Refusal of medical treatment and suicide

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I am interested to know people’s opinions on the decision to refuse to accept medical treatment and suicide. To what extent are humans obliged to cling to life, even if they don’t want to do so? How much suffering are people obliged to undergo? What if medicine is simply prolonging illness, with no chance of a recovery? How much is enough?
 
I know exactly how you feel, but you have to think of your loved ones, thats whats kept me alive for the past year.
 
This is a great question. I have pondered the same thing for a while now. I work in a nursing home and care for people who can’t feed themselves, can’t control their bladder or bowels, some who can’t carry an extended conversation, delusions, hallucinations, constant pain, etc… i have been thinking about this because I am a diabetic. If I simply stop taking my meds my sugar will climb, damaging vital organs which will lead to failure and death, probably within a year or two. Is it suicide to stop my meds, or am I just letting nature take its course? I think refusing medical treatment is not suicide. We will all die sometime, is dying with some dignity a sin? I don’t think so. This is different from taking poison, I believe. You are simply not doing anything.
 
One does not have to cling to life be the fingernails, but we cannot hasten or pursue death. The catechism says:
  1. 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.
In other words if death would be the natural outcome one can refuse medical treatment if that is not the primary goal. So if someone refuses treatment because they want to die that is immoral, but if they are merely accepting that death is the natural outcome that is acceptable.
 
Half the world’s population lives on less than $3 per day, most of them do not get this choice.
 
There are times when the difference between suicide and comfort care (palliative care) is only by intention.
from the Catechism of the Catholic Church (emphasis added):
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 you do something with the intention of killing yourself, that’s suicide. If you do something to relieve your pain and suffering, that completely allowed, even if it has the undesired effect of causing you to die sooner. One example of this might be stopping chemotherapy treatments because of the horrible side effects. Another is increasing morphine to stop someone’s pain, even though too much slows down breathing, sometimes bringing on death sooner than without the drug. However, if I stop chemotherapy and then that night take all the morphine I have with the intention of killing myself, that’s suicide.
 
from the declarion on Euthanasia

“It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity. It may happen that, by reason of prolonged and barely tolerable pain, for deeply personal or other reasons, people may be led to believe that they can legitimately ask for death or obtain it for others. Although in these cases the guilt of the individual may be reduced or completely absent, nevertheless the error of judgment into which the conscience falls, perhaps in good faith, does not change the nature of this act of killing, which will always be in itself something to be rejected. The pleas of gravely ill people who sometimes ask for death are not to be understood as implying a true desire for euthanasia; in fact, it is almost always a case of an anguished plea for help and love. What a sick person needs, besides medical care, is love, the human and supernatural warmth with which the sick person can and ought to be surrounded by all those close to him or her, parents and children, doctors and nurses.”

and

“it is that a prolonged illness, advanced old age, or a state of loneliness or neglect can bring about psychological conditions that facilitate the acceptance of death. Nevertheless the fact remains that death, often preceded or accompanied by severe and prolonged suffering, is something which naturally causes people anguish. Physical suffering is certainly an unavoidable element of the human condition; on the biological level, it constitutes a warning of which no one denies the usefulness; but, since it affects the human psychological makeup, it often exceeds its own biological usefulness and so can become so severe as to cause the desire to remove it at any cost. According to Christian teaching, however, suffering, especially suffering during the last moments of life, has a special place in God’s saving plan; it is in fact a sharing in Christ’s passion and a union with the redeeming sacrifice which He offered in obedience to the Father’s will. Therefore, one must not be surprised if some Christians prefer to moderate their use of painkillers, in order to accept voluntarily at least a part of their sufferings and thus associate themselves in a conscious way with the sufferings of Christ crucified (cf. Mt. 27:34). Nevertheless it would be imprudent to impose a heroic way of acting as a general rule. On the contrary, human and Christian prudence suggest for the majority of sick people the use of medicines capable of alleviating or suppressing pain, even though these may cause as a secondary effect semi-consciousness and reduced lucidity. As for those who are not in a state to express themselves, one can reasonably presume that they wish to take these painkillers, and have them administered according to the doctor’s advice. But the intensive use of painkillers is not without difficulties, because the phenomenon of habituation generally makes it necessary to increase their dosage in order to maintain their efficacy.”
Shalom
God Bless
 
Hi, Stevekehl,

I have worked in a nursing home as an RN. Whle there are no cures for the inability to feed one’s self, or control their bowels and bladder there is not reason why someone would be living in constant pain. Virtually all pain can be managed (but, usually not eliminated). The idea is that someone can function to the best of their ability and not be controlled by their pain.

There have been some excellent posts - and I think the reality we all must begin with is that death is inevitable. How we arrive at that point makes all the difference. For example, there is no obligation to accept medical treatment in cases where such treatment will not cure and have only minimal results on the outcome of a progressive disease like cancer. Refusing additonal treatment (which has its own risks and serious side effects) is not suicide.

May I suggest that if you are in a position to identify that someone in the nursing home is in pain that this be reported to the nursing staff. They have a legal and moral responsibility to bring this information (the patient is in pain) to the attention of the attending physician. We should be advocating for patients so that they are treated with dignity and respect - and we do the things that we can do.

God bless
This is a great question. I have pondered the same thing for a while now. I work in a nursing home and care for people who can’t feed themselves, can’t control their bladder or bowels, some who can’t carry an extended conversation, delusions, hallucinations, constant pain, etc… i have been thinking about this because I am a diabetic. If I simply stop taking my meds my sugar will climb, damaging vital organs which will lead to failure and death, probably within a year or two. Is it suicide to stop my meds, or am I just letting nature take its course? I think refusing medical treatment is not suicide. We will all die sometime, is dying with some dignity a sin? I don’t think so. This is different from taking poison, I believe. You are simply not doing anything.
 
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