End of Life Issues
April 3, 2022
Jesus Christ: Yesterday, Today, and Forever ~
We will all die. As obvious as that statement is, many people are dumbfounded when it comes to the end of their own life or that of a loved one. People avoid thinking of death because we don’t like to think about unpleasant things, understandable enough. Yet our generation ignores death more than any generation that has ever lived.
Over the past 50 years advances in medicine have been amazing in the areas of medication, technology, and knowledge of the body. These advances have significantly improved and prolonged life, contributing to a false sense of physical immortality; and a subconscious belief that we’ve beat death! We haven’t.
Another reason why this generation thinks less of death, and is less prepared for it, is because of our focus on what the Church calls materialism. Materialism is man’s obsessive focus on empirical things to the exclusion of the spiritual or moral. God after all, is the most important “thing” to focus on; not our bodies, money, careers, home(s), cars, clothes, entertainment, etc. And since we are physically mortal and spiritually immortal, we ignore God, our soul, and the souls of others, at our peril and theirs. Because of our generation’s obsession with material things, we aren’t prepared for what lay beyond this physical world so we cling to it, often pathetically.
Some of the most challenging moral decisions come in the final months and hours of our life, as we deal with balancing the nurturing of life with the acceptance that death is unavoidable. It is important to reflect on our lives, talk with our family members and care providers, and understand what end-of-life care is going to be prior to a health crisis. Here are some basics in understanding what end of life care should be.
All people are entitled to food, water, shelter, etc., ‘the basics’ if you will, throughout life. As infants we rely on our parents to shelter, feed, and change us. It may be that through a tragedy or simple natural decline, we find ourselves back in that situation; needing to be fed, changed, clothed, etc. This might be humbling and feel like an imposition on others, but it is not an excuse to give up on life. This level of care is called ordinary care and it is what we are obligated to give to someone in need if possible. Nutrition for someone who is not dying may even need to be given intravenously.
Extraordinary care is care that goes beyond the basics of nutrition and shelter; examples would include: CPR, blood transfusions, surgery, respirator, etc. It should be used when someone has a chance of recovering. Think of someone in a car wreck: they are banged up bad but if they get immediate medical help, they can recover and continue living; in this case the medical intervention would prevent death. The same could be said of most cancer diagnoses: immediate intervention might beat the cancer or stave off death for years. The same could be said for many things.
Extraordinary care that simply prolongs death is immoral. In the ordinary course of dying a person stops drinking, eating, and ultimately breathing. If a person stops doing these three things because their situation is terminal, then there is no moral imperative to intervene to keep them alive. I have to say this because many people think that hydration, food, medication, or even medical procedures should be forced upon someone who is dying of natural causes.
Think of these two words when considering extraordinary care: prevent or prolong. Then ask this question: does medical intervention prevent death so they can recover, or simply prolong death?
Pain management should always be used so that the dying may be kept as free of pain as possible, comfortable, and in a place where they wish to die. When a person is dying, at a certain point only medication for pain is morally licit.
Euthanasia is the gravely evil act of killing another person out of a misguided notion of mercy. Some of us remember the famous case in Florida of a woman who lived in a semi-comatose (coma) state: Terry Shiavo. Terry had been in a terrible car accident 17 years prior to her death that left her brain damaged and bed ridden. Her ex-husband, who still had legal custody of her, stated that: “Terry would not want to live this way”. He successfully had nutrition removed from her and Terry died of dehydration. This is a classic case of euthanasia. Terry was not dying, rather she lived a very simple, dependent life. To many, the thought of living a (seemingly) unproductive and burdensome life to others, riddles them with guilt – especially if financial burdens loom. We do not kill other people, loved one’s included, because we can’t stand to see them live the way they are. We are not God.
Assisted suicide is very much like euthanasia. Only in this case, the “mercy” killing is being imposed upon one’s self. We kill our self, with the assistance of a doctor’s lethal prescription to end suffering. This too is gravely evil. The mystery of suffering is real indeed and no one disputes another’s pain, however, killing our self is not how God intends for us to deal with it. Scientific advances have enabled us to live through much that our ancestors couldn’t live through, yet it has also brought palliative care that our ancestors did not have. Virtually all physical suffering and a great deal of psychological suffering can be alleviated through medication: faith and God’s grace can make up the difference.
Related to suffering at the end of life is the principle of redemptive suffering. While suffering can occur at any time in our life, the suffering preceding death presents a special time for reflection and offering. Dying gives each of us a chance to reflect on our lives and unite our sufferings with Christ’s on the cross, which then becomes redemptive to the dying and others; a participation in the salvific work of Christ and a purification of our sins. Dying doesn’t have to be depressing. It is also important, at this time, that the Church and her members support the dying and their family with prayers and the Sacraments.
If the person dying is Catholic, ask them if they would like to see a priest for the last rites. If they don’t know what that is or what good it would do for them, do your best to explain and promote it. The dying Catholic doesn’t need to be a practicing Catholic to have the last rites. For more information about the last rites, see my February 13, 2022 pastor’s column on the sacrament of the anointing of the sick. You can find it on Holy Redeemer’s website – click on the resources tab and scroll down to pastor’s columns.
There was a lot of important information in this pastor’s column. If it didn’t all stick you might want to save it or pass it along to others. My prayers and love.
In Jesus Christ, the Prince of Peace,
Fr. Thomas Nathe
