I am a member of the ethics committee at Falmouth Hospital. I have to say, it is the most enjoyable, thought-provoking, and beneficial meeting that I attend. At the meetings we strive to come to a morally ethical solution to medical issues that face patients in the hospital, especially when the patient is near death. The discussions can be as simple as how do we get the information out to people of the importance of having a health care proxy to very complex issues on life and death situations. Recently we had one of those cases where almost every discipline of the hospital was involved including the Chaplaincy Department. We spent several hours during the episode and as follow-up determining a proper course of action in a very difficult situation. I must say that it was amazing how all departments of the hospital worked together to resolve the issues. But that is a story for another blog.
What I think is more pressing is the importance of a HealthCare Proxy. A typical situation in the hospital is that the family is standing by the bed of a dying patient and they wonder what measures they should take for the patient. The patient may or may not have a health care proxy but invariably at least one member of the family doesn’t want to let go of their parent. They can become very emotional. They may feel that by removing the ventilation tubes they are killing their parent. I have to explain to them that is not the case. I find that most people are not well informed on the ethics in certain medical situations. Even more important is that very often, the family does not know what the desire of the patient is. For those who want to hold on to a parent who is dying I ask the question “What do you think your parent would want?”
All of this leads to several questions that I hope you will research, especially if you have parents or you are a parent who wants to have your children know what your desires are. I will include several links that are helpful in explaining various forms, situations, and ethical issues. As I mentioned, life and death situations can be very complicated and the ethical issues complex, especially regarding the teachings of the Catholic Church. An excellent source concerning ethics is Rev. TadeuszPacholczyk, Ph.D. (Fr. Tad) who is a priest of the Fall River Diocese.The National Catholic Bioethics Center in Philadelphia (which is also an excellent ethics source) and directs the Center’s National Catholic Certification Program in Health Care Ethics. You may have seen some of his articles in The Anchor “Making Sense Out of Bioethics”. I find him very knowledgeable and understandable.
Next is the Health CareProxy. The proxy is a simple two or three page form designating who you want to be your health care proxy It is legally binding in the state of Massachusetts but does not have very much explanation to it. A better document is the Roman Catholic Health Care Proxy which includes excellent explanations and guidelines on who to chose, what is Palliative and Hospice care, what are comfort care and DNR (Do Not Resuscitate), etc., all from a Catholic perspective.
One final aid in end of life desires is the “Five Wishes” form which is not legally binding in Massachusetts but provides an excellent discussion list for talking to your health care proxy about what your wishes are in various situations. There are a couple of reservations that the Catholic Church has with this form so it has to be used cautiously. One of the questions has to removal of food and water from a patient which means death by starvation which the Church obviously does not allow. Pope John Paul II said “Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission.
The first step we need to do is decide what measures we want in various serious medical or end of life situations. The next is to establish a health care proxy and finally you have to talk to you proxy or family about you wishes. We don’t necessarily like taking about our own death but it may make it much easier on the family when the final stages of life occurs.
Deacon Greg Beckel