-- Fr. Frank Pavone

Following are some key concepts to keep in mind as you provide guidance to others about end of life decisions.

Never to kill. The basic principle that we may not kill the innocent is always in force. There is such a thing as a worthless treatment, but there is no such thing as a worthless life. People always have to be given humane care, such as nourishment and comfort care.

You've got to be there. Questions about whether or not specific medical treatments are or are not morally obligatory can usually be answered only when one has the input of doctors who can give the medical details about the patient's condition, and about the anticipated benefits and burdens of the proposed treatment. To say "I don't want to be on a respirator" means one thing if it would only prolong imminent death for months on end, and quite another if it would only be needed for 48 hours after an accident, and one could be restored to normal health. Resist the temptation to give an answer on the spot as to what medical treatments should or should not be withheld.

"I wouldn't want to live like that." There are many people about whom we can all say this -- and not just those who are ill. I wouldn't want to live like the homeless, for example. But that does not give us permission to kill, or even ignore, the homeless, nor does it give them permission to kill themselves.

A straw is "artificial." We all rely on "artificial" things to sustain life and health every day. Many artificial machines and processes went into getting the cans of vegetables into your kitchen. The relevant moral distinction about what treatments are required is not found in "artificial" vs. "natural," but rather in whether the treatment will provide benefit without unreasonable burden.

The danger is not that we will be over-treated, but rather that we will be under-treated. We already have the right to refuse medical treatment. What we run the risk of losing is the right to receive the most basic humane care — like food and water — in the event we have a disability. Our culture also promotes the idea that as long as we say we want to die, we have the right to do so. But we have a basic obligation to preserve our own life. A person who leaves clear instructions that they don’t want to be fed is breaking the moral law by requesting suicide.

You can't predict the future. The reason you cannot indicate today what medical treatments you do or don't want tomorrow is that you don't know what medical condition you will have tomorrow, nor what treatments will be available to give you the help you need. Living wills try to predict the future, and people can argue over the interpretation of a piece of paper just as much as they argue about what they claim someone said in private.

Will to Live, NOT Living Will. The better solution is to appoint a health care proxy, who is authorized to speak for you if you are in a condition in which you cannot speak for yourself. This should be a person who knows your beliefs and values, and with whom you discuss these matters in detail. In case you cannot speak for yourself, your proxy can ask all the necessary questions of your doctors and clergy, and make an assessment when all the details of your condition and medical needs are actually known. That's much safer than predicting the future. Appointing a health care proxy in a way that safeguards your right to life is easy. In fact, the National Right to Life Committee has designed a "Will to Live," which can be found at www.nrlc.org and which I recommend highly.

Comments? Email us at mail@priestsforlife.org, Priests for Life, PO Box 141172, Staten Island, NY
10314; Tel: 888-PFL-3448, 718-980-4400; Fax: 718-980-6515; web: www.priestsforlife.org