I’ve been thinking about writing a book to help people dealing with end-of-life situations. Between the deaths of my wife and my parents and other family members, I’ve been through enough of them that I’ve had to think hard about the spiritual, moral, and evangelistic aspects of these situations.
If I am able to write such a book, one aspect that I will definitely cover is the need for humility and caution in assessing the sick person’s will to live.
Very frequently these days people end up in situations where they cannot speak for themselves and clearly communicate what kind of care they want or whether they even want care. In such situations, family members are typically consulted, and this can cause a rift inside the family as they try to figure out what their loved one would want.
This is one of the most painful kinds of conversations for family members to have, and it if goes the wrong way, it can permanently injure relations in the family. “You killed Dad!” or “You wouldn’t let Mom die with dignity!” are things that can haunt families for years after the event, permanently turning people against each other. (I am very thankful to say, however, that my own family was able to get through the difficult days without such damage being done—and in spite of the fact that I’m the only Catholic in my immediate family.)
Sooner or later the “Do you want to pull the plug?” question is going to be presented to virtually every family, and it’s good to be prepared for it.
In some cases the patient may have left explicit instructions, but often not. Sometimes family members will remember (or think they remember) things the patient said in conversation about what they would want if something terrible happened. Other times they won’t have such memories and will simply rely on their feeling of what the loved one would want.
Regardless of which of these is the case, there is reason for great caution here. The stakes are, after all, life and death.
But there is another reason for caution: None of these things—from explicit written instructions to the vague feeling of what someone would want—is a good indicator of what they actually would want now that they are in the situation.
Certainly, pre-written instructions are a better indicator than a gut feeling assessed in a moment of crisis. If someone has taken the trouble to write instructions in advance then those instructions are more likely to reflect the settled views of person in question. But the thing is . . . views change. Particularly when we’re put in a dramatically different life situation.
There is also a danger of the loved ones, without fully realizing it, simply taking the easy way out—regardless of what that easy way is for them.
For some people the easy way would be for the loved one not to want to continue treatment. Under the pressure of watching a loved one dying they are emotionally worn out and in pain and they are ready for it to be over. It’s not that they want their loved one to die. But they can’t stand seeing the loved one suffer and want the mutual agony to be done with.
This is a human response.
But it poses a danger of leading the relative to believe what is convenient rather than what is true. In this case what is convenient would be for the loved one to want to discontinue treatment, and so the relative starts feeling certain that the loved one would never want to live this way. That would be preposterous. Of course they would just want to let go and die in peace.
And if there are a few dimly-remembered conversations that might support this view then they will be taken as proof positive. There even might be a little exaggeration used to help convince doubtful relatives who are also being consulted.
But even if that isn’t the case. Even if the person clearly expressed a preference, that preference may no longer apply.
A good illustration of that is the case of the British man in this news story from July:
Richard Rudd was paralyzed and brain damaged after being injured in a motorcycle accident last October and suffering subsequent medical complications. Treated in Addenbrooke’s Hospital in Cambridge, England his family thought they knew he would not want to live.
“We said that knowing Richard, there was no way in a million years that he would want to live with his injuries,” his father told the Daily Telegraph. Rudd had told his daughter that if he suffered a severe injury in an accident like a car crash, he “wouldn’t want to go on,” Rudd’s father reported.
Rudd’s father gave permission for treatment to be withdrawn. As hospital staff gathered around Rudd’s bed, they noticed he was able to blink his eyes for the first time in several weeks.
The doctors asked Rudd three times whether he wanted to continue to live. He blinked “yes” in reply to each of their three questions.
Rudd was lucky, to say the least. No doubt there are vast numbers of people who aren’t.
But his case is illustrative of the fact that someone—when feeling able and healthy—could decide that they don’t want to live if it means the kind of existence Rudd is facing, yet when they’re actually in that situation they decide that they do want to live after all.
Rudd’s case is thus a valuable cautionary tale: We must recognize that past statements are not a good guide to what someone would actually want in this kind of situation. And especially we must not allow ourselves to believe what is convenient for us—the relatives— and what will help ease our own suffering.
This goes both ways, though.
Just as a person can change his mind about wanting to die, so he can change his mind about wanting to live.
There may be—and no doubt are—many people who when healthy and active think, “I’d want them to do everything to keep me alive, no matter what shape I’m in.” Yet, when they get down to the end of live, they may change their mind and say, “You know, I’m ready to go. I’m ready for this suffering to be over.”
In the same way, if they can’t speak for themselves, their relatives may make the same mistake of believing what is convenient rather than what is true. There are people—not as many as their used to be given our society’s growing death ethic—for whom the easy thing would be to keep the loved one alive as long as possible, for any number of reasons. They may find themselves thinking, “Of course this person would want to live! They would want everything done to keep them alive!” And perhaps the person even said this in the past, though now the person would say differently.
The point is that people’s minds can change and that we must cross examine our feelings when we are being asked these questions. We must make sure we are not just choosing what is easy and convenient for us to believer rather than focusing on what is true.
I’m afraid that I don’t have a magic solution, here. I wish I did!
Obviously, committing an immoral procedure—such as deliberately killing the patient or withholding nutrition and hydration that they would be capable of assimilating—is off the table. And, if the patient can’t speak for himself then previously written instructions are the best available guide, followed by clear memories of what the patient said, followed by fuzzy ones, followed by gut instincts. And the default should be in favor of preserving life.
But there is no one-size-fits-all solution to the question of when to end treatment. All too often a judgment call is involved.
The case of Mr. Rudd from England highlights the fact that people’s opinions can change and that we need to be cautious—and prayerful—in making these decisions.
What are your thoughts?
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My mother suffered from rectal/colon cancer from 1991 until her death in 1995. She told all of us that she wanted no extraordinary means used to keep her alive. She signed a Living Will, and we followed her wishes. I also recall my mother asking us not to pray for her to live. That might seem a strange request to some, but her reason was from her own experience when her mother was also terminally ill some 25 years earlier. The reason she gave was her realization that her praying for God to allow my grandmother to live was not for my grandmother, but for herself. I distinctly recall her saying, “I was being selfish, and not thinking about mama, but thinking about what I would do without mama”.
Great, and well written article. These are indeed tough things to think about, but they do need to be addressed since they are a part of our lives. I know that we have to always think about preserving life, but it’s always hard to know the boundaries especially given the advanced technology and artificial means that keeps people alive.
Jimmy, what do you think about, say, someone who is only kept alive by a machine, with no hopes of that person recovering or living without it? Should they be kept on it?
“Just as a person can change his mind about wanting to die, so he can change his mind about wanting to live.”
I think this is a great point. Few of us have approached the corridor of death and understand what this really means. We are talking about something we know nothing little about and need to be very careful. It’s arrogant of us to say that if we were in the same situation, we would quickly side with ending our life. It’s easy to say this when we are healthy. How do we really know?
That is why it needs to be placed in God’s hands as well. I believe He is working hard for the soul during this last period, drawing it closer to Him through His Grace. What may look to us as being long over could just be getting started for Him and the soul - in ways we may understand only when it is our turn. Maybe He is working harder than ever to bring the soul to Him. To repent for sins in one life that were rarely given a second thought up to that point. To give the soul borrowed time to attone for sins, out of His Mercy. Or, for a family member to call a priest to give last rites. “Pray for us sinners now and at the hour of our death”. Could it be possible that he uses the intervention of the Virgin Mary in these situations?
At a minimum, we need to ensure that those dying are given the sacraments first and foremost. And proper care according to Church teaching (food and water). Pray the Divine Chaplet frequently for them, offering it in in attonement for their sins. If possible, during the 3:00 hour of Mercy when Jesus died on the Cross. And ask for guidance for us.
I haven’t experienced this situation in a long drawn out manner like many other good people have so granted, my opinion probably means little. But, I think death is something very holy to God and at a minimum, he expects us to give it the basic human honor it deserves. By us trusting more in Him with regard to these situations rather than just science. After all, He is the one who gives life, takes it away, and can give it again.
@Gabe: regarding someone being kept alive by a machine, this really depends on the background. Some people are kept alive by machines long-term, like cystic fibrosis patients who have home-respirators. Obviously, turning the machine off is out of the question. At the other end you have someone who perhaps was found shortly after a cardiac arrest, resuscitated and is in intensive care on a respirator. All examinations show no brain activity, the MRI shows massive intracranial bleeding after the resuscitation attempt. Once the family has been assembled and has had time to say goodbye, maintaining artifical ventilation would be pointless and a waste of precious resources that could save other lives. In such a case it should be stopped.
In the original post: “Obviously, committing an immoral procedure—such as deliberately killing the patient or withholding nutrition and hydration that they would be capable of assimilating—is off the table.” Thank you for this! It is really uncommon to see someone add the caveat of “capable of assimilating”, and this is so important to understand. Of course a merely terminal patient should have food and water, but a patient who is very close to dying should not necessarily have intravenous fluids because the impending circulatory collapse puts them at high risk for pulmonary edema (a gruesome way to die).
mary, Sorry to hear that but Your friend should contact a Personal Injury Lawyer for a consultation.
A very timely article considering the circumstances that my daughter and son-in-law currently face.
Last August, my youngest granddaughter, Grace, (who was 5 months old at the time) was diagnosed with a rare form of brain cancer. The first treatment was surgery and approximately 80-90% of the tumor removed. The remaining bit of tumor was left alone due to its entanglement in Grace’s brain stem. The next treatment was a particularly aggressive round of chemotherapy which had to be halted about midway due to the fact that the therapy itself almost took Grace’s life. Next up was a two month regimen of weekly Proton Beam therapies (a highly centralized form of Radiation therapy).
The Proton Beam Therapy ended 4 months ago and last week during a follow up MRI, the tumor was seen to be rapidly regrowing. The surgeon has ruled out any further operations. Another experimental (and highly dangerous) round of chemo has been suggested, but considering how the first round went my daughter and son-in-law have ruled it out.
Two options remain on the table: An experimental treatment involving medicines the use of which the doctors have frankly admitted would be guided by guesswork…they don’t know what dosage to use; they are in-the-dark as to benefits, if any; they are equally in-the-dark as to side effects and what to do should they prove life-threatening. The second option is Home Hospice care…let the tumor run it’s course and keep Grace as comfortable and pain-free as possible until the end.
My daughter and son-in-law were due to meet with Grace’s doctors later today in order to give their decision. They are going to delay the decision and meeting for one more week in order to pray, think, talk further.
I am tormented by watching my family bear the burden of such a decision, but bear it they must. My advice was asked for and I cast my lot for Home Hospice care.
Any and all prayers offered on behalf of Grace, as well as my daughter and son-in-law will be eternally appreciated.
I work for a company called Young Living Essential Oils. These oils have been around for thousands of years and are being successfully being used to help cancer patients and those of us with asthma and allergies, etc.
So hope is around the corner.
Personally I am the last in my family alive, my father, mother and two brothers having died, three with cancer. I know from being in in-home caregiver of what I speak. Families are taking care of their loved ones with medical treatments, some that work and most that just cover up the symptoms.
I do nto want to make readers feel guilty about a loved-one’s death, but alternatives to the pills and chemo are out there. People need to search around. Sometimes, the brain has been needing a rest from stress. I have read that after even 20 years, someone singing a song from their past has caused a father in a coma for 20 years to wake up and start talking and seeing his grandchildren for the very first time. A wife has spend 20 years caring for him. It happened in Germany several years ago.
I heard of another grandfather whose family was surrounding his hospital bed with doctors and nurses around, saying their good-byes. The doctors had ‘determined that the man’ tests showed no hope of recovery and pulling the feeding tube was the best solution’. THe family agreed. A late family member walked down the hospital hallway and entered the hospital room.
His small son ran before him, saw his grandfather in bed, jumped on the bed calling out: “Grandpa, Grandpa!” The man sat up in bed, hugged the boy and started talking. Everyone was amazed. He went home the next day and remained alive and well and years. Doctors do not know when a person is dead or alive….truly. Read this last sentence over 5 times, slowly.
Patricia in St. Louis, MO
@Rebekka, wow thanks for the information. That’s very valuable info, so thanks for answering my question!
I am very sorry to learn that your wife has died. My wife died in 04, 38 years of marriage, it’s tough to deal with. Regarding euthanasia, Hospice is a form of it. A side effect(apart from the pain relief of course-which is it’s primary goal)of the increasing morphine is to eventually stop the heart. This whole end of life issue is very difficult, and I pray for anyone who has to deal with it.
Jim Roth
To those reading this, let’s face it our society doesn’t like to discuss death. My mom was seriously ill, she had a social worker go over a living will with her yet it wasn’t signed. So having been there with some other family members we had to sign to take her off life sustaining meds. I was her caregiver during her illness.Even knowing exactly what she wanted it still made it hard to sign the papers. The doctor had a hard time getting her to sing a DNA do not resuscitate order, and asked me if I could talk to her. My husband a physician said, “That’s not your job it’s his” well she wouldn’t discuss it with him. I asked God for help in bringing it up, well me mom said something first. So in asking her what she wanted and explaining in a hospital setting for what ever reason if you should stop breathing or have your heart stop they will do everything in their power to bring you back to life. She replied “what the hell for if I am already dead? That’s what they are asking you, your last wishes, bring me those papers. In a situation like this no one is thinking clearly, it’s over whelming for all involved. Guilt for those not able to be there, did I do enough for those there. The hospital should have all denominations available to help families come together on any decisions needing to be made. God provided us with many gifts, such as priests or pastors. Many don’t even think, since everyone is at odds, to use this help. Pray for our clergy as their position as Gods representatives is varied and they are trained in these areas, to help us be strong when we faced with such choices to face. My mother had also had me plan her funeral while she was alive, she said it would be easier. In all honesty she was right again, as I was a mess after 2days of no sleep. I hope many of you reading this will take the time to do a advanced living directive, leave funeral instructions, a will to help those we leave behind a clear understanding of what we want. I also appointed a medical directer to speak on my behalf to cover anything that may have been over looked, so my children wouldn’t have to.
To Jim,
I can assure you that hospice care is a service that has no such commitment to the use of morphine to commit euthanasia. In fact, the proper use of morphine in carefully increased amounts has been shown to actually increase life-spans, because untreated severe pain taxes the body so much that it can be life-shortening.
The proper use of morphine may include, in some instances, the unintended side-effect of supressing respiration. This is a classic case of the principle of double-effect, where it is morally acceptable to give morphine for the purpose of controlling pain even if that amount of morphine would increase the risk of shortening life. But this certainly is not the case in all proper uses of morphine.
Of course, any drug can be misused—either by hopice personnel or by non-hospice care-givers. But it is certainly wrong and unjust to suggest that all hospice services mis-use morphine. Hospice is a loving and life-affirming choice for those with incurable diseases. The hospice service people who assisted us as my dad died of liver cancer were a God-send, helping us in innumerable ways. They never suggested using morphine to kill him, but rather helped us to keep him comfortable and alert in many humane and dignified ways at home. God bless them, we couldn’t have done it without their help.
Randy Johnson-
Prayers on the way. May God’s will be done and may we all joyfully embrace whatever He intends.
Thanks for the article. My parents both in their eighties have their medical decisions (DNR, etc.), funeral expectations, etc. taped to their refrigerator and gave the same to all of their children (there are 10 of us) as Christmas presents (yes, really) over five years ago. It was a hard conversation to have but absolutely necessary. We all know what they want (all in accord with Church teachings) and won’t be caught off guard when they leave. I am grateful for their clarity of mind that had them doing it while they could.
But, in answer to the other question - write the book! It is clearly needed.
I encourage you to write your book, Mr. Akin. It is greatly needed.
“So hope is around the corner. “
Ah Patricia, hope is already here! Christ has conquered death. He is our hope and we have him now. Kudos to those like you who develop treatments to alleviate suffering, extend life, or perhaps one day even cure cancer. And praise God for miraculous and amazing healings. But still, we will eventually die and we must face that fact and put our hope where it belongs, in our Savior Jesus Christ.
Randy, you broke my heart with that story. I’ll spread the prayer intention around. God bless you guys.
As Catholic Christians, we are called to not cling to this life, but to look towards death as the door, the entry way to meeting our Creator, our Beloved, our very best friend, our very life, with expectant faith. Do not fear death. As a nurse I worked in critical care for years and saw first hand this whole conumdrum of trying to “plan” for our deaths, signing living wills, trying to have control over everything, right until the last moment. Now as a spiritual director, I see that the spiritual jouney/life is much more about letting go, and letting God have the dominion over life and death.I wonder about redemptive suffering and how powerful it is. Most people do not seem to understand this, especially in our self-centered culture. I wonder about embracing suffering instead of trying to numb it with medications and having mental clarity if at all possible at death. It certainly is very important to reflect on the end things, including death, and to not avoid talking about it. I don’t believe I saw anyone write, “What would God want?” Peace and Love of our Lord be with everyone today and forevermore.
@ Jim Roth: Sorry for your loss Jim. Though I agree with Sally R. My husband had just retired when they found out he had renal cancer that already metastasized to the lung wall. We were also married 38 yrs. This was 25 years ago.He lived 15 months. It was his decision not to go on Chemo (there was no encouragement that it would help) and we had hospice toward the end. His only medication was Tylenol every 4 hrs and Tylenol with Codeine only at night, so he would sleep. He had a morphine suppository hours before he died, so as to make it easier for him. I worked for Hospice later, not as a nurse, but in the office—I know a lot about how Hospice works and actually if the caregiver does not want morphine or any other medication used, they do not use it. The caregiver (which was me,the wife,at the time) calls the shots, so to speak. I really don’t like it when people say “it is a kind of euthanasia”. To me it is helping the patient to die in a natural way. (Morphine is for severe pain—had it myself after a surgery.) Hospice nurses take extra courses to become a Hospice nurse and they know a great deal about what a patient’s body is going through. I do not know what I would have done without Hospice, because I did not want my husband in a hospital, I wanted him home with me and he did too. Thank God for Hospice Care.
@ Jimmy Aken—I hope you do write that book. Good luck with it.
Praying for Grace.
The frightening possibility exists, it seems to me, of a dying loved one feeling uncomfortable sharing the true feelings that s/he wants to live, or die, (out of deep love for loved ones watching her/him slip away) because of the anguish and exhaustion of family members as they see and deal with their dying relative’s suffering. So, to me, it would seem important to be sure and talk with the dying family member about if s/he is more concerned with pleasing the wishes of the living members than with sharing his/her true feelings. In other words, perhaps family should gently draw out the real feelings of the loved one while trying to conceal their own feelings, at least while getting insight into the true wishes of the dying loved one, because maybe s/he is reticent to voice those wishes because of the behavior and strong feelings of others. I brought up this serious concern of mine in an ethics class, which outraged a much younger student. I never really understood the outrage. My dad had a lot of pressure from a sibling about what he should do, and my dad was definitely reticent about sharing his true feelings with that sibling and in fact did not. We privately did.
Praying for Grace and her family!
Kathleen, you are right about the patient possibly being reticent about sharing his/her feelings when terminal. A very good friend on mine died on the 12th of this month. Her husband telephoned me this evening and told me how the family came in from all over a few weeks before she died and they talked about “the end”, arrangements, etc. & also the good time they had together. Of course she was in her early 80’s and her cancer had recurred. When I worked for Hospice a family member of a patient came in and told us how they ‘celebrated’ the patient’s graduation into Heaven. All families are different in how they handle things. I was 56 when we found out abt. my husband’s metastatic cancer and I fought it hard; and for some time my husband was trying to get me to accept it. Our Hospice at the time was just starting and only had nurses. Today they have social workers and psychologists and they work with the whole family. Hospice always teach the family to let the patient know that it is alright for them to ‘go’ if that is what patient wants. These nurses know when the very end is near. I would advise anyone to use Hospice Care when needed.
@Steve Smith: Steve, I prayed for my husband to live and that is okay to do because God knows what is best for everyone. God allowed my husband to die and He had His reasons—-I do not know what it is but I put my trust in Him and maybe someday I will know. Faith is having Trust in God—that is how one gets through these hard times . What your Mom said about your Grandmother is true—it is selfish in a way, but it is also human. God gave us all the will to live too because the life he gave us is precious.
I have given much thought to this question and come to the conclusion that the Holy Spirit is Lord and giver of Life, and will bring my life to a close in His time, not mine. Dying in prolonged pain may be far more advantageous than it sounds, if that pain is united to Christ’s suffering. Which of us can imagine how much cleansing might be accomplished here rather than in purgatory by uniting that suffering to the suffering of Christ? Only in total submission to the divine will, both in pain and in pleaasure, can real happiness be found. As for me, keep me breathing, but please, please, keep praying with me, reminding me of what He went throught for love of this sinner.
Dan, agreed. Although I don’t understand this, I definitely sense that what you say is correct - it has to be. And I think the key is holiness. When one offers suffering of any kind and quietly and humbly unites it to Jesus suffering on the Cross, I believe this is the true definition of God’s Holiness. And, not necessarily just as death approaches when we need His Mercy the greatest.
Offering our small daily sufferings cheerfully to God may be acts of love and holiness that are also readily accepted by God - because they are real hard and force us to swallow our pride. I feel this because time after time I fail in these small daily tests and seem to be constantly reminded I have missed an opportunity yet again. But, God continues to give me chances to try to get better. And, in each case, it always seems to somehow lead right back to Our Lord’s suffering on the Cross.
I was given medical power of attorney for both my mom & dad, with the instructions that no surgery & no extraordinary measures were to be given. My mom died last Oct. and that is when I realized that there was no black or white decisions for their original desires. It quickly became apparent, that for her comfort and only hope to ease her newly unfounded fear of falling off the bed as they changed her, that I had to say yes to surgery in hopes that she would get just some of her strength back and therefore could cooperate with them in some way. After her surgery, we found out that it also made her dying less complicated & painful. Praise God. My dad died this March and it was no easier to make decisions for him than it was for mom. It was apparent that he definitely was not going to pull through this time. Now I had to decide which would be the easiest and least painful way for him to die. Congestive heart failure was not what anyone wants to die from. I had to weigh each treatment & procedure to see if helping this problem or that one, would cause greater hardship for dad than not doing anything at all. It was hard to decide, but with the Church as a sure foundation, I knew where the boundaries lie and that gave me great solace in making each decision. They are now both peacefully with the Lord and I have a clear conscience about each hard decisions I had to make.
As Catholic Christians, we should see that “what would God want” is built into His Creation as His Creation reflects God Himself. Death is not something that is good in and of itself but as that which, rightly identified by Sheila, is a door to heaven. Also, suffering is not a “good” either. When applied rightly to something that is good in and of itself, such as, reparation for sin to God or penance, then it is good. Sadness at death is not bad nor is relief of suffering, unless we make that relief paramount or when sadness at a death leads us away from friends, family, or God… things that are also good in and of themselves.
Thank you to all of those offering prayers on behalf of Grace and the rest of my family! May the peace of Christ rest on you all!
I told my brother I want to live no matter what. Even if I’m a vegetable or supposedly brain dead I want to live. He said that must be why I go to church so much because I’m afraid of dying. My response was no I just want to get as many people to heaven as possible through the grace of caring for me and the grace from my suffering. People don’t realize that God gave each of us a rose garden. Ask any rose enthusiest if it’s all sweetness and they’ll tell you no. You have to deal with diseases, blights, bugs, manure, thorns, pruning, etc. if you want to have beautiful roses bloom.
I don’t know—I just don’t understand this suffering pain for God’s sake or doing penance here on Earth. For me, God is my spiritual Father who wants the best for me. The parable of Adam & Eve teaches us that life WILL be a garden of roses, with thorns, etc. If God wanted us to suffer pain, he would not have allowed our Medical world to come as far as it has to heal our bodies & keep us from pain. To me, everything Good on our earth comes from God. It is humans who abuse it and this brings us strife. Yes, Christ died on the Cross for our sins and to me it is His example of the crosses (pain) we bear in life, whether a child on drugs, or the death of a child or spouse, etc. (it is on the Cross that He taught us how to forgive also). I asked a priest once what he thought Hell was and his answer was “our soul being apart from God”. I really think God cries every time one of His children suffer, just as our earthly parents do. I do not believe He wants us to have pain in any form—-pain comes from “the fall of Adam & Eve”—-remember there is other “pain” that we bear, besides physical pain when ill. Gets confusing, in trying to explain. “Offering Up Pain” as the Church teaches does not mean we have to suffer, it means that sometimes there is nothing we can do about it, so just leave everything to God. I still remember the day my priest came to my husband’s bedside hours before he died, trying to get him “into the church” and I looked at him and said “Father, you and I have nothing to do with this, THIS is between my husband and God”. When my husband was dying, I felt very alone (my only relative close by was a son & his wife) God, IN HIS WAY, let me know I was not alone and shortly after he died I had a very vivid dream of my husband walking toward me with a smile on his face, his arms extended and he said “you thought I left you” and he hugged me—I awakened and actually felt that hug. See, he did not leave me, he is still in my heart and a part of my soul. I really believe that was God speaking to me again. I have lived alone for 25 yrs. and in so many ways, God has shown me that he watches over me and protects me. You just have to open your heart and be aware. There is so much more to us humans than we know—life on earth is a mystery. As to sadness when a loved one dies, yes God ‘knows’ this because he gave us the ability to love “life” and then, in time, our heart heals because He lets us know our loved one is with HIM. Just my thoughts…..
I encourage you, Jimmy, to write a book to help people dealing with end-of-life situations. Along this line I have asked myself, “What is the reason people are afraid to die?” Three possibilites come to mind:
1 Death could be painful
2 I don’t know for sure what will happen to me in the afterlife
3 I think my afterlife may find me in purgatory, or worse.
First, Randy, your grandaughter and family will be in our prayers. Sometimes there just are no easy answers.
Second, in response to the article, I remember when Terri Schievo was being starved to death. One of the most compelling letters to the editor I ever read on her behalf was from a man with a debilitating disease. Before his diagnosis, he had stated that if he ever was disabled, he wouldn’t want to live.
After his diagnosis, and rapid degeneration, he found that (as mentioned in the article,) he did INDEED want to live! He had to endure costley treatments, and was wheelchair bound. His condition was terminal, but the treatments would prolong his life several years.
His wife, however, felt that he was being selfish! She told him that their savings were meant to be the source for the sons college education, and he was being selfish to use it up. After trying to convice him (unsuccessfully,) to stop treatments and die, she divorced him.
I can’t imagine what kind of pain you would feel at the hands of that kind of deep betrayal. But it also serves as a warning.
We must also keep in mind that any sufferings we have during death can also be used for the expiation of our sins, it has the advantage of shortening our purgatory, or eliminating it altogether before we die; or in some cases, even suffering for the sake of others souls. It can be a source of God’s mercy. Many saints have been through such horrible sufferings. We too must be brave to face such an inevitable end if God determines it thus for our own good. We can turn our sufferings into penance. It is better to suffer in this life for our sins rather than to face it in Purgatory, which would be far worse, though with the added benefit of seeing God and knowing that we are saved, thus the souls in Purgatory willingly undergo it rather than to come before God in an unclean state.
@ Sue
In the beginning God created a perfect world with no death and suffering. The Book of Genesis is not merely a parable, it is real history. Mankind, in Adam, sinned by rejecting God and attempting to set itself up as God, but realized its folly in discovering that it is not God and thus the universe and everything in it is subject to God’s divine power to sustain it in existence. Thus death and sufferings that did not exist before entered the World. And not only that but corruption invaded our very souls due to sin that is driven by the body. Death destroys our body so that our soul may live, and God sent His Son to experience death and suffering so that through Him we can obtain salvation and live with Him in eternity. These means He provides through His sacraments givn through His Church, where we obtain His grace which will allow us to be in union with God and go to heaven. However we lose this grace when we sin, and because we sin, there is a penalty and we must make good on this. To do this the Church provides Indulgences and the Sacraments and recommends penance. Think of it as jailtime or community service when someone commits a crime. We must accept this punishment, or may the fine or make good on something we undid. If we completely absolve ourselves and obtain God’s grace before we die then we enter heaven. If we do not, we must spend time in Purgatory because sins that still remain with us have not been clensed and we cannot enter heaven into the presense of God without being clean, because God is so good and holy that His very presense destroys all that is unclean and unholy. Thus if we want to be completely with Him, we too must be cleansed. Purgatory does this, it is like a prison, where our sins are always before us and we suffer due to their remains until our sentence is over. However the pains of Purgatory are very terrible to bear! So God in His mercy allows us to access the sacraments and do penance on Earth to cleanse ourselves as much as we can and obtain God’s grace! So offering our sufferings to God on Earth is good because it helps us avoid worse sufferings after we die and God wishes that we suffer little, but because of our condition, we must suffer and carry our crosses as Christ did. He led by example! Sufferings need not be for ourselves. Christ suffered for the sake of others. And we too can suffer to ease the punishments due to loved ones who do not take recourse to God’s mercy on Earth. When God sees our desire to save someone else through our sufferings, he looks kindly on it and helps our lost loved ones return to Him or to ease their debt for sins.
The CCC covers end of life decisions according to Church teachings, pargraphs 2276, 2277, 2278, 2279.
Please do not ask your Catholic relatives to be your Health Care Representative/surrogate, if you chose not to adhere to the CCC. Catholics must adhere to Church teachings.
The USCCB has a recommended Catholic Advance Directive for Health Care on their web site. Some Bishop’s Diocese have this on their web sites as well.
@Johnno: I do not think you understood my note. A priest told us that a parable is a story that was used “way back then” to teach, just as you would teach a child by using a story. Yes, Adam means life but I do not think you understood the rest of my note, because it equates yours. I just don’t understand why the Church always talks of suffering with physical pain as if we have to endure it to get Grace. Jesus died on the Cross to teach us that because of Original sin by our First Parents, we also will suffer on earth with different kinds of pain but he also gave us the ability to ease that pain through our medical & psychiatric world. We all have our punishments on earth through all kinds of pain besides physical. I will tell you that if I have a toothache, I am not going to sit and “offer it up”, I want it to stop—and I bet you do too. The pain my husband suffered was leaving his family at a young age, he was used to physical pain, he fought in 5 battles during WWII. I can understand bearing a physical pain if there is nothing left to ease ones pain. We all have physical problems that we endure as we get older and much non-physical pain. People with diabetes and M.S., etc. endure their kind of pain. I also believe a person can receive Grace by doing good to others. Jesus taught us that too. Also it seems to me that you are implying that in Purgatory we endure physical pain. If a loved one of mine committed a serious crime, it would pain me something awful—yet it is not a physical pain. I really agree with my other Pastor who said Hell to him meant being apart from God’s presence when we die. Also another priest said once about the Fires of Hell and Purgatory “who ever died and came back to tell us”. Was the “Fires of Hell” the bibles way of explaining how we would feel, not being in God’s presence? I guess it is all in how one believes. I just believe in a VERY LOVING GOD,who sent us His Son to teach us how to live and how to endure the pains from our first parents, Adam & Eve. Nobody’s life is perfect, there is pain in it, besides physical pain. I remember in grade school, the Nuns made us memorize questions as well as answers in religion: What is a mystery? A mystery is a truth that we cannot fully understand. Life and Death are mysterious. I am a very simplistic person, as you can see.
Sue, Jesus was very specific in what He expects of us. “If anyone would be my disciple, let him deny himswelf,take up his cross daily and follow Me.(Lk. 9:23) We follow Him to Calvary to suffer with Him so that in dying to ourselves with Him we might rise with Him. This is why Paul can cry out “I rejoice in my suffering for you, for I fill up in my own flesh whatever is lacking in the sacrifice of Christ for His body which is the Church.”(Col.1:2) We do not enjoy pain for its own sake; that is bizarre. We accept what trials are sent us with the resignation with which Christ accepted His cross, to atone for our sins and for those whom we love, uniting our difficulties to His for their good and for God’s greater glory
@Sue
I did not mean that we just stand by and accept sufferings. God doesn’t want that for us either. We have all the right in the world to access medicine and health care to ease our sufferings. That is all well and good. What I’m referring to is that despite any medical help we will still have to undergo some sufferings and discomfort until we are healed, or in some cases, healing will not come. During such instances we can offer our sufferings to God as penance for ourselves and others. So even in pain there is an opportunity for good to come of it. So whenever we or another have to go through these things we must try to remain strong and see the good that may be working under the guise of despair. There is a ressurrection following the the scourging, shame and crucifixion. We may see someone suffering greatly and wonder whether it’s right for us to end their life. And it is terrible to withstand, but just perhaps it is God’ mercy at work so that that soul that might otherwise have had to suffer in hell or Purgatory might be saved from such pains. It is not only their sufferings that God accepts, but also our sorrow and internal sufferings when we witness our loved ones in this condition. Together, or one on the behalf of another can offer these sufferings up to save a soul and expiate the punishments for sins. And you are right that in hell the greatest pains suffered is our separation from God because we are so filled with Sin that we now discover how good God is, and we can see our horrible selves through His eyes and know that we are of such a state that we can never be set free, and thus these realizations torture us intensely and eternally and the pain never goes away. Our decisions in life exist in time and we can change our minds. But in eternity, a decision made is made forever and the soul either choses God and gains everything or refuses God because of his attachment to sin and loses all that is good. That is why it is important to condition ourselves in this life to always choose God and to be holy.
@Dan “We accept what trials are sent us with the resignation with which Christ accepted His cross, to atone for our sins and for those whom we love, uniting our difficulties to His for their good and for God’s greater glory”
Also @ Johnno:“What I’m referring to is that despite any medical help we will still have to undergo some sufferings and discomfort until we are healed, or in some cases, healing will not come. During such instances we can offer our sufferings to God as penance for ourselves and others.”
I said:“I can understand bearing a physical pain if there is nothing left to ease ones pain. We all have physical problems that we endure as we get older and much non-physical pain. People with diabetes and M.S., etc. endure their kind of pain.”
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I cannot see the difference from what you two said. When we endure pain that we have, we endure it with Christ’s help and naturally offer it up. Accepting it, IS offering it up to God. To “endure pain” is the same as saying, Lord, I accept this pain for your sake, because it is Your Will—help me through it. My diabetic niece was a happy, smiling person along with the pains in her legs, etc and never complained. A great example to all of us, as are most people with that kind of suffering. I tried to point out that sometimes mental pain, or pain of the heart (a loved one doing something bad) or leaving/losing a loved one during death, can be great pain also, and we put it in God’s Hands. When my husband was dying, it was great pain for me too and God let me know, EXPLICITLY that “you are not alone”. Believe this or not, makes no difference, but I know—-I was at my lowest and He raised my spirits and I was able to get through it. He knew my suffering and He helped me. This is all I know. (having just my son living near me and the rest of my family states away did make me feel alone).
You guys sound like theologians or deacons. I am just a li’l old lay person, with a strong believe that God is Good and God loves us. God knows what is in my heart.
Jimmy, thank you for your thoughtful column. These are issues that I think about as I am suffering from terminal cancer at age 47. I am a single parent of three. My family is not Catholic, so I have made it clear that I want a priest when it comes down to it, and a Catholic funeral Mass. I do believe they will respect my wishes. I have found that having cancer can be a great witness to others about the faith that we have in Jesus Christ. Suffering brings us closer to the Lord if we let it. It also brings us closer to our friends and family.
I feel well now, but when the time comes I want to be kept as free from pain as possible, but don’t want heroic measures to be taken to lengthen my life by only a few days. I know that Heaven awaits me. My only regrets are leaving my parents and my children behind.
Lisa: If your cancer is terminal, then I would recommend a Hospice to help you get through this. If you speak to your doctor he will let you know and either he or you can contact Hospice. You can, in the meantime, call any Hospice near you now, on your own, and ask them questions to see if this is what you want. They will keep you from pain as much as they can, they will work with your doctor and they will help other members of your family to cope. I wish you well and always remember that God knows what you are going through and will be close by you. My heart and prayers are with you.
Lisa, am sad to hear about your cancer. Your words in faith and embracing of Our Lord make me feel humble for being such a constant complainer about stupid little stuff - this is exactly what I need. I will remember you as often as I say this Divine Devotion, given by Our Lord to St. Faustina. God Bless, and get better.
http://thedivinemercy.org/message/devotions/image.php
@ Edward- Very wise words. We have already pointed out to Mother that she cannot have part of her ashes scattered at Wrigley Field, and parts of said ashes in other places around greater Chicagoland, as she is a Catholic, and we are Catholics who simply will not do that. It did not bode well for her to hear that news. So far, she has argued with her pastor and the deacon that she won’t be here any more. Yes, they told her, but your children will.
Dad has also chosen cremation, but is following Church guidelines.
When a person is dying as my mother did with cancer and in pain, hospice does not increase the dosage of morphine, but because the patient is no longer processing waste the morphine simply builds up in the system and death results..this is not euthanasia because the purpose of giving the morphine is not to kill the patient but to relieve the pain of someone who is hours away from death to begin with…
It is incredibly hard to watch someone die in terrible pain…in my mother’s case she went for days without real coverage for her pain and only in the last few hours was she relieved…At the end she saw something beautiful that gave her a lot of comfort - I like to think it was our Lord come to take her home..
Our family, unlike some, had a horrible experience with hospice. Not only did they not provide the services that they told us they would, but when my mother-in-law was struggling to breathe (from what turned out to be pneumonia) and was terrified, we had to fight to get her “off” hospice in order to get treatment just in order to make her comfortable. She died peacefully a couple of weeks later. Our experience has made us totally unwilling to use hospice again. We have also found how absolutely explicit you have to be with doctors in order to get the kind of end of life care the Church requires. When my husband’s aunt was suffering from a diminished swallow response, the doctor recommended we simply “let her go.” Instead we explained our Christian position on life, including insisting on a feeding tube and she lived for another nearly 9 months. She was still aware and communicating at the time that he was making this recommendation, although she was really unable to make a decision of this sort herself due to mini strokes that impaired her thinking. It was certainly more demanding on us as a family both physically and financially, but when Auntie finally died peacefully at home it was because it was truly her time.
When my mom was in her last days she was no longer able to assimilate nutrition and the doctor said the IV would actually be a burden to her. When my sister was in a coma after a pulmonary embolism (with a flat line EEG and an equally horrible MRI we chose to pull the respirator (she was over-breathing it anyway), but leave the IV in place and she died about 12 hours later.
So we’ve been there and done that, like Jimmy a number of times. Each time has been somewhat different, and I truly hope we won’t have to face this type of decision again (both my father and father-in-law died instantly from heart attacks). However, we now know something about the types of pressures that families face, the fact that you may have to really press the doctors for the true facts, and the fact that hospice is not the panacea that a lot of people think it is. We did far better with hired home health people, and the visiting nurse than with hospice which never even came through with the promised respite workers or homemakers. Hospice in other places may be different, but around here they aren’t great, particularly when dealing with the elderly.
Liz: I am truly sorry you had a bad experience with Hospice. When my husband was on Hospice (1985)it was a small org. with a pt. count of 8. Today they are in 10 counties with a pt. count of 1,000. I have a friend who was disappointed in them in recent yrs. When an org. gets big, sometimes they begin to be lax in certain areas. The world is different today and we have to really educate ourselves first before we make decisions. With the computers, that is much easier to do. When my husband was on Hospice, I was the caregiver and nothing was done without my consent. [I know of one family who did not want the pt. on strong drugs, even tho she suffered badly—they wanted her to be lucid and being the caregiver, her wishes were granted] It is that way today, but again these org. have to be checked out, so that you will know their and your expectations. I also know people who were very dissatisfied with hired home health groups. So, it really is a matter of checking your sources first. I am 83 and I can honestly say that with all the deaths in my family, all were handled properly, except for my twin sister—-I did think the doctors in the hospital kept her alive too long because of the wishes of her husband & because the doctor always gave them a little hope. Fortunately she was not aware. Death of a loved one is never easy in any circumstance.
Study what the Church teaches,...and seek a holy priest for direction.
I would agree with almost everything the author said - but with one little disagreement to the order of importance he gave for written instructions, then clear memories of what was said, then fuzzy ones, then gut instincts. I would move “gut instincts” up in the chain, maybe above even clear memories of what was said, definitely above fuzzy ones, for the simple reason that the Holy Spirit can have profound influence when we are making such difficult decisions, especially if the family has specifically sought spiritual help on the topic through prayer. That being said, though I am not a Catholic, as a religious Christian of another faith I have seen the sacred experience that a family can have surrounding a loved one’s death. If they are ready to go, there can be very few cases where there is a greater feeling of reverence and of sacredness than when a loved one passes from this world into the next prepared to meet their Heavenly Father. I have unfortunately also seen heartbreaking cases of both extremes, both when life was artificially prolonged beyond what was needed, or also when life was snuffed out far too quickly, denying some families those sacred experiences of a loved one’s peaceful passing. Death, and also pain, are feared too greatly in our society, I think: both are necessary points on our path back to God and are full of valuable instruction if we see them as a normal part of life.
Study what the Church teaches,...and seek a holy priest for direction. ...is what Elizabeth said a few messages ago. I agree with this phrase completely.
We came into this world with people helping us; it is appropriate to seek people to help us and those we love to leave this world.
Patricia in St. Louis, MO
Hi:
I really appreciated this article on Euthanasia.
I realize that this is a hot button issue of the Church. I realize that many Church officials advise and/or assist with matters like these.
I also realize that the Church provides guidance to Church officials in addressing these matters.
I heard about the issue as a student in grammar school. I recall being quite vocal about the issue then.
I have somewhat of a position on the issue but feel more comfortable expressing it in the presence of a minister or spiritual director to ensure proper posture. I also feel that the position is undeveloped as it seems to vary from case to case.
When I better develop the position, I will post again.
I have, however, come across other blogs that discuss increased flexibility in the area of Euthanasia, especially for baby boomers.(http://exiteuthanasia.wordpress.com/2011/01/26/euthanasia-on-the-big-and-the-small-screen/).
I look forward to engaging in additional postings.
Thank you,
Nina
You have written a thought provoking article.
When my dad died about 8 years ago (he died of pneumonia after surgery) I also remember him saying that he didn’t want extraordinary means used (such as a machine).
However, I also remember him either hallucinating or actually seeing some loved ones at his bed and him saying “No, I’m not ready to go now!”
I also know of a friend who died of cancer after undergoing much chemo, and at the end despite knowing that more probably wouldn’t prolong her life, courageously decided to undergo it anyway.
I think that “the will to live” is very strong in all of us, and in many cases we DO want every means taken to prolong our life.
However, there are always some who have suffered so much should be able to let go if they wish, and not have to undergo for example useless CPR if they already are dying.
I believe that all of this should be discussed with the family (and help from your pastor) beforehand if possible, and written down.
In the British case you wrote about, eye movement might be a good way to learn the patient’s wishes if he can’t speak. You never know how God will work, example Fr. Groeshel who was thought to be dying, and still living to accomplish whatever task God had in mind for him.
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