My Health Care Directive: Being Specific

I’ve been distracted this week.

Wednesday morning I got and started reading documents involved in setting up family property/estate/whatever arrangements for at least the next generation. I was part-way through the last document when a video conference with the lawyer started.

Good news, we caught a misspelling of my name and clarified a few points.

Surprising news, one of the documents was a health care directive. It includes a dozen or so places where I’m writing in details for what I want for situations in which I am terminally ill and/or unable to communicate.

I’ll be working on that at least into the weekend.

Deciding who I pick to speak for me if I can’t is easy, since I’m blessed with family who share my beliefs.

Killing Sick People Isn’t Nice

What’s not easy, from an emotional viewpoint at least, is getting specific about what I see as acceptable medical care.

That’s partly because I’m a Catholic, one who takes what the Church says seriously. I’ve also had opportunities for learning just how flexible medical ethics can be. It’s not that I’d insist on having a crucifix on the wall, or fish on Friday. Although the latter would be nice during Lent, and that’s another topic.

My native culture’s values and assumptions do not line up with mine in some literally vital ways.

Take, for example, being given food and water; even if I’m terminally ill. Or, in medical jargon, nutrition and hydration.

The good news is that the Church has noticed this SNAFU, and gotten specific about that particular aspect of palliative care:

“…It should be recognized, however, that the definition of palliative care has in recent years taken on a sometimes equivocal connotation. In some countries, national laws regulating palliative care (Palliative Care Act) as well as the laws on the “end of life” (End-of-Life Law) provide, along with palliative treatments, something called Medical Assistance to the Dying (MAiD) that can include the possibility of requesting euthanasia and assisted suicide. Such legal provisions are a cause of grave cultural confusion: by including under palliative care the provision of integrated medical assistance for a voluntary death, they imply that it would be morally lawful to request euthanasia or assisted suicide.

“In addition, palliative interventions to reduce the suffering of gravely or terminally ill patients in these regulatory contexts can involve the administration of medications that intend to hasten death, as well as the suspension or interruption of hydration and nutrition even when death is not imminent. In fact, such practices are equivalent to a direct action or omission to bring about death and are therefore unlawful. The growing diffusion of such legislation and of scientific guidelines of national and international professional societies, constitutes a socially irresponsible threat to many people, including a growing number of vulnerable persons who needed only to be better cared for and comforted but are instead being led to choose euthanasia and suicide.…”
(“Letter Samaritanus bonus on the Care of Persons in the Critical
and Terminal Phases of Life
” , 4. Palliative care; Congregation for the Doctrine of the Faith (July 14, 2020)) [emphasis mine]

I’d like to think “it can’t happen here”, but — I’ve been paying attention and know my history. Humanity’s track record doesn’t inspire blind optimism. Or despondency. And that’s yet another topic.

Life, Death, and Making Sense

More good news: the Maryland Department of Health and Human Services asked bishops in my country what they thought about some aspects of Medicare and hospice care. That, I think was a very nice gesture.

Among other things, the bishops quoted part of “Letter Samaritanus…”, pointing out that starving a patient isn’t nice, even if it’s legal. Talking a patient into seeing suicide as a good idea isn’t nice either, and we shouldn’t do it. Ever.

I realize that may sound “judgemental”, but I’m a Catholic.

If I take my faith seriously, I must see life as precious. Even if that goes against my culture’s preferences.

One more thing before I wrap this up. Since I’m a Catholic, getting all ‘spiritual’ about pain and suffering — let’s put it this way. Using my brain is a good idea.

“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.”
(Catechism of the Catholic Church, 2279) [emphasis mine]

I’ve talked about some of this before:


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About Brian H. Gill

I was born in 1951. I'm a husband, father and grandfather. One of the kids graduated from college in December, 2008, and is helping her husband run businesses and raise my granddaughter; another is a cartoonist and artist; #3 daughter is a writer; my son is developing a digital game with #3 and #1 daughters. I'm also a writer and artist.
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