Apropos of my most recent post about why euthanasia may someday be legal (because the medical-industrial complex insists on keeping people alive indefinitely, no matter what their condition), the US bishops have issued revised directives that require artificial nutrition and hydration for people in persistent vegetative states and even dementia, unless death is expected in two weeks. These directives apply to Catholic hospitals even when an advanced directive from a patient indicates otherwise.
I must admit, I'm really bad at morality (at least at moral theology). But this seems to fly in the face of good sense and Catholic tradition. I get that the bishops are worried that folks in these conditions (PVS, dementia, etc.) may be denied care if they or their families have request it, but why this additional burden on making decisions for yourself?
More interestingly, the bishops don't seem to take into account the common good: Does it really make moral sense to provide this kind of care to a dying person when those medical resources (money, doctors/nurses, etc.) could be used with greater benefit to other patients? That has always been part of the equation, the argument being that medical resources need to be directed to the good of the whole community, not just privileged individuals, as is the case with our current woefully unjust health care system.
Again, I'm not talking about denying extraordinary care to someone who requests it, just my own ability to make informed conscientious decisions about my care in these kinds of circumstances.
I just find all of this particularly burdensome for most peoples' consciences. I don't have any problem telling those responsible for my care that they can feed me by hand until I stop eating–I will at least still be in some relationship with them, which seems to be at least one good measure of a "human" life as opposed to bodily function.
But if I stop taking food and liquid by mouth with no reasonable chance of recovery, I don't feel morally obligated to allow a physician to open a hole in my stomach so a nurse can pour in some Ensure every four hours. In fact, I would see that as an immoral act of violence against my bodily integrity. I doubt a lot of Catholics would be able to say that, given the guidance they're getting from their pastors.
Or is my conscience poorly formed?
Consider this from a commenter on the previous post:
What about older people who don't want to be kept alive beyond when they become very sick and debilitated? Demographic data tells us that expenditures on persons in their last 2 years of life account for 40 percent of all Medicare expenditures. Some, or many, older people must be thinking about how their disproportionately high medical costs may well leave no Medicare for their children and grandchildren and great grandchildren.
I raise this question at age 69, after a minor heart procedure, thinking of a very good, moral, caring, religious man who after many years on kidney dialysis, stopped it and died in a week, at age 85. He'd lived longer than several relatives who died much younger with the same inherited disease. I don't know his reasoning, but he was intrigued when, three years earlier, James Michener went off dialysis and died. This seems a moral question for us all — particularly for those of Medicare age. There must be many people like this man and like James Michener — thinking of others, leaving something for others, leaving the world a better place than they found it. I'm thinking about it. I'm leaning in their direction. How I will think and feel later, I can't say. But it is something to consider, discuss and pray about.
Good questions. What might a group of older, conscientious Catholics say about care at the end of life? Should that inform what the bishops say?
