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Making Health Care Decisions: Seeing the Total Picture |
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For years we worked with doctors who knew our families and stories. We now work within managed care systems where what is known is a list of symptoms. There are pros and cons to this new reality. Our concern here is that we no longer have the luxury of depending on one doctor who knows our values to make or suggest medical choices for us. Church Tradition for 500 years has held that people have the right to refuse treatment they consider of little benefit or especially burdensome, even when doing so results in death. Deliberately destroying human life is not acceptable. However, when the person's intent is not to choose death but to protect human dignity by refusing medical measures that are overly painful, costly or of questionable value, this choice is neither euthanasia nor suicide. A recent example of this is John Paul II who, after months of seeking treatment for his deteriorating condition, finally chose to discontinue life-prolonging procedures and to die at home with dignity, without any infusions from his heart and without a ventilator. Knowledge Is Key It is important to make medical decisions based on knowledge, not just emotion. Surgery, amputation or invasive treatment might be a wise choice when a person's general health is good and medical personnel can predict with some confidence an improved quality of life after the treatment. The very same surgery, amputation or treatment might be refused when a person's underlying condition is not strong enough to support the procedure and/or the following rehabilitation. Each of us is the head of our personal medical team. It is too easy to shrug off our God-given responsibility and to “do whatever the doctor says.” Doctors, family, friends, faith community each have something to contribute to our individual ability to make informed, moral decisions about which options to choose and which to refuse. Every adult is wise to have written and signed Advance Directives, especially a Durable Power of Attorney for Health Care, in which you name a person to make choices for you when you are not able to do so. Conversations with that person (and with loved ones) can insure that choices they make will be in accordance with your beliefs and wishes. End of Life Considerations There comes a time when health is so compromised that it can no longer support life; since death is built into the human experience, hospice and other palliative (comfort) care are both moral and holy choices. Hospice is fully covered by Medicare and most other insurance. Doctors are trained to do everything possible for their patients in hopes that certain treatments will extend a person's life, but not necessarily the quality of life. You may have to be the one to say it is time to replace aggressive treatment with palliative care. Only someone trained in hospice admissions criteria can make a determination as to when a patient is eligible for palliative care. Hospice is available long before the last few days or weeks of life. Hospice respects the way God made us. Hanging on when there is no longer any quality of life can be a rejection of what even Jesus experienced. He surrendered his life, accepting the helplessness, dependency, pain, hopelessness, loss of self-esteem and grief that are part of letting go. The largest percentage of Medicare dollars is spent in the last year of life—to prevent dying. It is obviously a losing battle. Diminishment and death are part and parcel of the human package. As a people we embrace all human experience because we believe we are living into a resurrected life. “For those who believe life is changed, not taken away.” About the author: Marjorie Heidkamp, BVM (Herberdette) has been Health Care Resource Coordinator for the Great Lakes Region of the BVM congregation, and a former hospital and hospice chaplain. Return
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A deeply held belief in Catholic/Christian teaching is that life is sacred, a gift to be received gratefully and cherished responsibly. In this hopeful view of human existence, medical and end-of-life decisions become acts of faith.