A Question about End of Life Treatment

A reader writes:

Today, after reading your article in the National Catholic Register, I was going to send you a further question, but I think that I just found the answer in this story.

The video is about winning the lottery and giving it all away to charity, but what impressed me was the written story that followed, about the death of Ms. Large after a long struggle with cancer. I was going to ask you: I am now 69 years old, my physical health is pretty good, and my mental health (depression) has made great progress in the last few years. However, supposing that some 10 years or more from now, I was found to have a terminal illness, such as cancer. Getting older, no matter how well my illness would be treated, I would be dying a few years later anyway. Then, would it matter if I decided, not to terminate my life, of course, but to forego most treatments, since they would not significantly add to my life on earth? Would that be suicide, or just letting the natural end of my life take its course?

Of course, now, after reading about Ms. Large’s last years, I am having second thoughts. And I thought that you might be interested to know about this too.

Here’s what Pope John Paul II says in Evangelium Vitae:

Euthanasia must be distinguished from the decision to forego so-called “aggressive medical treatment”, in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience “refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted”. Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death.

In modern medicine, increased attention is being given to what are called “methods of palliative care”, which seek to make suffering more bearable in the final stages of illness and to ensure that the patient is supported and accompanied in his or her ordeal. Among the questions which arise in this context is that of the licitness of using various types of painkillers and sedatives for relieving the patient’s pain when this involves the risk of shortening life. While praise may be due to the person who voluntarily accepts suffering by forgoing treatment with pain-killers in order to remain fully lucid and, if a believer, to share consciously in the Lord’s Passion, such “heroic” behaviour cannot be considered the duty of everyone. Pius XII affirmed that it is licit to relieve pain by narcotics, even when the result is decreased consciousness and a shortening of life, “if no other means exist, and if, in the given circumstances, this does not prevent the carrying out of other religious and moral duties”. In such a case, death is not willed or sought, even though for reasonable motives one runs the risk of it: there is simply a desire to ease pain effectively by using the analgesics which medicine provides. All the same, “it is not right to deprive the dying person of consciousness without a serious reason”: as they approach death people ought to be able to satisfy their moral and family duties, and above all they ought to be able to prepare in a fully conscious way for their definitive meeting with God.