject (CA sends people to them)

they have more too there and one can always call an ethicist.

ncbcenter.org/document.doc?id=430

ncbcenter.org/document.doc?id=9
 
fred_conty said:
Here is some earlier info on CAF.

forums.catholic-questions.org/showthread.php?t=731151
Catechism says:
Quote:
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 the only thing keeping someone alive is a ventilator, it is permissible to let life run its inevitable course. You may not starve or dehydrate someone to death - food and water are not extraordinary procedures.​

I think it would be okay and I know I personally would not want to be kept alive under those circumstances. If I can’t be alive and fully living and conscious, then keeping me alive like that is just keeping me from heaven is how I feel. Plus I wouldn’t want to be a burden on anyone and would want to be remembered the way I am now, not as a vegetable.​

Is the breathing tube the only thing keeping this person alive? If so then removing it and letting life run its course is permissible.

If you change the scenario so that everything is identical but the person in question could breathe on their own, even if a feeding tube is needed, you CANNOT remove the breathing tube and let the person eventually starve to death.​

Purposefully, no. There are very difficult scenarios where a person is just conscious enough to make a feeding tube and or IV impossible to keep in, and the choice is to keep them heavily sedated to the point of unconsciousness or keep them bound in restraints in order to get them nutrition.

But yes, purposefully witholding hydration and nutrition in order to hasten or cause death is immoral.​

You are right. Purposefully doing anything with the intention of hastening or causing death is murder. Period.

However, no one is required to begin, or to continue the use of extraordinary means to prolong life, even if those extraordinary means have a high likelihood of success.

Just what constitutes “extraordinary means” can vary from circumstance to circumstance, but nutrition and hydration are clearly ordinary means and must be continued at least until death is imminent (ie within hours).

It is also important to understand that it is morally acceptable to give treatments that may have the side effect of hastening death, as long as there is no intent to hasten death and the treatment is intended to help the patient in some way. A good example is giving morphine to ease pain even though it is certain that the morphine will compromise the patient’s ability to breathe, thereby hastening their death​

ncbcenter.org/page.aspx?pid=1204

these are the goto persons on this subject (CA sends people to them)

they have more too there and one can always call an ethicist.

ncbcenter.org/document.doc?id=430

ncbcenter.org/document.doc?id=9
Click to expand...
What if she is able to breath without the aid of a machine, but is in a vegetative state, is a feeding tube then required to sustain their life? This could be the possible outcome. She might be able to breath on her own, but be in a vegetative state. What measures should be taken to keep her alive, if any, at that point?
 
fred_conty said:
Here is some earlier info on CAF.

forums.catholic-questions.org/showthread.php?t=731151
Catechism says:
Quote:
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 the only thing keeping someone alive is a ventilator, it is permissible to let life run its inevitable course. You may not starve or dehydrate someone to death - food and water are not extraordinary procedures.​

I think it would be okay and I know I personally would not want to be kept alive under those circumstances. If I can’t be alive and fully living and conscious, then keeping me alive like that is just keeping me from heaven is how I feel. Plus I wouldn’t want to be a burden on anyone and would want to be remembered the way I am now, not as a vegetable.​

Is the breathing tube the only thing keeping this person alive? If so then removing it and letting life run its course is permissible.

If you change the scenario so that everything is identical but the person in question could breathe on their own, even if a feeding tube is needed, you CANNOT remove the breathing tube and let the person eventually starve to death.​

Purposefully, no. There are very difficult scenarios where a person is just conscious enough to make a feeding tube and or IV impossible to keep in, and the choice is to keep them heavily sedated to the point of unconsciousness or keep them bound in restraints in order to get them nutrition.

But yes, purposefully witholding hydration and nutrition in order to hasten or cause death is immoral.​

You are right. Purposefully doing anything with the intention of hastening or causing death is murder. Period.

However, no one is required to begin, or to continue the use of extraordinary means to prolong life, even if those extraordinary means have a high likelihood of success.

Just what constitutes “extraordinary means” can vary from circumstance to circumstance, but nutrition and hydration are clearly ordinary means and must be continued at least until death is imminent (ie within hours).

It is also important to understand that it is morally acceptable to give treatments that may have the side effect of hastening death, as long as there is no intent to hasten death and the treatment is intended to help the patient in some way. **A good example is giving morphine to ease pain even though it is certain that the morphine will compromise the patient’s ability to breathe, thereby hastening their death **​

ncbcenter.org/page.aspx?pid=1204

these are the goto persons on this subject (CA sends people to them)

they have more too there and one can always call an ethicist.

ncbcenter.org/document.doc?id=430

ncbcenter.org/document.doc?id=9
Click to expand...
Thank you for clarifying this point (see bolded). This is what happened to my mother. Now I understand why she died in two days instead of two months.
 
lakotak said:
Thank you for clarifying this point (see bolded). This is what happened to my mother. Now I understand why she died in two days instead of two months.
Click to expand...
This is a very confusing time for someone. And it isn’t easy to come to the right decision.

A relative of mine was on life support for a couple of days. And it was decided that after the third day, they would be taken off. And when they were, they began breathing on their own. So it was decided to take them home since that is where they wanted to be. And a week later they passed away.

God bless.
 
fred_conty said:
This is a very confusing time for someone. And it isn’t easy to come to the right decision.

A relative of mine was on life support for a couple of days. And it was decided that after the third day, they would be taken off. And when they were, they began breathing on their own. So it was decided to take them home since that is where they wanted to be. And a week later they passed away.

God bless.
Click to expand...
Please see my question on your post #3. This seems to be the way this might turn out.

Thanks
 
I am so sorry for what is happening.

Yes you are correct, nutrition and hydration are ordinary, not extraordinary, measures.
 
lakotak said:
What if she is able to breath without the aid of a machine, but is in a vegetative state, is a feeding tube then required to sustain their life? This could be the possible outcome. She might be able to breath on her own, but be in a vegetative state. What measures should be taken to keep her alive, if any, at that point?
Click to expand...
Theoretically, a person who will not be harmed or discomfited by being fed and hydrated *must *be fed and hydrated (to the extent the carers of the person are able.)

It is important to understand that those in the process of dying often have a slow shut-down of organs. When the organs involved in digestion shut down, it is no longer necessary to feed and/or hydrate as the patient does not benefit and the action may increase their pain.

There *may *be other situations under which withdrawal would be permissible, but that would be related to a particular situation. What I have outlined is what I (non-doctor, non-theologian) have gathered from reading many different sources.

In the case you describe, a person able to continue breathing on her own but with minimal consciousness, feeding and hydration would most probably be called for. We are not to starve and dehydrate people to death, even if they are not conscious.
 
=lakotak;12087790]My roommate has been in the hospital since Friday. They now say that she has no brain function, but that she has some activity in the central cortex because she is moving her arms and legs some. This is a very recent development. She is currently on life support. This was drug overdose case.
Click to expand...
Now here is my question according to the ethics and morals of the Church: If they remove the life support and she can breath on her own without the support then should a feeding tube be inserted and kept alive. I need to advise her son as to what the Church says about this. They want to take her organs as she is a donor, but she has been my friend for 30 years and I want to see the proper moral and ethical thing done. I am assuming that if she can breath on her own when they remove the support then she is alive? If so, then she should not be starved or anything else to end her life, although, she may be in a vegetative state as far as her brain functioning.
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Anyone out there that knows, please help me to understand
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This is FAR to serious an issue to guess at. TALK to your parish priest ASAP.

I’ll add your friend to my prayer list,

The church teaches that “extraordinary measures” need NOT be used. The issue then is what does the term “extraordinary measures” actually mean? Be careful who’s advise you take on this.:o

God Bless you

Patrick
 
St_Francis said:
Theoretically, a person who will not be harmed or discomfited by being fed and hydrated *must *be fed and hydrated (to the extent the carers of the person are able.)

It is important to understand that those in the process of dying often have a slow shut-down of organs. When the organs involved in digestion shut down, it is no longer necessary to feed and/or hydrate as the patient does not benefit and the action may increase their pain.

There *may *be other situations under which withdrawal would be permissible, but that would be related to a particular situation. What I have outlined is what I (non-doctor, non-theologian) have gathered from reading many different sources.

In the case you describe, a person able to continue breathing on her own but with minimal consciousness, feeding and hydration would most probably be called for. We are not to starve and dehydrate people to death, even if they are not conscious.
Click to expand...
This is what I fear the case could turn out to be. I think they will be removing life support from her tomorrow to see if she can breath and continue to breath on her own. The doctors feel that this will be unlikely, however, this will only be known when they remove the breathing tube.
 
PJM said:
This is FAR to serious an issue to guess at. TALK to your parish priest ASAP.

I’ll add your friend to my prayer list,

The church teaches that “extraordinary measures” need NOT be used. The issue then is what does the term “extraordinary measures” actually mean? Be careful who’s advise you take on this.:o

God Bless you

Patrick
Click to expand...
Yes, this is what I am trying to do. I understand the situation, but I want to be sure that if her life ends it will be by God’s Will and not at man’s will.
 
If I am in that kind of state u r talking about and I had said earlier I didn’t want to exist like that and wanted my caretaker to heed my wishes and she agreed who r u to say I cant have a say in my death?
 
lakotak said:
Now here is my question according to the ethics and morals of the Church: If they remove the life support and she can breath on her own without the support then should a feeding tube be inserted and kept alive. I need to advise her son as to what the Church says about this.

The USCCB published a document called Ethical and Religious Directives for Catholic Health Care Services. Part 5 is entitled Issues in Care for the Seriously Ill and Dying. You’ll find many of your answers there. Even though this document is directed at Catholic institutions, it provides solid guidance for Catholics in other institutions as well.
usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf
They want to take her organs as she is a donor, but she has been my friend for 30 years and I want to see the proper moral and ethical thing done. I am assuming that if she can breath on her own when they remove the support then she is alive? If so, then she should not be starved or anything else to end her life, although, she may be in a vegetative state as far as her brain functioning.

Anyone out there that knows, please help me to understand.
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I would avoid using vague and, therefore, meaningless, terms like “life support.” That could mean anything, including ordinary air and water. If you don’t know the correct terms, learn them. Medical people have a responsibility to tell you specifically what is going on.
 
atjar said:
If I am in that kind of state u r talking about and I had said earlier I didn’t want to exist like that and wanted my caretaker to heed my wishes and she agreed who r u to say I cant have a say in my death?
Click to expand...
No one said that you could not have a say in your own death this is your free will… The issue is do you have the right before God to take that right out of his hands for your will. Not wanting to remain in a certain state is man’s will. It may be God’s Will for His own purpose that He would keep you in whatever state…
 
Sad to say that this area of ethics should require a hotline, HOWEVER, I am glad such a hotline exists. Medical personnel are often not very knowledgable or cooperative in such matters. A person’s durable power of attorney is not always interpreted well. I have worked with doctors and nurses who make quality of life decisions that are at odds with an individual’s and family’s beliefs.

Yet we need medical (name removed by moderator)ut to make a clear decision on these issues. Try to get the facts without anyone’s opinion about the quality of life. A prognosis is helpful but may not be accurate. I’ve seen predictions that someone would be dead within 24 hours and two years later they died…

It’s not a factual science. But, as I’m sure you know as a Catholic, our one belief is that we are not God, the author of life. We also know that miracles CAN happen. We also know that sometimes sustaining life gives other family members a better chance to prepare themselves for loss. Hospice workers have said that every step of dying is important and the patient and their family benefit by making wise choices for a peaceful death ( not euthanasia).

My mother was “supposed” to die in November but she came back and hung around until June. The doctor was so certain that she would die that night and that we should remove the respirator.

On the other hand, we had a comatose patient whose husband wanted her on a respirator for months. It was hard to reason with him and he seemed very out of touch with the world.

I think it’s good that you are trying to make some kind of informed decision. I’ll pray for you all.
 
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