In light of a recent law legalizing assisted suicide in New York, Catholic bishops urged Catholics to make end-of-life decisions prayerfully and with guidance from the Church.
In a recently published updated end-of-life guidebook, the Catholic bishops of New York state outlined the Catholic Church’s teaching on assisted suicide as well as what care is morally obligatory or morally optional.
The updated pamphlet, “Now and at the Hour of Our Death,” is designed “to simply explain the moral principles of Catholic teaching with regard to end-of-life decision-making and to outline the options that exist in New York state for advance care planning,” according to its introduction. The pamphlet also encourages Catholics to appoint proxies who are informed on their values to make medical decisions should they be unable to make them.
“Medical advances bring with them new and complex questions with regard to medical treatments and moral decision-making,” the introduction to the guidebook reads.
The guidebook specifically addresses the moral problem of assisted suicide but also goes into detail about other important end-of-life decisions.
“Assisted suicide is the voluntary termination of one’s own life using physician-prescribed chemicals or drugs that will cause death. It is considered active euthanasia,” the guidebook reads. “Our Church warns us in no uncertain terms that this practice is objectively immoral and must be avoided, despite the false veil of compassion with which it is sold.”
What types of medical interventions are morally required for Catholics?
Basic lifesaving medical interventions, such as feeding tubes, are generally considered morally obligatory by the Catholic Church, according to the bishops’ guidebook.
The bishops distinguish between these morally required “ordinary” medical interventions and “extraordinary” or morally optional interventions. Determining which is which requires “the weighing of benefits and burdens expected for each individual.”
“This is not just a pragmatic decision of costs and benefits but a moral decision that affects our spiritual health,” the bishops say of end-of-life decisions.
The bishops note that “we must always accept (and others must provide) ordinary medical means of preserving life.”
“Ordinary means are those that offer us a reasonable hope of benefit and would not entail excessive burden on us, our family, or the community,” the bishops continue.
The pamphlet goes into the distinction between “ordinary” and “extraordinary” treatments and its connection to assisted suicide.
“The immorality of directly intending and bringing about our own death or of assisting in the death of another by intentional action is self-evident,” the bishops state. “Decisions can become much more complex, however, when we contemplate the removal or withholding of medical treatment, such as a ventilator or dialysis.”
“Withholding ordinary care with the intention of causing death is considered passive euthanasia and is always gravely contrary to God’s will,” the bishops continue. “But Catholics are not morally bound to prolong the dying process by using every medical treatment available. Allowing natural death to occur is not the same as killing.”
But the bishops note that “extraordinary treatments” are “considered morally optional.”
“For example, it would be permissible for a cancer patient to forego a particularly aggressive and expensive treatment if the patient judged the survival rate too low and the pain of the treatment too great a burden,” the bishops say.
The bishops emphasize that the distinction can be complex and encourage Catholics to seek guidance in these decisions.
“Weighing the burdens and benefits of particular medical treatments for each individual requires us to apply the virtue of prudence, using practical reason to discern the true good and choose the right path,” the bishops say. “Because such decisions are often sensitive and complex, Catholics may wish to seek guidance from a priest, chaplain, or ethicist whose counsel is informed by Church teaching.”
For instance, the bishops note that there is an obligation “in principle” to always provide patients with food and water, including when patients require medical assistance or have irreversible conditions. The bishops also note that this moral standard can have exceptions in extreme cases, such as “when death is imminent” or if the gastric tube causes severe side effects; even then, hydration and nutrition should be provided to the extent possible.
“It is never permissible to remove a feeding tube, or any other form of life-sustaining treatment, based on a belief that the patient’s life no longer holds value or with the intention to terminate the patient’s life,” the bishops state.
How should Catholics make important medical decisions?
The bishops emphasize that the guide “is by no means a substitute for prayer.”
“Determining if and when a particular treatment can morally be withheld or withdrawn should be done collaboratively with the patient or surrogate, family members, health care providers, and spiritual adviser,” the bishops say.
The bishops encourage Catholics to plan in advance and ensure that surrogate decision-makers, a legal standard in New York, will honor “your values and beliefs.”
The bishops recommend the health care proxy as “the most morally appropriate advance care planning tool in New York state.” The New York State Catholic Conference referred New York Catholics to fill out a government form that enables citizens to appoint a trusted loved one to make health care decisions and also to include instructions for their proxy.
Dennis Poust, executive director of the New York State Catholic Conference, noted that the original issue of the guidebook has been a useful tool “for more than 15 years.”
“Our hope is that many thousands more Catholics in the years to come will find ‘Now and at the Hour of Our Death’ to be a useful guide in what is by nature a very stressful time,” Poust said. “We urge Catholics to read the booklet and familiarize themselves with Catholic teaching on these issues and the options available in New York now, before they or their loved ones are facing a health crisis.”
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