Many Catholics misunderstand when treatment may be withdrawn

February 17, 2014

PHILADELPHIA – There is "great misunderstanding" among Catholics and others about the Church's teachings on whether and when life-sustaining medical treatment can be withdrawn when death is near, says a leading Catholic bioethicist.

Marie Hilliard, director of bioethics and public policy and a staff ethicist at the National Catholic Bioethics Center, said the centre conducts about 2,000 consultations a year with "families in distress" who want to talk with an ethicist "about the Church's teaching in light of their (family) situation."

Staff members hear from people who believe that "dialysis can never be discontinued," for example, or that a feeding tube is obligatory "even when it is doing more harm than good," she said.

"Persons who are dealing with crises need to be helped to understand in that situation what is the natural moral law," Hilliard said. "The Church always deals with the good and trying to reach the good," even when that means accepting the natural process of dying.

As outlined in the U.S. bishops' Ethical and Religious Directives for Catholic Health Care Services, the Church teaches that patients "may forgo extraordinary or disproportionate means of preserving life."

Extraordinary means are defined as "those that in the patient's judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community."

Survey results recently released by the Pew Research Religion & Public Life Project found that 57 per cent of Americans would tell their doctors to stop medical treatment if they had a disease with no hope of improvement and were suffering a great deal of pain.

However, 35 per cent said they would tell the doctors to do everything possible to save their lives. Eight per cent said it depends or they did not know.

Hilliard said the attention given to the cases of Jahi McMath, a 13-year-old girl from Oakland, Calif., and Marlise Munoz point out the importance of every person having "a good conversation" with a family member or friend about his or her wishes in a medical crisis.

A simple checklist of possible medical scenarios is no substitute for the designation of a health care proxy and a thorough discussion of one's beliefs with that person, she added.

"Because, as we ethicists often say, when you've seen one case, you've seen one case," Hilliard said.