Should my Health Care Directive be the Catholic one? Is the state prepared one okay?
by Father Dale Kinzler
Father Dale Kinzler
In our May issue of New Earth, I responded to a reader’s question about care of the dying, and mentioned we would visit the question of advance health care directives in a future article. I addressed the question on nutrition and hydration, arguably the most difficult topic among the items of concern in preparing a health care directive.
I mentioned that we encourage you to visit the North Dakota Catholic Conference web site, ndcatholic.org. There you will find a version of a health care directive that satisfies both the requirements of state law and the ethical principles of our Catholic teaching on end-of-life care.
The NDCC site also provides a helpful guide to the directive. It gives advice on how to complete the directive, and has a page on the fundamental principles that should guide us in our health care decisions. In summary, these principles are:
1. Human life is a precious gift from God; every person has a duty to preserve his or her life and use it for God’s glory.
2. We have the right to direct our own care, and the responsibility to act according to the principles of Catholic moral teaching. (Principle of Autonomy) We have the subsequent right to clear and accurate information about a proposed course of treatment and its consequences to make an informed decision whether to accept or decline the treatment (Principle of Informed Consent).
3. Euthanasia, by direct action or omission intended to cause death, and assisted suicide, are never morally acceptable.
4. Death need not be resisted by any and every means. In the Christian perspective, death is not an end but a beginning of eternal life. A person may refuse extraordinary means of treatment. Extraordinary means are those that offer little or no hope of benefit, or cannot be provided without undue burden, expense or pain.
5. There should be a strong presumption in favor of providing a person with food (nutrition) and hydration (water) even if medically assisted. These should be considered ordinary care except when a person is no longer able to assimilate nourishment, or when death is so imminent that withdrawing food and water will not be the actual cause of death.
6. We have the right to comfort and to seek relief from pain. This is true even if the treatment indirectly (unintentionally) shortens life. However, a dying person should not be deprived of consciousness without a serious reason.
In completing the directive provided by the Catholic Conference, we are to designate a health care agent who can work with the care providers and family to discern the best course of action in each particular circumstance on behalf of a patient who has become unresponsive. We should discuss our values and preferences with our chosen agent, so that he or she can apply them to the actual current situation. The North Dakota state document also provides for the designation of your agent.
This is by far preferable to a “living will” document in which we specify a fixed approach to treatment in advance, rather than entrusting the decisions to our health care agent.
Most secular hospitals and attorneys with whom we may work on advance directives are not likely to have, or be familiar with, the Catholic Conference version. No doubt, the majority of our area Catholic population who have worked on a directive will have used the version provided by the State of North Dakota or Minnesota. We are not suggesting that you tear up that directive and start over. However, there are some special items of concern to watch for, and you will want to review your document in light of these concerns.
For example, the North Dakota directive takes a “value neutral” approach to the various choices regarding the level of treatment we want, including assisted nutrition. If you have completed a state-provided document or are working on one, you may want to review it with your pastor or the Respect Life Office, or one of us whom the diocese delegates as liaison. I am pleased to have worked with a number of our pastors who called us for consultation with a parish member working on their advance directive.
It was a little over a decade ago that Christopher Dodson, director of the North Dakota Catholic Conference, and others worked very diligently to prepare our Catholic Health Care Directive and guide, ensuring that it fulfills the requirements of state law as well as our moral principles. No law actually requires that a person use the North Dakota statutory form. In fact, state law makes it clear that the form is optional.
Meanwhile, our culture is being influenced by a number of groups actively promoting assisted suicide and coating it with more compassionate-sounding language in their literature. That is why we urge our readers to consider our version of the directive or to take another look at the state version you have prepared. Catholics and all persons of good faith will want to take our general principles of morally responsible health care into account.
Father Kinzler serves as the pastor of St. George’s Catholic Church in Cooperstown as well as pastor of Sacred Heart, Aneta; St. Olaf’s parish, Finley; and St. Lawrence’s parish, Jessie. He can be reached at firstname.lastname@example.org.
Editor’s Note: If you have a question about the Catholic faith and would like to submit a question for consideration in a future column, please send to email@example.com with “Ask a Priest” in the subject line or mail to New Earth, 5201 Bishops Blvd. S, Suite. A, Fargo, ND 58104, Attn: Ask a Priest.