Discussing end-of-life issues

By Tanya Connor | The Catholic Free Press

Mr. W., an 84-year-old with no living relatives, has Parkinson’s, arthritis, and trouble swallowing and speaking. He’s had multiple hospitalizations.
It sounds like he’s an expensive burden. And he’s suffering. Maybe we should take him out of his misery.

Dr. Natalie Rodden presented this scenario at the Converging Roads End of Life Issues conference held Monday at Assumption College.
About 50 clergy, religious, health care professionals and others from Worcester and neighboring dioceses attended, according to Allison LeDoux, director of the diocesan Respect Life Office, who helped bring the conference here.
The conference was presented by the Worcester Diocese, the Massachusetts Catholic Conference (the bishops’ lobbying arm) and the St. John Paul II Foundation. It was the foundation’s first conference here, said co-coordinator Susie Lopez, noting that this Catholic apostolate was formed more than three years ago. Its mission is to proclaim the good news about life and family through education and formation, according to its website.
In her talk, Dr. Rodden, a palliative medicine physician in Colorado, identified Mr. W. as Karol Wojtyla (Pope John Paul II). He battled sickness, made international trips, wrote encyclicals, “and, oh, yeah, he’s a saint,” she said.
“He’s such a symbol of suffering,” Dr. Rodden said, and quoted from his apostolic letter “On the Christian Meaning of Human Suffering,” which links suffering to Christ’s cross.
She and other conference speakers talked about the need to alleviate suffering rather than kill the person who is suffering. While that might sound obvious, the series of talks painted a different picture of attitudes and practices today.
The question of how things got to this point was addressed by Marie T. Hilliard, president-elect of the National Association of Catholic Nurses-U.S.A. She challenged listeners to respond.
Ms. Hilliard, a nurse with multiple degrees, said she was not schooled in how to abort a child or how to help someone die unnaturally. She said she thinks the change to present practices started with the use of contraception.
“My generation – we wanted to control everything,” she said. “Everything became about me. We want the perfect life. Therefore, we want the perfect death.”
Factors she named that lead to the lack of respect for life include: the elderly becoming expensive to care for, doctors being rewarded for cutting costs, and reimbursement given for medicine to kill oneself. Also, once something is legal it’s seen as ethical, and medical professionals are expected to violate their consciences and help patients kill themselves.
But money and pain are the least-cited reasons patients give for choosing physician assisted suicide, she said; “It’s all about (the fear of) being abandoned.” A society unable to share the suffering of sufferers is a cruel and inhumane society, she said.
Bishop McManus suggested that parishes could  “create communities of compassion” for the sick who don’t have families. That might help ward off thoughts of physician assisted suicide, which is aimed at cutting costs, he said.
His focus was on the “Ethical and Religious Directives for Catholic Health Care Services” developed by the U.S. bishops.
He noted the need for ongoing formation for the clergy, and for adult education. He said there are two generations that don’t know much about Church teachings; they’re more American than Catholic, and are influenced by the moral relativism in the culture. Ethical issues should be addressed in homilies, and in  longer talks which laity could initiate, he said.
Although people are uncomfortable talking about their death, they should have informed discussions with a trusted person, if the family won’t listen, he said. And practicing Catholics who suspect their non-practicing descendants won’t have a Catholic funeral for them should put their desire for a funeral Mass in their will, he suggested.
Dr. William L. Toffler, professor of family medicine at Oregon Health and Science University, talked about the history of, and myths about, physician assisted suicide, which is legal in Oregon.
He began by praying, “Lord Jesus, help us be mindful of your presence in every person we meet.”
While many states have considered legalizing physician assisted suicide, the good news is that 45 do not allow it, he said. Out of about 190 countries, nine allow it, he said.
If patients’ pain increases and they get good care, their desire for physician assisted suicide decreases, he said.
One myth about physician assisted suicide is that the doctors know the patients well, he said. But these doctors focus on what patients say, when the patients might mean something else. For example, “I want to die” might really mean, “I feel useless.”
He called for treating the source of the pain if a patient is in physical pain and providing companionship if a patient is lonely. He told listeners to work to reflect the inherent value of those who don’t value their own lives.
Good professionals and priests are needed to counteract the culture, Ms. Hilliard said.
“You have to be there,” she told listeners. “Don’t be afraid to go into the professions.”
Dr. Rodden talked about the field of palliative medicine: specialized medical care for people of any age, at any stage in a serious illness, which aims to improve the quality of life for patients and their families.
She said good palliative care can be the antidote to end-of-life suffering, giving it meaning, but physician assisted suicide undermines palliative care goals.
Both palliative care and hospice use the philosophy of whole-person care, she said. A multidisciplinary team addresses physical, psychological, spiritual and social issues.
The palliative care team provides an extra layer of support, working alongside those treating the disease. When treatment becomes more burdensome than beneficial, the patient can transition to a hospice team, which provides comfort without seeking a cure.
Some people delay this transition, thinking that Medicare covers only six months of hospice care. But, Dr. Rodden said, patients can get re-certified, and some even “graduate” from hospice.
She expressed a desire to help people prepare for the end of life and the beginning of eternal life.