End-of-Life Part III: Advanced Directives and Aggressive Treatment

This is the last in a series of 3-Minute Catecheses on end-of-life issues and how the Church expects us to respond when death is near.

The Church takes seriously her role in educating about the sanctity of life at all levels. The concern is that we seem to be becoming a society in which life is not respected and cherished. People are expendable if they make us angry or inconvenience us in some way. Just this last week, one of the young men working on our landscaping project was killed by drug dealers in a case of mistaken identity when he went to visit his family in Mexico. Life is often not treated as the precious gift that it is.

So what happens if you or a loved one become seriously ill? Can Catholics have Advanced Directives, including Do Not Resuscitate orders?

The Catholic Church does not prohibit Advanced Health Directives which lay out in written form what your wishes are in case you are unable to communicate. However, Advanced Directives can be morally problematic because they require a person to make blanket general statements about possible scenarios in the future.

That is why, from the Church’s point of view, it is far more preferable to have a health care proxy. A health care proxy is an actual person whom you have designated to stand in your place and make a health care decision on your behalf. Such a person is able to assess the totality of your circumstances in a way that is sensitive to the conditions of your situation.

While true compassion encourages every reasonable effort for the patient's recovery, at the same time, it helps draw the line when it is clear that no further treatment will serve this purpose. The decision to forego aggressive treatment is an expression of the respect that is due to the patient at every moment. From the patient's perspective, this is not "giving up" nor disregarding the obligation to care for oneself: rather, it is an acceptance of the human condition in the face of life-threatening illness. It is at this point that many patients and their families opt for hospice care, which often allows the patient to die, in peace, at home.

The Church understands that thoughts of death are accompanied by mixed feelings, conflicted between hope in immortality on the one hand and fear of the unknown on the other. This is why Anointing within the Last Rites, which is less for physical healing than for spiritual healing and strength, is so important. Through the sacraments, the Church strives to give each dying person loving care as they prepare to cross the threshold of time to enter eternity.