I’ve been distracted this week.<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Good news, we caught a misspelling of my name and clarified a few points.<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
I’ll be working on that at least into the weekend.<\/p>\n\n\n\n
Deciding who I pick to speak for me if I can’t is easy, since I’m blessed with family who share my beliefs.<\/p>\n\n\n\n
What’s not easy, from an emotional viewpoint at least, is getting specific about what I see as acceptable medical care.<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
My native culture’s values and assumptions do not line up with mine in some literally vital ways.<\/p>\n\n\n\n
Take, for example, being given food and water; even if I’m terminally ill. Or, in medical jargon, nutrition and hydration.<\/p>\n\n\n\n
The good news is that the Church has noticed this SNAFU, and gotten specific about that particular aspect of palliative care:<\/p>\n\n\n\n
\n“…It should be recognized, however, that the definition of palliative care<\/strong> has in recent years taken on a sometimes equivocal connotation. In some countries, national laws regulating palliative care (Palliative Care Act)<\/strong> as well as the laws on the “end of life” (End-of-Life Law)<\/strong> provide, along with palliative treatments, something called Medical Assistance to the Dying (MAiD)<\/strong> 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.<\/strong><\/p>\n\n\n\n
“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.<\/strong> 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<\/strong> of national and international professional societies, constitutes a socially irresponsible threat to<\/strong> 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.<\/strong>…”
(“Letter Samaritanus bonus on the Care of Persons in the Critical
and Terminal Phases of Life<\/a>” , 4. Palliative care<\/a>; Congregation for the Doctrine of the Faith (July 14, 2020)) [emphasis mine]<\/p>\n<\/blockquote>\n\n\n\nI’d like to think “it can’t happen here”, but \u2014 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.<\/p>\n\n\n\n
<\/a>Life, Death, and Making Sense<\/h4>\n\n\n\n
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.<\/p>\n\n\n\n
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- To<\/strong>: Centers for Medicare & Medicaid Services, Department of Health and Human Services:<\/a>
Re:<\/strong> Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; RIN 0938\u2013AV78 (June 1, 2026)
From:<\/strong> Office of the General Council, USCCB (United States Conference of Catholic Bishops)<\/li>\n<\/ul>\n\n\n\nAmong 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.<\/p>\n\n\n\n
I realize that may sound “judgemental”, but I’m a Catholic.<\/p>\n\n\n\n
If I take my faith seriously, I must see life as precious. Even if that goes against my culture’s preferences.<\/p>\n\n\n\n
One more thing before I wrap this up. Since I’m a Catholic, getting all ‘spiritual’ about pain and suffering \u2014 let’s put it this way. Using my brain is a good idea.<\/p>\n\n\n\n
\n“Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted.
“The use of painkillers<\/strong> 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]<\/p>\n<\/blockquote>\n\n\n\nI’ve talked about some of this before:<\/p>\n\n\n\n
\n
- “Potpourri Post: Family Business and an Exoplanet With Air<\/strong><\/a>” (July 18, 2026)<\/li>\n\n\n\n
- “Early Diagnosis, Tardy Treatment, and a Gimpy Hip<\/strong><\/a>” (January 25, 2025)\n
\n
- Hip Dysplasia and Me<\/a>\n
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- Shock at the Reference Desk<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- A Birth Defect That’s Not a Birth Defect?<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- “Saints, Depression, Assumptions, and Me<\/strong><\/a>” (March 23, 2024)\n
\n
- Dealing With Depression \u2014 and Suicide<\/a>\n
\n
- Depression, Faith, and Making Decisions<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- Poverty, Terminal Illness, and Ham Sandwiches<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- “I’m Not as Crazy as You Think I Moose!<\/strong><\/a>” (April 9, 2022)\n
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- Taking my Medicine<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- “Health Care Directive<\/strong><\/a>” (November 24, 2019)\n
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- Changing Times: Coffins, Cholera and Care for the Sick<\/a>\n
\n
- Bioethics<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- A Task (Nearly) Done<\/a>\n
\n
- Death and Signatures<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n
- “Misusing Opioids<\/strong><\/a>” (July 7, 2017)\n
\n
- “Opioid Crisis”<\/a>\n
\n
- Oral Traditions<\/a><\/li>\n\n\n\n
- Poppies<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n
- Prescribed, But Abused<\/a><\/li>\n\n\n\n
- Dead Counselors<\/a>\n
\n
- Realities<\/a><\/li>\n\n\n\n
- Good Health: Within Reason<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"
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 … Continue reading