DECISIONS BEFORE DEATH

NOVEMBER 11, 2007

As the Church’s year of worship approaches its end, we are invited to turn our attention to the end of our earthly lives, and to the future coming of Christ. If Christians were asked to associate the word “death” with something, many would surely think of “resurrection”. It is hard for us to think about death without remembering our Lord’s resurrection and the promise of our own future resurrection

The light of faith enables us to see that death is not so much the end of our mortal earthly existence as it is the portal to eternal life. The Apostle Paul asks, “Where, O death, is your victory? Where, O death, is your sting?” (1 Cor 15:55). He reminds us that in death, life is not ended but changed “in an instant, in the blink of an eye (1 Cor 15:51).

The assurance of our faith, however, should not lead us to be cavalier about death, or to become lax in our duty to continually renounce sin and seek our salvation in the Lord. Nor should we be remiss in preparing for death by failing to confront important end-of-life moral decisions we must make. Here are some of the most important things to keep in mind.

Because God formed the human body and breathed his own life into it (Gen 2:7), it possesses great dignity, and we are bound to care for our own body and those of others, even when they have become frail due to advanced years, or suffer from disfigurement, advanced disease, or debility. This is so, even though we recognize that our physical life, health, and activities are subordinated to final spiritual ends. It is always wrong to undertake any action, or forego any action, which has as its direct intent to bring about someone’s death. The first action is active euthanasia, the second is passive euthanasia.

One difficult question, in light of modern medical technology, has to do with what is morally obligatory to sustain life, and what is a matter of choice. In a word, we are bound to use ordinary means to sustain life, but not extraordinary, or disproportionate, means, when death is immanent. What is extraordinary is determined by cost or difficulty. For example, if aggressive medical treatment for a terminal disease like cancer would be overly painful, cumbersome, or financially burdensome, a person may forego it, even though the result will be an earlier death. If a treatment for a serious disease is new and experimental, a person is also free to elect to submit to it or to forego it.

Decisions must always be based on the best available information and medical judgment, and so all pertinent medical information must be provided. The truth must always be told. This is an important obligation of medical professionals and also of family and friends.

When death is near at hand, all treatment may be refused that would only result in a precarious and burdensome prolongation of life. At the same time, one near death may accept medication for pain relief even though it may produce disorientation or unconsciousness, or indirectly shorten life.

The provision of food and drink is considered ordinary care, not medical treatment. However, when a dying person cannot benefit from it, and would only suffer more intensely from it, as in the case of someone in the final stages of stomach cancer, it is not obligatory. In contrast, persons in a persistent state of unconsciousness or paralysis, but who are not near death, have a right to the sustenance of their lives, and others have the obligation to provide it.

How should we prepare for life’s end? We should prepare written directions for family and medical personnel that they can follow when the time comes. I am speaking of a Health Care Proxy document (also known as a Durable Power of Attorney for Health Care) and an Advance Medical Directive. These documents have legal power and take effect whenever a person can no longer make his or her own health care decisions. Catholics should seek out the Sacrament of Penance, and be sure to indicate they want a priest to administer the Last Rites of the Church.

Everyone should carefully read any papers a hospital or other health care institution asks patients to sign before treatment, to insure they conform to what they stated in their Advance Medical Directive and Health Care Proxy. No one is obliged to sign a hospital’s advance medical directives. It is good to consult with one’s pastor when difficult moral decisions must be made regarding one’s health and life.

Making a Last Will and Testament is always important, as well as expressing personal wishes regarding one’s funeral. The Church has traditionally opposed cremation because it was at times carried out due to the mistaken belief that the body is an evil prison of the soul, and must be destroyed in order to release the soul. The Church teaches the goodness, in fact, sanctity, the human body, and while the Church today continues to prefer internment of the body in the ground or entombment in a mausoleum, cremation is now permitted, preferably after the funeral rites, so long as the motives are not contrary to the faith. In all events, the cremated remains of the deceased should be committed to final rest through burial or entombment.

Christ, by his death and resurrection, has opened for us the hope of salvation and eternal life. Thus, we can approach death with joy as the end of all separation from God, and the moment at which we will be able to behold the face of our Savior.

+Bishop Raymundo J. Peña

last updated 05-Jun-2008 11:14 sitemap