Use of ordinary care even as we are Dying

Catholic Candle note: Recently, Catholic Candle examined the permission the Church traditionally gives to a person who is in danger of death, to confess to a priest whom an uncompromising Catholic could not otherwise support (or confess to) because that priest is a compromiser, an apostate, or someone whom it is otherwise impermissible to support.  Find the article here: http://www.catholiccandle.org/2020/01/01/using-a-compromised-priest-when-dying/

Catholic Candle also addressed how uncompromising laymen can bury their dead in these times of great apostasy when an uncompromising priest is not available.  Find the article here: http://www.catholiccandle.org/2020/04/02/a-traditional-catholic-funeral-and-burial-when-there-is-no-uncompromising-priest-available/

Between this last confession (discussed in the first of those articles) and the burial (discussed in the second article), is the crucial moment of death.  We gave recommendations how to assist at a person’s death, based on the experience of some of the Catholic Candle Team, who recently assisted at the deaths of two uncompromising Traditional Catholics.  Find the article here: http://www.catholiccandle.org/2020/06/01/how-to-assist-a-person-in-dying-a-holy-death/

Also, in our last days of life, we must continue to give sufficient care to sustain our life – even as it is waning – and must not yield to the culture of death, which promotes euthanasia.  Below, we examine the minimum care we are obliged to provide to sustain our life even when we are dying.

We recommend that you save these articles for future reference and use.

Our Duty to Use (at least) Ordinary Care to Preserve Our Life, even as we are Dying

We are free to choose (or not choose) to make extraordinary efforts to preserve our life.  However, there is a minimum, ordinary effort we must make, in order to avoid the sin against the Fifth Commandment, of failing to protect our life.  As St. Thomas teaches:

God commands man to sustain his body.  Otherwise he would be his own killer. …  By this Commandment [viz., the Fifth Commandment], man is bound to nourish his body and do those other things without which his body cannot live.[1]

Even though we foreseeably will die in the near future, we must continue to make ordinary efforts to preserve our life.  So just as our impending death (e.g., from disease) does not allow us to jump off of a cliff (and so hasten death), likewise we cannot hasten our death in any other way, such as by starving ourselves to death.  If a person starved himself to death even one day before he would have died of disease, he has committed suicide.

Although we know we must do those things without which our body cannot live – as St. Thomas teaches (quoted above) – what are those things?  We do not need to do strange, extreme, and unreasonable things to preserve our life.[2]  However, we must preserve our life by making efforts which are reasonable, common, and ordinary under our circumstances.[3]

 

What specific ordinary efforts must we make to preserve our life?

There is no complete list of ordinary efforts required to preserve our life.  In part, the list of what is common, reasonable, and ordinary depends upon our physical condition and our access to health care. 

We do not need to do those things which, when taking into account our circumstances and medical condition at the time, would not help us preserve our life.  For example, we normally must take nutrition and hydration (food and drink) to sustain our life.  However, in the final short period of our life, if our body’s organs are shutting down and no longer functioning, and the nutrition and hydration are no longer being absorbed and no longer usable by our body, then we do not have the obligation to take nutrition and hydration since they no longer help us to preserve our life.  In other words, we do not need to do things that won’t help to preserve our life in the circumstances at the time.

 

Common, ordinary, and reasonable efforts to sustain life

We observe that, generally, the list of common, ordinary, and reasonable efforts to sustain life has grown with the safety, ease, and widespread use of those procedures.  So, e.g., in a past time, using a hypodermic needle was extraordinary.  (They did not even exist before the 17th Century.)  But now hypodermic needles are used daily by many ordinary persons, e.g., diabetic persons needing insulin injections.  Here are a few examples of procedures we consider ordinary, common, and reasonable means of preserving a person’s life, in most developed countries of the world:

  Automated external defibrillators (AEDs) These have become an ordinary means of preserving a person’s life when he has a heart rhythm problem.  AEDs are routinely used by paramedics[4] and are made available to the untrained general public, for use in an emergency, e.g., on planes, trains, and in public buildings. 

  Injections, shots, intravenous feeding/therapy (IVs), EpiPens (Epinephrine autoinjectors) – These have become ordinary means of preserving a person’s life.  They are routinely used not only by paramedics[5] and nurses but also by the general public, e.g., for administering insulin to diabetics, for administering adrenaline where a person suffered a severe reaction to a bee sting, etc.

  CPR (cardio-pulmonary resuscitation).  This is an ordinary procedure.  The public is taught to perform this common emergency procedure.  It is also routinely performed by paramedics.[6] 

Obviously, though, CPR has its reasonable limits.  We know of a dying man whose heart stopped and he was revived several times, only to have his heart stop again, each time, a short time later.  The pattern became plain and there is no obligation to interminably revive a very sick, dying person.

 

A “Do not resuscitate” (DNR) order directs that CPR not be administered.  Such DNRs must be used carefully to apply only when CPR would be beyond reasonable limits.

 

  Gastro-intestinal tubes.   These are routinely and ordinarily used (as necessary), and are inserted in the nose or mouth, or directly into the stomach, to administer liquids and liquified food.

 

  Supplemental oxygen.

 

  Kidney dialysis.

 

  Common medicines including antibiotics.

 

Conclusion of this section of the article

We have a duty to take reasonable care of our life, including using the ordinary, common, and reasonable means generally employed.

 

What can we do to ensure (at least) ordinary means are taken to preserve our life, even when we are dying and we are unable (or less able) to defend ourselves from those seeking to end our life?

We live in a “culture” of death, of murder, and of suicide.  For example, in Britain and The Netherlands, people are sometimes murdered by the medical establishment because they are inconvenient.[7]  This also happens in other countries too.

Further, we should not think that we are protected from being murdered (euthanasia) because we receive care from a “Catholic” hospital, nursing home, or hospice organization.  Even care facilities which assure you that they follow Catholic rules, are sometimes ready to murder their patients. 

The conciliar church now promotes euthanasia, even for the mere convenience of the caregivers![8]  Even the “conservative” wing of the conciliar church – e.g., the Society of St. Pius X – has now sunk so low as to promote a conciliar booklet which approves of starving people to death for the convenience of their caregivers![9]

Clearly, we need to take precautions to avoid being murdered (euthanasia).  We should make known our insistent refusal to follow the new, sinful standard of the conciliar church, as approved by the N-SSPX.  We should sign a carefully-drafted Living Will, stating our determined will for end-of-life care in the absence of our ability to make those decisions at the time. 

 

Use a Living Will

Below, we give a draft declaration regarding medical treatment a/k/a a Living Will.  This draft might need to be revised based on the laws of a particular jurisdiction.

 

DECLARATION CONCERNING MEDICAL TREATMENT

This declaration is made this         day of ____________________, 202__.  I, [name], currently residing at [address], being of sound mind, willfully and voluntarily state my desires concerning medical treatment that would postpone the moment of my death.

Except as specifically provided below, I direct my healthcare providers to use all medical treatment that would 1) preserve my life; 2) cure or improve my physical or mental condition; or 3) reduce or prevent my physical or mental deterioration.

I direct my healthcare providers to provide me with food and fluids orally, intravenously, by tube, or by other means to the full extent necessary to preserve or extend my life and to assure my optimal health.

I direct that medication be administered to me, including painkillers, provided that this medication is not used to cause or hasten my death.  I direct that cardiopulmonary resuscitation and all other necessary medical and surgical procedures be used to the full extent necessary to correct, reverse, or alleviate life threatening or health-impairing conditions, and complications arising from those conditions.

I reject any treatment that uses an organ or tissue of another person obtained in a manner that causes, contributes to, or hastens that person’s death.  I reject any treatment that uses a vital organ “donated” by any other person who is declared “dead” (usually this declaration of “death” is made shortly before the organ is removed).  I also reject any treatments that use an organ or tissue of an unborn or newborn child who has been subject to an induced abortion.

I direct that I receive all medical treatment and care to preserve my life without regard to my age, physical or mental ability, the “quality” of my life, or the “dignity” of my death.

If I should have an incurable and irreversible injury, disease, or illness judged to be a terminal condition by my attending physician who has personally examined me and who considers that even with maximum medical treatment, I have less than three months probable, foreseeable life expectancy, I direct that I not be kept alive artificially through major surgery, chemotherapy, and cardiopulmonary resuscitation.  However, in no case do I wish to be deprived of food, fluids, oxygen, and common medications such as any antibiotics.

I do not want any of my organs to be donated.  I wish my bodily remains to receive a traditional Catholic burial as outlined in my letter to my executor.

In the absence of my ability to give directions regarding my medical treatment, it is my intention that this declaration shall be honored by my family and physician as the final expression of my legal and moral right to direct the medical or surgical treatment I am given.                                          

 __________________________________

                                                                                                            [name]

City, County and State of Residence: ________________________________

The declarant is personally known to me and I believe him to be of sound mind.  I did not sign the declarant’s signature above for or at the direction of the declarant.  At the date of this instrument, I am not entitled to any portion of the estate of the declarant according to the laws of intestate succession or, to the best of my knowledge and belief, under any Will of declarant or other instrument taking effect at declarant’s death.  I am not directly financially responsible for declarant’s medical care.

 

Witness:                                            Witness: _______________________                       

 

Address:                                            Address: _______________________                                 

 

What should we do with our Living Will after it is signed?

After our Living Will is completed and signed, we should not merely put it with our important papers or in a safety deposit box at a bank (although it is good to place a copy there).  We should give a copy of our Living Will to our family, friends, and caregivers – because when we have a medical emergency, they are going to be focused on our treatment, not focused on searching through our important papers.

Therefore, we should disseminate widely our Living Will to our family and friends and to all of our caregivers who have a patient file concerning our treatment, e.g., our hospital, our primary care doctor, our specialist doctors, our dentist, our assisted living facility, etc

Broadly disseminating our Living Will makes it more likely that it will be known and used in an emergency because more people will know about it and have access to it. 

Further, broad dissemination is an act of religious courage – standing up for the Natural Law (and God’s Law), against euthanasia.  Our Living Will provides a good example to others who might otherwise yield to the culture of death.

 

Conclusion

We have a duty to preserve our life using (at least) all common, ordinary, and reasonable means, based on our physical condition at the time.  We should prepare a Living Will, which is an important tool to ensure that happens.

 



[1]           Words of St. Thomas Aquinas, quoted from his Commentary on II Thessalonians, 3:10, ch.3, lecture 2.

 

[2]           Here is how McHugh and Callan describe this minimum effort to preserve our life:

 

A very painful and uncertain operation or mutilation is not obligatory, unless one has dependents, and the danger to life from the operation is slight.

 

Moral Theology, by John A. McHugh, O.P., and Charles J. Callan, O.P., revised and enlarged by Edward P. Farrell, O.P., published by Joseph F. Wagner, Inc., New York City, © 1958, quoted from section #1571(b).

 

Here is how Slater describes this minimum effort to preserve our life:

 

We are obliged to take ordinary means to preserve our lives, for to do otherwise would be virtually to commit suicide.  There is no obligation to take extraordinary, unusual, or very painful or expensive means to preserve our lives. And so, one in feeble health, who will probably die if he spends the winter in England, is not bound to expatriate himself and go and live in a milder climate.  Nor am I bound to undergo a painful and costly operation in order to save my life; I may if I like choose rather to die, unless my life is of great importance for the common good, for then the public good must be considered first.  Except in such a case as this, a superior could not oblige a subject to undergo a very painful operation or to submit to the amputation of a leg; obedience to human authority does not seem to extend to such matters as these.

 

A Manual of Moral Theology, Rev. Thomas Slater, SJ., Vol I., Fifth and Revised Edition, Burns Oates & Washbourne Ltd., London, ©1925, Part 5, The Fifth Commandment, Ch.1, On Suicide.

 

[3]           Here is how Henry Davis, S.J., describes this minimum effort to preserve our life:

 

Section 2.  Preservation of Life

 

By Natural Law, man enjoys the use, not the dominion of his life.  He neither gave it nor may he take it away.  God only is the Author of life.  Man must preserve it by the use of ordinary means; he is not bound to employ extraordinarily expensive methods, nor methods that would inflict on him almost intolerable pain or shame. 

                                                                                                                     

Quote from Moral and Pastoral Theology, by Henry Davis, S.J., Sheed and Ward, © 1959, Vol. Two, page 113.

[9]           The N-SSPX made an end-of-life presentation to parishioners which was approved by N-SSPX Bishop Bernard Tissier.  This presentation included the promotion of a conciliar booklet approving of starving a patient to death even for the mere convenience of the caregivers.  https://catholiccandle.neocities.org/priests/tissier-praises-euthanasia-booklet.html