ARTICLES

End of life decisions need family consultation

by Steve Neill
of The Catholic Virginian

While most people don’t like to think about their own mortality and envision themselves in a trauma ward from an accident or being in a permanent comatose state, it does happen to some people.

The medical response in such situations ideally should be guided by the wishes of the patient and his or her family members, says a trauma surgeon who often has been guided by such wishes.

These issues surfaced at a seminar April 17 at St. Benedict Church in Richmond entitled “Faith, Law and Medicine.”

The event, which included a buffet style dinner, was sponsored by the Father William J. Nolte Council of the Knights of Columbus.

Pointing out that the American Civil War began 150 years ago on April 15, 1861 at Fort Sumter in South Carolina, Bishop Francis X. DiLorenzo said the war caused much suffering when soldiers became infected from bacteria and other issues like loss of life from the battles. There were questions about right to life, but much has been answered today because of better knowledge, better research and better technology.

“We now wind up with newer questions,” the Bishop said, adding that complications can arise in medical treatment of a human being.

“Now all of a sudden you are in a quandary... and you want to do the right thing,” Bishop DiLorenzo said.

As Catholic Christians seek to promote and uphold the sanctity of life, he pointed out that “some people do not share the same views we have as Catholic Christians.”

Dr. Therese Duane, a member of St. Mary Parish in Richmond, deals mainly with accident victims at VCU Medical Center. She said that the age of a trauma victim has great bearing on the prospects for their full recovery.

For example, a 20-year-old person who has been in a serious car accident has a much better chance of resuming a normal life than one who is 65 years old.

“The majority of what we deal with are situations where recovery is unlikely,” Dr. Duane said.

She stressed that it is important to “know your moral code.”

Dr. John Seeds, who previously chaired the OB-GYN department of the VCU School of Medicine for 14 years and is now Senior Associate Dean for Professional Education Programs at VCU, served as moderator of the panel. He suggested that patients have a right to ask their physician about their religious faith. But he pointed out that he had only been asked this question by patients twice in his 35 years in medicine.

As to the doctor’s response in being asked the question, he said, “If they’re offended, you’re in the wrong office.”

“You should never have to apologize for your faith,” Dr. Seeds added.

Gray Jennings, who identified himself as a pro-life attorney and a member of St. Benedict Parish, said that Catholic teaching specifically states that feeding and hydration are basic rights of patients, even when given by artificial means.

The Vatican Congregation for the Doctrine of the Faith states: The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life.

“It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient.

“In this way suffering and death by starvation and dehydration are prevented.”

Dr. Duane, in an interview with The Catholic Virginian after she spoke, asserted that advance medical directives dictated by the patient are sometimes ignored by health care providers if the patient’s loved one “is standing right there” and goes against the directives.

“The burden is on the patient, but often the family is not willing to let go,” she said, adding that she has felt loved ones sometimes exhibit unrealistic expectations and may use their faith to support their unwillingness to let go.

Patients who have been deprived of prolonged oxygen to the brain could be reduced to a permanent vegetative state with only life support keeping them alive. Someone who has “too much faith” has difficulty recognizing that some artificial life support measures are unnecessary and can actually be burdensome on the patient.

Dr. Duane stressed that husbands and wives and mothers and fathers express their wishes of advance directives before any emergency situation exists.

Two-thirds of Americans have not made any such directives, Mr. Jennings said, expressing a concern that euthanasia is being encouraged throughout the United States, including Virginia.

“We do live in a culture of death,” Mr. Jennings said. He went on to say that there are people who would say in the event of what they perceive a terminal illness “Hurry up and die!”

He also said it was important to have prepared medical directives regarding life support in advance of any emergency.

“Do not assume your spouse or siblings will act on your behalf without documentation,” he said.

Mr. Jennings also urged caution before signing any document unless one has carefully read it beforehand. Often patients being admitted to a hospital are asked to sign required forms and do so without full understanding of what they are signing.

He stated that no one should sign any document specifically stated “Living Will.”

By doing so, this allows strangers among medical personnel to make decisions on what they feel is quality of life for the patient.

“This, in turn could result in the withholding of food, water and pain medication or the purposeful administration of an overdose of pain medication which would likely end your life,” Mr. Jennings said.

Dr. Dominick Hankle, a professor of psychology at Regent University who is the new Diocesan Theologian, stressed that there are a number of gray areas that need consideration.

“For example, when hydration and nutrition are not being assimilated into the body, does that mean it is proper to remove these interventions? That is why pastoral care is exceptionally important.”

He emphasized that while it is easy to articulate theologies as principles, “it takes a skilled pastor of souls to apply these theological norms and truths to specific family situations.”

Dr. Hankle also said that suffering is not evil itself, but is the result of evil existing in the world.

Proceeds from the dinner and auction of a television set raised more than $7,000. The proceeds will be used to help purchase an ultrasound machine for the Pregnancy Resource Center in Richmond. Dr. Seeds is one of the center’s two medical directors.

Jeff Caruso, executive director of the Virginia Catholic Conference, said that the two Catholic Dioceses of Virginian — Richmond and Arlington — had gathered both priests and physicians who helped put together a package of documents dealing with end of life issues which are available on the Diocese of Richmond website through the Office of Justice and Peace.

To access these materials, visit the website www.richmonddiocese.org/ojp, then select “publications and documents” to view the resources under “Advance Medical Directives.”

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