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Mary_Cath
Guest
What are extraordinary medical measures in terminal illness? Feeding tube, IV nutrition? Moral decision-making of family when elderly patient requests no treatment?
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Karin
Guest
why would the family make any decisions if the patient has stated what he or she wants
End-of-Life Decisions good article here
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Liberian
Guest
Mary Cath,
Hello and welcome to the Catholic Answers Forums. I hope you have a blessed and fruitful time here.
While I do not know exactly where the line is between ordinary and extraordinary measures, it’s pretty easy to say definitely that some things are on one side or the other. For example, a feeding tube is not an extraordinary measure (Terry Schiavo comes to mind here) while an invasive surgery is an extraordinary measure. In general, medical procedures (as distinct from nutritive support) with the sole purpose of delaying an imminent death are not required morally.
Hello and welcome to the Catholic Answers Forums. I hope you have a blessed and fruitful time here.
While I do not know exactly where the line is between ordinary and extraordinary measures, it’s pretty easy to say definitely that some things are on one side or the other. For example, a feeding tube is not an extraordinary measure (Terry Schiavo comes to mind here) while an invasive surgery is an extraordinary measure. In general, medical procedures (as distinct from nutritive support) with the sole purpose of delaying an imminent death are not required morally.
- Liberian
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mosher
Guest
Ordinary Means of Care are such things as nutrition and normative medical treatment.
Extraordinary Means of Care are things that can be done but are not necessary. These include such things that are both a grave over-burden to the family and/or patient and treatments that have no possibility of ending the illness.
So common ordinary means are such things as food, water, antibiotics, other medication, resuscitation if the person is likely to live an extended life after such resuscitation.
Extraordinary means are things like Live Support Systems (qualified as necessary for life without any possibility of positive progress), treatments that will only prolong life for a short period of time without relative certitude that it will help bring about positive medical progress. Procedures that would but a grave financial strain on the family.
A good book to own (and should be in the library of every good Catholic) is called “Catholic Bioethics and the Gift of Human Life” by William May. This book is easily accessible and is very clear to express not only examples but the objective principles surrounding all Bioethical issues.
It can be found at Amazon and other internet book sales locations.
Extraordinary Means of Care are things that can be done but are not necessary. These include such things that are both a grave over-burden to the family and/or patient and treatments that have no possibility of ending the illness.
So common ordinary means are such things as food, water, antibiotics, other medication, resuscitation if the person is likely to live an extended life after such resuscitation.
Extraordinary means are things like Live Support Systems (qualified as necessary for life without any possibility of positive progress), treatments that will only prolong life for a short period of time without relative certitude that it will help bring about positive medical progress. Procedures that would but a grave financial strain on the family.
A good book to own (and should be in the library of every good Catholic) is called “Catholic Bioethics and the Gift of Human Life” by William May. This book is easily accessible and is very clear to express not only examples but the objective principles surrounding all Bioethical issues.
It can be found at Amazon and other internet book sales locations.
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Steven_Merten
Guest
Hello Mary,
Welcome to Catholic Answers Forums.
We had quite the debate during the Terry Schiavo feed tube period.
Is it murder for third world nations not to use feed tubes in times of terminal illness? Is it murder for Catholics not to supply third world nations with feed tubes to keep the terminally ill poor people from dying of malnutrition? It is not the $35.00 feed tube but the $5000.00/month in health care related to keeping terminally ill third world nation people alive beyond normal bodily functions which becomes the hardship. Aqusing third world nation Catholics of being murderers because they did not use feed tubes can become a very spiritually burden for them.
If the Catholic Church was just aqusing capitalist health care providers of being murderers and not Catholics, one has to ask do capitalist health care providers rather than Catholics need papal guidance? I never heard the Pope assure poor third world nations catholics that he was not aqusing them of being murderers for not using feed tubes. I never heard the Pope assure 1.1 billion Catholics that they were not murderers for failing to incert feed tubes into third world nation’s poor people who were terminally ill. Is the Church murderering third world nations teminally ill by failing to supply and incert feed tubes into third world nations terminally ill, murder?
Many bishops, I would imagine especially third world nations bishops, did not seem to go allong with the Vatican in calling people murderers for not using feed tubes.
It is a touchy issue.
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psteichen
Guest
Steven: Feeding tubes are a basic and simple level of care in the USA. That may not be the case in all countries. If simple care such as feeding tubes are cost prohibitive in some countries then it becomes extraordinary care, which is not required.
As to Catholics being guilty of murder for not supplying such aid: Since when is failing to provide charity considered murder?
Also, as to the Pope not providing assurances: Why would he have to assure them of something so obvious? You are the only person I’ve heard express this concern. So for your benefit I will assure you myself. No, you are not guilty of murder for failing to provide charity. But if you can afford to do so, feel free.
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Steven_Merten
Guest
Hello psteichen,
What you say is not the way I read Pope John Paul II.
Please visit CAF thread:
Can third world nations afford the Pope’s demands to use feeding tubes?
ADDRESS OF JOHN PAUL II
TO THE PARTICIPANTS IN THE INTERNATIONAL CONGRESS
ON "LIFE-SUSTAINING TREATMENTS AND VEGETATIVE STATE:
***SCIENTIFIC ADVANCES AND ETHICAL DILEMMAS" ***
**I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, *ordinary *and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.
The obligation to provide the “normal care due to the sick in such cases” (Congregation for the Doctrine of the Faith, Iura et Bona, p. IV) includes, in fact, the use of nutrition and hydration (cf. Pontifical Council “Cor Unum”, Dans le Cadre, 2, 4, 4; Pontifical Council for Pastoral Assistance to Health Care Workers, Charter of Health Care Workers, n. 120). The evaluation of probabilities, founded on waning hopes for recovery when the vegetative state is prolonged beyond a year, cannot ethically justify the cessation or interruption of minimal care for the patient, including nutrition and hydration. Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission…
…First of all, no evaluation of costs can outweigh the value of the fundamental good which we are trying to protect, that of human life. Moreover, to admit that decisions regarding man’s life can be based on the external acknowledgment of its quality, is the same as acknowledging that increasing and decreasing levels of quality of life, and therefore of human dignity, can be attributed from an external perspective to any subject, thus introducing into social relations a discriminatory and eugenic principle.
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pilchard
Guest
If and elderly person has had an operation to ease the pain of a tumuor but doesn’t come out of the anesthetic - and is breathing with a ventelator - can this be turned off? How long should one wait?
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Catholic_Action
Guest
The Catholic Charter for Health Care Workers has this-
wf-f.org/healthcarecharter.html#Anchor-III-3800
The point is that there is no formula to cover all situations merely morally binding guidelines which cannot be ignored. What must be rejected is the notion that “quality of life” should be a significant factor in life or death decisions.
wf-f.org/healthcarecharter.html#Anchor-III-3800
As a health care worker in a setting where I treat the acutely ill elderly this is a question I often have to ponder. Where death is inevitable and imminent and a person has a chest infection then giving fluids will not prolong life more than a few hours and will increase suffering by adding to the fluids in the lungs. Withholding fluids may be appropriate. On the other hand assessing imminent death is not an exact science and if a person is still alive within 24 hours should fluids be resumed?
The point is that there is no formula to cover all situations merely morally binding guidelines which cannot be ignored. What must be rejected is the notion that “quality of life” should be a significant factor in life or death decisions.
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CRW
Guest
vatican.va/holy_father/john_paul_ii/speeches/2004/march/documents/hf_jp-ii_spe_20040320_congress-fiamc_en.html
ADDRESS OF JOHN PAUL II
TO THE PARTICIPANTS IN THE INTERNATIONAL CONGRESS ON “LIFE-SUSTAINING TREATMENTS AND VEGETATIVE STATE: SCIENTIFIC ADVANCES AND ETHICAL DILEMMAS” Saturday, 20 March 2004
Your answer is only a click away…
Sorry, I see that this has already been posted so I added this comment by the edit function.
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Steven_Merten
Guest
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Steven_Merten
Guest
Hello psteichen,
You seem to be preaching in opposition to Christ’s teachings. Do you agree or disagree that Jesus will burn people in hell for not caring for the poor.
NAB MAT 25:41
Then he will say to those on his left, 'Depart from me, you accursed, into the eternal fire prepared for the devil and his angels. For I was hungry and you gave me no food, I was thirsty and you gave me no drink, a stranger and you gave me no welcome, naked and you gave me no clothing, ill and in prison, and you did not care for me.’ Then they will answer and say, ‘Lord, when did we see you hungry or thirsty or a stranger or naked or ill or in prison, and not minister to your needs?’ He will answer them, ‘Amen, I say to you, what you did not do for one of these least ones, you did not do for me.’ And these will go off to eternal punishment, but the righteous to eternal life." LUK 16:19 The Rich Man and Lazarus
"There was a rich man who dressed in purple garments and fine linen and dined sumptuously each day. And lying at his door was a poor man named Lazarus, covered with sores, who would gladly have eaten his fill of the scraps that fell from the rich man’s table. Dogs even used to come and lick his sores. When the poor man died, he was carried away by angels to the bosom of Abraham. The rich man also died and was buried, and from the netherworld, where he was in torment, he raised his eyes and saw Abraham far off and Lazarus at his side. And he cried out, 'Father Abraham, have pity on me. Send Lazarus to dip the tip of his finger in water and cool my tongue, for I am suffering torment in these flames.’ Abraham replied, ‘My child, remember that you received what was good during your lifetime while Lazarus likewise received what was bad; but now he is comforted here,** whereas you are tormented. Moreover, between us and you a great chasm is established to prevent anyone from crossing who might wish to go from our side to yours or from your side to ours**.’
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Steven_Merten
Guest
Hello psteichen,
Pope John Paul II clearly states that “no evaluation of costs can outweigh… trying to protect, that of human life”. What you are saying is that evaluating costs should be taken into consideration as to who to save from starvation with feed tubes.
The Church has 1.2 billion Catholics commanded by Christ to care for the poor or burn in hell. The Church chose to give Pope John Paul II, a white European male pope, a feed tube. The Church does not supply feed tubes to a vast amount of non-white non-popes in third world countries to keep them from starving to death. Is this "thus introducing into social relations a discriminatory and eugenic principle"?
If the pope’s document is just a slam on American capitalist health care businesses, rather than a Pope sheparding and guiding billions of Christians as to what Jesus wills them to do, in regard to feed tubes, to go to heaven, then let us get the Church to acknowledge this clearly. If people, Third world or first world, cannot afford to keep their loved ones on life support, and the Pope feels that they can pull the feed tubes and let them die of starvation or never incert the feed tubes, because of the high cost, and let them starve to death and this is ok with Jesus, the Pope did a very confusing job of explaining this to billions of Christians.
First of all, no evaluation of costs can outweigh the value of the fundamental good which we are trying to protect, that of human life. Moreover, to admit that decisions regarding man’s life can be based on the external acknowledgment of its quality, is the same as acknowledging that increasing and decreasing levels of quality of life, and therefore of human dignity, can be attributed from an external perspective to any subject, **thus introducing into social relations a discriminatory and eugenic principle. **
quoted from: vatican.va/holy_father/john_paul_ii/speeches/2004/march/documents/hf_jp-ii_spe_20040320_congress-fiamc_en.html
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mosher
Guest
Remember, try to avoid situational ethics but know the principles and the answer will be evident.
In this case without knowing any further information I would say that the medical opinion would have to be that the person would never come out of the vegetative state (via anesthetic) and that without the ventilator the person would have naturally died. In this case I believe that it would be permissible to allow death to take its course since medical intervention would be in vain.
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Steven_Merten
Guest
Hello all,
What do you think?
Should Pope John Paul II have requested that his opportunity to recieve a feed tube, at 84 years old and terminally ill, be given to a third world ill child who would would be saved from death and live to their eighties?
Would this be a Christian thing to do?
Obviously, at the present donation rate of 1.2 billion Catholics, the Church has to carefully, sellectively, choose just which ill people they will save from starving to death with feed tubes.
What is the Christian moral theology on how the Church spends limited Catholic donation funds? Should an amount and quality of life gained per limmited Catholic donation funds spent, be taken into consideration? Should Church stature be a consideration on how limited Catholic health care funds are spent? Should First world/Third world stature be a consideration on how limited Catholic health care funds are spent?
What do you think?
Should Pope John Paul II have requested that his opportunity to recieve a feed tube, at 84 years old and terminally ill, be given to a third world ill child who would would be saved from death and live to their eighties?
Would this be a Christian thing to do?
Obviously, at the present donation rate of 1.2 billion Catholics, the Church has to carefully, sellectively, choose just which ill people they will save from starving to death with feed tubes.
What is the Christian moral theology on how the Church spends limited Catholic donation funds? Should an amount and quality of life gained per limmited Catholic donation funds spent, be taken into consideration? Should Church stature be a consideration on how limited Catholic health care funds are spent? Should First world/Third world stature be a consideration on how limited Catholic health care funds are spent?
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djamu
Guest
hey, i had a feeding toob once. and an IV a couple iof times.
not fun.
not fun.
- Status