Death is part of life; we are all going to die.
While we typically cannot plan the hour of our death, we can prepare for it, said panelists
discussing the legal, medical and moral considerations surrounding death.
The panel presentation on end-of-life care was held at St. Gabriel Church the evening of Oct. 18. It was the third in a series of four events hosted by the Archdiocese of Louisville’s Office of Family and Life Ministries in observance of October’s Respect Life Month.
Retired Archdiocese of Louisville priest Father Tony Smith spoke to the theological and ethical side of end-of-life care. He told his listeners that people have a stewardship to — not a dominion over — life.
“Life is a gift from the divine,” he said. “What is the purpose of the gift of life? Unity with God when we die. Life is not an absolute. We do die. Even Jesus, the son of God, died.”
As it applies to end-of-life decisions, Father Smith said the church teaches that there is an “ordinary understanding to protect life,” but there’s a difference between preserving life and prolonging death.
Questions about ventilators, feeding tubes, receiving artificial nutrition and hydration, ectopic pregnancies that threaten the mother’s life and assisted suicide are end-of-life issues that don’t just need legal consideration but moral consideration as well, he said.
“There comes a time when we say, ‘I’ve done what I can do, it’s time to go home to God,’ ” he said.
Father Smith noted that Catholics derive morality from three places: Scripture, tradition and experience.
“Our conscience helps us know the difference between right and wrong,” he said.
As it applies to end-of-life decisions, we have to decide if medical treatment is considered ordinary or extraordinary — and whether the burden outweighs the benefits.
“There comes a time when we say, ‘I’ve done what I can do, it’s time to go home to God.’ ”Father Tony Smith
The American bishops “have documents that say you are the one that chooses” your course of treatment, he said, using kidney dialysis as an example.
Father Smith said he’s decided for himself that he will never receive dialysis, even if it’s the only treatment for an illness, even if denying it means he will die. And morally, that’s OK, he said.
“It’s very important that you talk to everyone involved” about your end-of-life decisions and wishes, he told his listeners.
Misty Clark Vantrease, a partner at Kentucky ElderLaw, echoed Father Smith’s sentiment.
“Communication is key,” she said. Talking about “how you feel, what care you want, how to handle” different situations when you’re unable to decide for yourself is difficult but important.
“Families who have these conversations have a better end-of-life experience because they know they’re making the right decisions” for their loved one.
Clark Vantrease said there are four documents everyone should complete when they turn 18: power of attorney; healthcare power of attorney; a living will; and a medical order scope of treatment.
- A power of attorney, also called a durable power of attorney, is a financial document that allows someone to handle your finances and make sure your bills are paid.
- A healthcare power of attorney, also known as a healthcare surrogate, decides who can make medical decisions for you if you’re unable to.
- A living will is “our chance to say, ‘Legally, these are my wishes,’ ” Clark Vantrease said. The document is only taken into consideration when doctors determine your condition is terminal, that you’re permanently unconscious. It takes into consideration circumstances such as being kept alive on a ventilator or feeding tube or receiving artificial nutrition and hydration.
- A medical order scope of treatment document should be filled out by a patient with their physician, detailing what kind and type of treatment the patient does and doesn’t in certain situations.
Father Smith suggested revisiting those documents every few years.
“Medical advancements change, laws change,” he said. “Don’t set it and forget it.”
Both panelists noted a recent shift in physician ideology. Whereas in the past, doctors focused heavily on quantity or years of life, they now tend to prioritize quality of life.
“They focus on palliative care,” Clark Vantrease said. “They realize life is only good if it’s worth living.”
Father Smith noted that for so long, doctors saw patients who died as “failures.”
“But it’s death,” he said. “Everyone dies. Now it’s more along the lines of cure when possible, care always.”