Q: I am writing the Advanced Health Care Directive, and there are some questions that I do not know how to answer in order to be morally right. The questions are: 1) If I want my life to be prolonged or not; 2) If yes, to specify which life prolonging procedures are allowed to be performed: respirator, surgery and blood transfusions; 3) If I want or not want food and water to be administered. I appreciate your answer very much. Thank you. – J.C.
Answered by Fr. Edward McIlmail, LC
A: While it is good that you are thinking about end-of-life issues, it might be better to think about a health-care proxy instead.
A health-care proxy is an agent who makes decisions on your behalf when you become incapacitated. You should designate in writing who the health-care proxy will be.
The problem with trying to answer those seemingly simple questions in the Advanced Health Care Directive is that they can’t foresee a particular situation that arises. Each medical case can be extremely complicated, so it’s virtually impossible to give a suitable one-size-fits-all answer.
That is why having the proxy is preferable and recommended by the Church. The proxy can size up the medical situation with the help of various health-care workers and pastoral agents.
The Church doesn’t require people to submit to disproportionate means to maintain life. For instance, one question asks about surgery. But what will it mean in practice?
It’s one thing for a 88-year-old to undergo a minor procedure; it’s quite another to undergo a heart and liver transplant. From a moral viewpoint, the first case would be justifiable, but probably not the second case.
The Catechism in No. 2278 says: “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.”
Given that it’s impossible to foresee every contingency, it might be better to choose a person who can make decisions if you become incapacitated.
You could speak with this person and let him or her know your general desire and your wish to adhere to Church teaching. You could ask this person, if need be, to consult with a Catholic chaplain and/or ethicist.
You could find out more about a proxy statement at the National Catholic Bioethics Center site, https://www.ncbcenter.org/endoflifeforms-english.
I hope some of this helps. Count on my prayers.
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