End-of-life decisions are some of the most agonizing heart-breaking.
When my mother was dying in the hospital, I was chosen to be her medical power of attorney, which meant that I had to make decisions about her care. It was a position I desperately did not want to have, because it felt like there were no good choices to make. If anyone out there has been in a similar position, my heart goes out to you.
But what are our guiding principles when making these end-of-life choices?
There are many varying factors at play here. But as a Catholic, you want to avoid the 2 extremes: Functionalism and Vitalism.
Functionalism is the belief that human dignity is based on having certain qualities or attributes. If a person no longer has the attributes, then their life no longer has value. For example, if someone loses consciousness or mobility or the ability to communicate, functionalists would say that the value of this life is lesser. As a result, the functionalists tend to believe in euthanasia, which is the intentionally killing of the sick.
You can see this functionalist mindset at play in Canada. Not only is euthanasia legal, but it is even encouraged by many in the public and private sector. The functionalist would say to the infirmed person that they are being selfish for being a burden on their families. On this view, the most compassionate thing to do is to end your own life if it is too burdensome for your loved ones.
This would also apply if the loved ones are the ones making those life decisions. In the Netherlands, a committee of physicians introduced the Groningen Protocol, which laid out conditions where children under the age of 1 could be euthanized under certain conditions. The Dutch government adopted regulations that would make it possible for parents to euthanize their infants. On this functionalist view, the suffering of the child and the burden of the parents make the killing allowable.
Of course the Catholic church is against all forms of euthanasia. All life is sacred and we do not have the right to murder, even self-murder. That isn’t to say that we are indifferent to the suffering of the sick. We can do all within reason to alleviate the suffering of others. The Catechism states, “The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.” (Catechism of the Catholic Church, 2279).
It is important to avoid this philosophy of functionalism, because it becomes to easy to reduce the value of a human being to what they can do or contribute. If you have lesser ability, on the functionalist view, your life has less value. This is completely opposite of what our Lord taught us. Every human being, regardless of their ability, is made in God’s image and is of intrinsic value.
On the opposite extreme we have vitalism, which is the believe that any and all means necessary must be used to extend and persevere human life.
I want to be very clear at the outset, there is nothing wrong with using any ethical means to keep someone alive. When my mom was struggling, we had the option to remove her from her breathing machine. I asked her what she wanted and I followed her wishes to be kept on it. There is nothing in and of itself sinful about using things like ventilators and the like to prolong life.
But vitalism states that we must use these extreme measures. However, the Catholic Church holds that this is not necessary. Death is a natural part of our current state of human life. All ordinary means of keeping someone alive (e.g. food and water), must be given. But we do not need to go through excessive means to keep someone alive. Something like a ventilator is an extraordinary means. As a Catholic, if someone has no hope of recovery, a ventilator can be removed and natural death can take its course.
