By Marty Denzer
Catholic Key Reporter
1. Catholic teaching states that “each and every human life is an unrepeatable gift, created in the image and likeness of God. We are called to respect and protect human life because of its inherent dignity, sacredness and value. We understand that life is a sacred trust over which we have been given stewardship, but not ownership. Our life belongs to God and we do not have absolute power over it. So while it is entrusted to us, we are called to care for it, preserve and use it for the glory of God.”
2. Don’t wait until illness or incapacitation strikes to choose someone who knows you well to speak for you for medical care decisions in case you can’t speak for yourself. Writing down your choice empowers that person to make healthcare decisions for you that are consistent with your preferences. In Missouri, the person you name to make decisions for you is called your Durable Power of Attorney for Healthcare, agent or surrogate. Most people select a spouse, a partner, relative or close friend as their agent. That person doesn’t need to be a Missouri resident, but should be willing and able to travel to your bedside if needed. Your Durable Power of Attorney must be willing to take any action consistent with Catholic teaching that he/she deems necessary and appropriate.
3. Catholic Church guidelines suggest the wording of the Durable Power of Attorney for Health Care as follows: “I, ________, hereby appoint my _________, ______, as my durable attorney in fact (hereinafter Health Care Surrogate) to make health care and personal decisions for me as authorized herein. I desire that my Health care Surrogate base his/her healthcare decisions for me on what he/she believes to be my wishes and in my best interest, taking into account all that the Catholic Church teaches.”
Write down your choice of health care agent, even if it’s on a napkin, and have your signature and that of your choice notarized. It’s a good idea to choose and alternate agent, in case your first choice is unable to speak for you, and that their signature is notarized also, suggests Bill Francis, the diocesan Respect Life Director. It is not necessary to involve an attorney but you are planning ahead, it makes sense to add choosing and notarizing an agent for healthcare to your checklist.
Under Missouri law, your agent cannot be your attending physician or an employee of the physician; an owner, operator or employee of the health care facility, unless you or your agent are related: parents, children, siblings, grandparent or grandchildren, or you and your agent are members of the same community of vowed religious who conduct or assist in conducting religious services and actually and regularly engage in religious, charitable or educational activities or provide health care services.
Missouri law and Catholic teaching both suggest that when choosing your agent, trustworthiness and dependability are crucial. You might also want to choose someone you’d consider to be good at asserting your health care wishes if others argue against them —calm and persistent, especially under pressure. Another viable reason for choosing a trustworthy, dependable agent is that all the advance directives in the world are useless if they aren’t paid attention to, and that does happen. Having both an agent and advance directives based on Catholic Church teaching is recommended by the National Right to Life Committee.
4. The Ethical and Religious Directives for Catholic Health Care Services, published in 2009 by the U.S. Conference of Catholic Bishops mandates instructions for Catholic Health Care facilities and providers. Catholic hospitals, nursing facilities and hospice houses offering care to those who, due to illness, accident or advanced age, are in danger of dying, should provide them appropriate opportunities to prepare for death, to discuss what’s happening with their physician and family, and to receive the sacraments.
5. Catholics have a moral obligation to use ordinary, proportionate means of preserving their lives. Those are procedures and treatments that in the judgment of the patient or their agent offer a reasonable hope of benefit and don’t entail an excessive physical burden, such as intense and/or chronic pain, or excess expense imposed on the patient, his/her family or the community. These include food and water whether given orally or medically assisted if the patient cannot take food by mouth, pain relief, comfort, warmth and cleanliness. The patient’s wishes regarding the use of treatments and procedures to sustain life, when made by a competent adult patient or agent, especially if in writing and up-to-date, should always be respected, unless they are contrary to Catholic moral teaching, such as assisted suicide or euthanasia. Remember that treatments and procedures may be refused if the patient is not benefitting from them and if continuing them would prolong the death process.
6. Health care preference forms available at hospitals and physician’s offices are templates: since they are not set in stone, you can list your wishes in your own words. With medicine and medical technology changing constantly, it might be helpful to review and update your preferences every four years or so. A downloadable Catholic Durable Power of Attorney for Health Care form is available at no charge on the Diocese of Kansas City-St. Joseph website, www.diocese-kcsj.org. Remember to take the documents with you should you be admitted to a hospital or nursing facility or tell your health care agent where they are and how to access them.
The document known in Missouri and Kansas as the Transportable Physician Orders for Patient Preference, is a portable medical order that goes with the patient and is intended to give health care providers immediate information as to what interventions should or should not be undertaken when a patient is near death. It differs from a Do Not Resuscitate Order in that it also includes directives about life sustaining measures in addition to cardio-pulmonary resuscitation (CPR), such as intubation, antibiotics, and artificial means of providing nutrition and hydration, usually feeding tubes. The TPOPP aids health care providers in understanding your wishes at a glance. It is not a substitute for a properly prepared advance directive and Durable Power of Attorney.
7. Taken together, Catholic advance directives and Durable Power of Attorney for Health Care provide details about your agent, your health care preferences and your wishes regarding organ donation. These documents become a lifeline. Unless you write down your wishes about the kind of medical treatments you want, and those you don’t want, and name someone you trust to oversee your care if you cannot, those decisions could be taken out of your hands and given to someone who knows little about you, your faith, personality and history, your wishes and medical care preferences.
8. Pope Francis recently wrote, “Illness, especially serious illness, always places human existence in crisis and brings with it questions that dig deep.” Jesus comes to those in need, he continued, offering his mercy and healing. The Catholic Church teaches that suffering can be redemptive, and the faithful should not be afraid of natural death, because it opens the door to eternal life with Christ. (Message for World Day of the Sick 2016, released Sept. 15, 2015, Feast of Our Lady of Sorrows.)
9. Many funeral homes, in particular the Catholic funeral homes in the diocese, offer pre-need packages, some in partnership with a cemetery, wherein burial plots or inurnments can be pre-purchased, caskets, urns and flower arrangements pre-selected, preferences on visitations listed and costs locked in. Check with your preferred funeral home or cemetery for details.
10. The four diocesan cemeteries — Mt. Olivet-Kansas City, Mt. St. Mary, Resurrection and Mt. Olivet-St. Joseph — are special, holy places of the Catholic faith: beautiful, well maintained places to visit the final resting places of loved ones, to pray and to meditate.