Should I Have a Living Will?REV. TADEUSZ PACHOLCZYK
Many people believe they can exercise better control over their own destiny by filling out a living will (also called an "advance directive.")
One of the major difficulties with some living wills is that they may be written using broad and imprecise language, giving rise to the idea that all treatment options are morally equivalent. One widely available living will called "5 Wishes" offers questionable options and morally dubious choices to the patient by including, as but one example, the following series of check-boxes:
The various options presented above cannot be morally legitimate for every case of severe brain damage, even though they are offered as if they were. Severe brain damage affects different people differently, but even when likely to cause a permanent disability, or otherwise lower the individual's "quality of life," this does not imply that we always have a valid moral option to discontinue life-support. Many people live in compromised, less-than-ideal situations, yet are valuable members of our families and communities. Some have argued that the loose language of many living wills has the effect of setting up a "glide path" into euthanasia or physician-assisted suicide.
Too often, people imagine that the choice to accept or decline a particular medical intervention can be made in a kind of vacuum, as if every decision were equally acceptable, since we are "free to choose." But the freedom to make our own health care decisions implies that we have moral obligations and duties, one of which is to be certain that we are using all the "ordinary" or "proportionate" interventions necessary to maintain our life and health. To put it simply, those medical treatments, medications, and procedures that offer reasonable hope to protect and preserve life without grave burden to oneself or another are ordinary care, and are required as part of our duty to care for ourselves.
Another story involves a businessman who had diligently filled out his living will, indicating that if he were to suffer a serious injury or sickness, he wouldn't want any tubes or mechanical assistance with breathing. He just wanted to be let go. One day he had a heart attack, and was struggling to breathe. The ambulance rushed him to the local hospital. In the emergency room, they showed him his living will, which they had on file, and said, "You didn't want us to do anything, according to your advance directive." He blurted out, "Look, I don't care what I wrote there — I can't breathe, and I want you to help me now!" We don't always know what a particular situation will really be like beforehand, or how we will approach urgent life and death decisions when they arise.
There is a better choice available to Christians than a living will. We can choose a surrogate, a living person, who will make health care decisions in real time on our behalf if we are rendered unable to do so. The proposed surrogate (also called a "health care proxy") is someone who cares deeply about us, who loves us, and is reasonably able to make decisions in accord with our known wishes and with our best medical and spiritual interests in mind. Filling out a form to designate our health care proxy is something that each of us should do as a sensible way to prepare for difficult end-of-life situations that may arise. Preparing such a document can also prompt us to begin discussing these important topics more effectively with our families and loved ones.
[Forms are available to assist with selecting a health care proxy: click here to view to the "End-of-Life Guide" under the Publications section of The NCBC website — www.ncbcenter.org].
Rev. Tadeusz Pacholczyk. "Should I Have a Living Will?" Making Sense Out of Bioethics (March 1, 2007).
Father Tad Pacholczyk, Ph.D. writes a monthly column, Making Sense out of Bioethics, which appears in various diocesan newspapers across the country. This article is reprinted with permission of the author, Rev. Tadeusz Pacholczyk, Ph.D.
The National Catholic Bioethics Center (NCBC) has a long history of addressing ethical issues in the life sciences and medicine. Established in 1972, the Center is engaged in education, research, consultation, and publishing to promote and safeguard the dignity of the human person in health care and the life sciences. The Center is unique among bioethics organizations in that its message derives from the official teaching of the Catholic Church: drawing on the unique Catholic moral tradition that acknowledges the unity of faith and reason and builds on the solid foundation of natural law.
Inspired by the harmony of faith and reason, the Quarterly unites faith in Christ to reasoned and rigorous reflection upon the findings of the empirical and experimental sciences. While the Quarterly is committed to publishing material that is consonant with the magisterium of the Catholic Church, it remains open to other faiths and to secular viewpoints in the spirit of informed dialogue.
Father Tadeusz Pacholczyk earned a Ph.D. in Neuroscience from Yale University. Father Tad did post-doctoral research at Massachusetts General Hospital/ Harvard Medical School. He subsequently studied in Rome where he did advanced studies in theology and in bioethics. He is a priest of the diocese of Fall River, MA, and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia. Father Tadeusz Pacholczyk is a member of the advisory board of the Catholic Education Resource Center.
Copyright © 2007 Rev. Tadeusz Pacholczyk, Ph.D.
Not all articles published on CERC are the objects of official Church teaching, but these are supplied to provide supplementary information.