For the past three to five years up until May 28th, 2007
our family dealt with something we never had to deal with
before: the death of a loved family member, my father, Stephen
William Humphrey Jr. who I privately refer to St. Stephen
of North Sudbury. (Note: I overlook the last few years where
he really didn't have his mentals.)
I can now appreciate the anxiety and variety of emotions
among family members that go along with the death of a loved
one when he/she is near death; probably more than I experienced
because we are a pretty closed-knit family.
The main thing I prayed for was that my father have a Catholic
death.
I wanted to share with you some of my struggles during this
period of time. Although at times I felt like an emotional
basket case, the Lord blessed my heart and mind to dialogue
about the Church's teachings on "End of Life" issues,
with my colleague, Richard Chonak, who lost his temporal
mother a few years back.
Although he was unaware of it, my dialogue with Richard
was immensely helpful when my non-practicing Catholic mom
came to me personally asking about how to deal with the doctor's
question:
Mrs. Humphrey, Do you want to give us permission for a
DNR (No Not Resuscitate) order?
For this reason he has permitted me to share our dialogue
via e-mail below.
Mike
| { On the passing of my father — dialogue and reflections. } |
Mike replied:
|
Sat 5/19/2007 4:33 PM
Hi guys,
I forgot to tell you that my temporal father is on a
respirator and not responsive to anything.
The doctors
have been starting to ask my mother "those" questions
about whether we want them to resuscitate.
My mom, who is not a religious person, asked me, and
I think I put it in a simple manner.
- If you are not the Author of Life, why should we give
any doctor the OK to be the Author of Death?
- Why should we give any doctor the OK to break their Hippocratic
oath?
I can appreciate the difficulties that families go through
during this period of time, with the evil ones placing
anti-life thoughts on their minds.
In my opinion, this period of time is a mystery of faith.
Why?
Because as I sat there, praying and watching his vitals,
with my worldly eyes and maybe some secular ideas, I
had said that things seem hopeless.
Nevertheless, the Catholic faith side of me was saying,
that my father, like myself, has (present tense) a specific
purpose in life and even though I can't communicate with
him, he is fulfilling that purpose in a way I can't understand
but I know is ordained by Our Lord. (Maybe through a
redemptive suffering, though he didn't seem to be in
pain.) My job as a faithful son, to pray and be with
him. After all he is breathing, his heart is beating
and he does have some blood pressure.
To those that have little or no faith, they wouldn't
be able to see this "mystery of faith" because
they don't understand that as long as Our Lord ordains
that my father lives another hour he is fulfilling the
purpose he was created for from the beginning of time.
I am familiar with what is required and not required
in these situations by the Church.
All I'm praying for is a holy Catholic death .. if this
is his time. I said the St. Michael exorcism prayer to
ward of the demonic spirits several times last night
before I left the hospital at 5:30am.
He wasn't suppose to make it through the night :)
Pray that we can stand up to the "culture of death" mind
set these doctors appear to have and maybe a miraculous
recovery?
Mike
Father: Stephen William Humphrey Jr.
Mother: Dorothy Mae Humphrey
Brothers: Stephen and Mark
Steve's Family: Wife Denise
Mark's Family: Wife Pam: Kid: Katy, Brain, Justin, Stevie
|
Richard
replied:
|
Sat 5/19/2007 4:43 PM
Hi, Mike —
Don't be stricter than the Church here: not all treatment,
including resuscitation, is mandatory.
The National Catholic Bio ethics Center (an orthodox
organization) puts it this way:
"We are also free, however, to refuse treatment
that is of dubious benefit or when its burdens are clearly
greater than its benefits."
A Catholic Guide to End-of-Life Decisions
If it helps any, it might be worth considering the example
of Cardinal Cooke of New York, who was diagnosed with cancer
in 1965, and after some years of treatment, eventually
turned down further therapy and died in 1983. Fr. Groeschel
is promoting his cause for sainthood.
— RC
|
Mike replied:
|
Thanks Rich,
I'm aware of what you sent but don't be less strict
than the Church.
I'm trying to approach it the way Our Lord would want me to. I don't see what's wrong
with that.
Mike
|
Richard replied:
|
Mike,
You are right to say that a doctor should not be an "Author
of Death".
We must not act so as to *cause* death.
- Refusing food and water would cause illness and
death directly.
- Refusing simple treatments or common medications
would be bad, too: that would cause illness and death
by negligence.
However, using extraordinary treatments such as respirators
is not required. If a patient (or his family) declines
to use such treatments, that is simply accepting death
when it comes.
If a resuscitation would help your father return to
consciousness, and remain alive indefinitely without
a respirator, those would be clear benefits that would
make resuscitation worthwhile, perhaps even a duty.
But if you don't expect a resuscitation would lead
to any stable improvement, it is not required; there
is no duty to hold off death for another six hours
or two days by performing a resuscitation.
But I trust you are spending time with your father
during his last days and hours, as Our Lady and St
John did at our Lord's side.
If you're concerned that my advice on this is less
strict than the Church, please let me know.
— RC
|
Mike
replied:
|
Hi RC —
I thought these specific paragraphs addressed the
issue pretty well.
Obligatory and Optional Medical Means
Specific Moral Teachings of the Church
My dad's condition would obviously be no burden on
me at all and I'm not going to let any doctor break
their Hippocratic oath. I personally don't want any
of my family members nor doctors killing my father
either.
If they removed the status quo (current life support),
that's what they would be doing **PERIOD**.
Pius stated: "Life, health, all temporal activities
are in fact subordinated to spiritual ends."
I'd agree with him here.
Among family members, these issues over time have to
be addressed if they critically effect **their** spirituality
and spiritual needs.
I still may have a bone to pick with Pius XII, and
I think I'm allowed to as a Catholic because this is
not a dogmatic or doctrinal issue, but only moral **guidelines**
issue when he says:
"Normally one is held to use only ordinary
means-according to the circumstances of persons,
places, times and culture-that is to say, means that
do not involve any grave burden for oneself or another."
- Because I think my dad is extraordinary, I think
he deserves extraordinary measures.
- Plus, I didn't know a respirator was considered
extraordinary.
- Also, back in Pius's time there was not a culture
of death as much as there is today. I'm not buying
into any "culture of death" mind set.
Why not let the Author of Life decide when my father's
purpose in life is fulfilled?
Certainly Pius isn't going to disagree with that! Is
he Richard?
Back to the point Pius and I agree on: My older brother
and mother are not as strong in the faith spiritually
as I am. I can see where over time, it would become
a burden to them. Especially, my non-practicing mother.
I fear, but would accept God's will, that this "could" lead
down to an Audrey Santos/Terri Schiavo "type" of
path.
I was able to put the five-fold scapular I had been
wearing on my father last night. The Catholic nurse
understood and was helpful.
No reply needed. Just say some prayers for me and
our family.
Mike
|
Richard
replied:
|
I had to look into these issues a few years back at
the time of my mother's last illness, so it's still
kind of fresh for me. As things worked out, Mom passed
away during an operation despite being on life support
at the time, so we were spared any complicated moral
decisions to make; I only regret now that I encouraged
her to accept the doctor's advice and have the operation
— she probably would have lived a few months longer
at home in reasonable comfort without it.
About respirators: there isn't a hard and fast rule
to define what medical techniques constitute extraordinary
(and therefore optional) means of treatment. As technology
advances over time and across countries, more techniques
change from being extraordinary (complex, expensive,
burdensome in themselves) to ordinary (routine, modest
in cost, relatively safe).
I still count respirators as "extraordinary" because
they are burdensome (stressful on the body and harmful
over the long haul), they are complex (using sophisticated
high-tech machinery), and costly (even if most of the
cost is being paid by insurance).
— RC
|
Mike
replied:
|
Hi RC —
I visited my father tonight and while driving home,
I was thinking about the argument that you were putting
forward for Pope Pius XII.
I think the reason I'm having a hard time, "logically" swallowing
your argument is because the Church has always presented
the Truth to the faithful in black and white colors,
but in this instance it's giving the faithful two blacks
(one modified) and a possible white.
The Church prohibits the taking innocent life from
the moment of conception (to natural death.)
the first black: natural death
is the best because (you are allowing the Author
of Life to decide when a person's specific purpose
in life has been concluded.)
the second black: we are changing "the
first black" so that:
(we are determining) when we think, with
our limited finite minds, the person's specific
purpose in life has been concluded.
This second black above appears to be what you
and Pius are arguing.
It's like: If we get impatient with God, we will
play God. (Sounds like a white, or a morally incorrect
view.)
As I said earlier:
Nevertheless, the Catholic faith side of me was saying,
that my father, who is unconscious, has a specific
purpose in life and even though I can't communicate
with him, he is fulfilling that purpose in a way I
can't understand but I know is ordained by Our Lord.
(Maybe through a redemptive suffering, though he didn't
seem to be in pain.)
See my point?
Any way, Mom called tonight and asked if he had received
Last Rites and I told her he has received it twice
last Thursday and Friday.
I don't know what's going to happen. They may go ahead
and do something without my knowledge.
I'll keep you informed.
Mike
|
Richard
replied:
|
HI Mike,
You said:
I visited my father tonight and while driving
home, I was thinking about the argument that you
were putting forward for Pope Pius XII.
What a compliment: the idea that I'm helping Pope
Pius out with making his case! :-)
You said:
It's like: If we get impatient with God,
we will play God.
The decision does involve making a judgment call,
but it shouldn't be a judgment on the person's merits.
We certainly don't have a right to say "you've
lived long enough, now please go die".
But we do have to make judgment calls about the proposed
treatments and whether they are likely to be effective
for the patient, and for how long. And you have to
weigh that against the burden imposed by the treatment
— harmful side effects, pains, and even costs.
If a treatment is going to be totally futile, then
it would be wrong to even attempt it. If it has some
possibility of success, then it can be acceptable to
do it, and if it is certain to give the patient a
major benefit, it may even be a duty to do it.
But here we're thinking about cases where the results,
good and bad, are uncertain.
Our old friend the "principle of double effect" comes
into this. If a proposed course of action has both
good and bad effects, you have to check some points:
* What is the proposed action (or omission)?
* What is the good effect of the action?
* What is the bad effect of the action?
* Are the bad effects of the action *disproportionate*
to the good effects?
* Do we intend to directly bring about the bad effect?
* Does the bad effect *cause* the desired good effect?
If any of these last 3 questions has a "yes" answer,
then the proposed action is not acceptable.
* What is the proposed action?
To omit an extra resuscitation attempt and stop
treatment if the patient's vital signs fail.
* What is the good effect of omitting resuscitation?
It avoids prolonging the burdens of the resuscitation
and subsequent treatment on the patient: pains, stresses
on the body. Based on the doctors' prediction/opinion,
the patient or his representatives make an estimate
of what those burdens are, and how certain or uncertain
they are.
* What is the bad effect of omitting resuscitation?
The patient will not get any possible benefits of
the resuscitation, so the patient is likely to die
shortly. Here you and the doctors have to make a
rough prediction of how much probability of health
improvement and how much longer life would come from
doing a resuscitation and additional treatment.
* Are the bad effects of omitting resuscitation *disproportionate*
to the good effects? Or does the good at least balance
out the bad?
This is where the issue of "extraordinary" means
may come in: Are the treatments particularly stressful,
complicated, or costly, in comparison with the expected
health benefit and its duration, for this particular
patient?
At that step, we're not in a black-and-white case:
We don't really know the future, but we have a duty
to use reason and the limited human knowledge we have.
So we're using estimates of what benefits and burdens
the patient would get from resuscitation. Furthermore,
weighing the two against each other isn't exactly a
science.
Judgments can even vary from place to place and through
time: Treatments considered rare heroic efforts in
one era may become more common in another.
* Do we intend to directly bring about the bad effect?
Do we intend to cause the death of the patient?
This proposed action does not take life. While
we do expect the patient to die, we do not desire
it or intend to promote that. The patient's death
is caused *directly* by his disease, and only indirectly
by the failure to resuscitate him.
In Catholic Christian morality, we must not intend
to directly harm another person. (See Germain Grisez's
book "Beyond the New Morality".) An unintended,
indirect harm is tolerable, provided that the "double
effect" criteria are met.
* Does the bad effect *cause* the desired good effect?
We must not attempt to do good by means of harming
others. — No, the bad effect does not cause the
good effect. As soon as you act — as soon as you
stop attempting resuscitation and treatment — the
burdens of more treatment are avoided. That is the
desired good effect, and it happens immediately,
even before the patient dies.
(If it happens that the patient's death is already
established before you get to the point of attempting
or not attempting a resuscitation, then the resuscitation
is already not possible, and the whole question is
moot.)
Sorry this is so long. It's late / early.... :-)
— RC
|
Mike
replied:
|
Hi RC —
Thanks for the late night reply. It is appreciated.
For situations where Our Lord, for some reason, does
not wish to take my father's life naturally, your reply
below was very helpful and timely.
Less then an hour after I read your reply, my mother
wanted to talk to me privately at my apartment. The
social workers and so-called lady "chaplain" had
talked to her about giving the OK for DNR (Do not resuscitate).
She was very honest, saying that she had one son who
was a religious freak :)
I took it as a compliment.
She wanted my view on the issue.
I tried to explain to her the balance of making a
good decision based on two questions:
What is the probability that dad's health will be
restored to a normal lifestyle if we DO resuscitate?
What are the spiritual, emotional and financial
burden on the family if we DO resuscitate?
I shared with her my personal view: that although
I would have a hard time accepting a (DNR) decision,
I could live with it. [What I didn't say: The reason:
Due to my concern for the spiritual well-being of other
family members. ]
I also shared with her that either decision would
be OK with the Church. (my assumption being a respiratory
is a extraordinary circumstance.)
Her main concern was whether I would hold her decision
against her forever, if she gave the OK for DNR.
I was emphatic that I would never turn away from
her or hold anything against her due to any decision
she made in this area. Why?
She's my mother and I love my mother! Without her,
I wouldn't be here!
I went on to say that I would be at peace if two things
happened:
- That my father dies with the five-fold scapular
I put around his neck last week AND
- If there is an OK for DNR, that the doctors and
staff don't do ANYTHING purposely to bring about
that situation.
To you, the only remaining question I have left is:
Why God through the Church allows its members to be
put in certain situations to play God themselves?
- If the Lord wanted to: All deaths could be nature?
- That does fit within His job description doesn't
it :)
Mike
|
Richard
replied:
|
I think that's how things turn out generally.
Families end up worrying about awful contingencies
and scary scenarios, disagreeing about what should
be done, and then things change — for worse or better!
— and most of the time the complicated scenarios just
disappear.
RC
|
Mike
replied:
|
Hi RC—
I've been thinking about that question:
Why would God put families in stressful prolonged "life
situations" that can burden many families, when
he could just take their life naturally and have my
father die at the hospital on his own without a respirator?
I think this is doable and I think this fits God's
job description :)
As I was driving home, the only answer that came to
mind is this:
To test how WE value life OR importantly to test how **
I ** value life.
Pray that I pass the test.
Take care,
Mike
|
Richard
replied:
|
That's
beautiful.
I hope it'll help your Mom get through your
father's illness over the next days.
— RC
|
Mike
replied:
|
Mike said:
The committee of doctors met to talk about my father
and they told mom that a decision on DNR (Do not resuscitate)
would not be needed because they foresee him dying
on his own.
My brother Mark called today and said that based on
what he heard from mom, our talk went over REALLY well.
He gave me a Kudos :) despite the fact that no decision
on DNR was required.
Mike
|
| { On the passing
of my father - dialogue and reflections. } |
Over the weekend, the doctors called my mother and told
her that Dad was breathing on his own and that it was not
recommended medically to keep my father on the respirator.
Neither my mother nor I liked the idea of taking my father
off the respirator because we thought he would die within
minutes. They had called us on a Saturday and he passed into
eternal judgment/life on Monday; on exactly his 84th birthday,
except this time it was into eternity.
Mike
replied:
|
Hi RC—
During our conversation today, my mother asked if
I would say something at a future funeral. She didn't
want to.
I personally think this is because for the past 3-4
years he had lost his mentals and was very arrogant
and pushy toward her. I tried to explain to her, that
was not the real husband she married.
Mike
|
Richard
replied:
|
A little talk at the funeral really should not say
much in praise of the departed: that would make it
a eulogy, which is not what the Church wants there.
Here's what I wrote for my mother's funeral, in case
it helps:
The main things were:
- to thank people outside the family who had been
good to her;
- to express faith that she is now among the faithful
departed *on the way* to God — not perfect yet;
and
- to thank people for adding their prayers for her.
Short, and in simple, gentle words, very restrained
and (I hope) dignified.
— RC
|
Final Note:
|
Speaking for Richard, we hope you have found this
dialogue helpful.
Mike
|
|
