The Milwaukee Journal-Sentinel has an article about a new advance directive adjunct document that is causing a stir among the Roman Catholic hierarchy.
A statewide pilot program aimed at getting more people to document their wishes for end-of-life medical care is modeled in part on a successful La Crosse program that has been touted as a national example.
But the new initiative will exclude one key feature of the La Crosse plan, a bright yellow document that directs emergency caregivers – paramedics and emergency room doctors – to provide or withhold lifesaving treatment in accordance with a patient’s wishes.
Advocates consider the POLST, or Physician Orders for Life-Sustaining Treatment, an important tool that gives chronically and terminally ill patients greater control of their care in the final moments of their lives.
Critics, including some physicians and Wisconsin’s Catholic bishops, fear it can be abused to expedite death and advance euthanasia.
The debate raises moral and ethical questions that lie at the heart of end-of-life care, including what constitutes living, what medical care is normal and what is extraordinary, and who decides how and when life should end.
But efforts to expand their use in Wisconsin hit a hurdle this year when the state’s most influential religious lobby, the Catholic bishops, issued a letter urging their faithful – more than a fourth of the state, by some accounts – not to use POLSTs or living wills.
“A POLST form presents options for treatments as if they were morally neutral. In fact they are not,” the bishops said in the letter published by its lobbying arm, the Wisconsin Catholic Conference.
The bishops argue that health care decisions are too complex to address in advance, and they cite a number of concerns, including the lack of a patient signature on the Wisconsin form and the absence of a conscience clause for health care providers.
Bishops encourage members instead to designate health care powers of attorney who can speak for them if they are incapacitated. Milwaukee Archbishop Jerome Listecki and La Crosse Bishop William Callahan declined to be interviewed for this story.
A Catholic Guide to End-of-life Decisions imparts a couple lessons:
- That suffering has redemptive power by virtue of sharing in Christ’s suffering: “By virtue of our being made one with Christ in Baptism, we can join our suffering to that of Our Savior on the Cross at Calvary and thereby assist in His work of salvation for the entire world….Christ is with us during our illness and shares in our suffering as we share in His.” Well, shall we maximize suffering then? This is so stupid.
- There are obligatory and optional moral-medical choices: “Generally, a medical procedure that carries with it little hope of benefit and is burdensome is deemed ‘extraordinary’ and is not obligatory.” Or, in the words of that most modern of men, Pope Pius XII, “Life, health, all temporal activities are in fact subordinated to spiritual ends.” I’m sure all of us who are affected by the needless suffering and cost of the pointless prolonging of “life” will take comfort in this.
The Guide, in the end, says that when death is imminent, or further treatment are not likely to cure or prolong life, stopping treatment is morally acceptable. It says that euthanasia is a haunting specter and is a big no-no. Big surprise. That sentiment is already engraved in every bioethics document in every health care facility in this country. So the take home, I suppose, is that the Bishops’ reaction to this new document is just more spittle-drenched sabre-rattling by idiots who care so much about “life” that they are subordinate it to an imaginary plane.
An incredibly cynical way of looking at it would be that the Catholic hierarchy isn’t content with controlling the fate of your eternal soul, and of every detail of your Earthly existence, but also the point of permissible transition of said soul into the afterlife. Priests should dictate the terms of the medical aspect to the end of your life, not you and your doctor!