Catholic hospitals and nursing homes must grapple with a revised ethical and religious directive from the U.S. Conference of Catholic Bishops on use of artificial nutrition and hydration.
Catholic directive may thwart end-of-life wishes
Seeded on Wed Feb 24, 2010 8:58 AM EST (msnbc.com)


The Bishop's policy goes too far to limit the wishes of the patient as defined in an advance directive. I am only 59, but I have set up an advance directive, which states that in case of a terminal illness or condition, with no hope of recovery, I do not want use of heroic measures (that includes use of a mechanical respirator or feeding tube, etc.). I would expect these wishes to be honored. I am also a Catholic, and the Bishop's directive does NOT change my opinion or plans. The article states that the facility in question tried to transfer the patient to a facility that would honor the directive, but the patient's delegate (a nephew) insisted on the feeding tube. So, the main villain here (and that is what he is) is the nephew, who used his role as delegate for the patient to thwart the wishes of the patient. That is unconscionable. So besides having a directive in place, the lesson is to be careful who you have selected as a delegate, and be sure they are willing to support your wishes as expressed in the directive.
So true. As a family, you must clearly express your desires and be sure that everyone involved understands and is willing to carry out those wishes, otherwise have names removed.
I agree the nephew was the main culprit... and was in need of a smack to the head.
I agree about the nephew. Indeed you do need to be careful who you select as your decision-maker should you not be able to make decisions for yourself; you need to have ongoing conversations with that person to make your wishes crystal clear (as well, of course, as having them in writing); and if you are asked to be the proxy for someone whose beliefs conflict with yours, for goodness sake, refuse and suggest they find someone more appropriate.
It is absurd that the nephew accepted this responsibility but then refused to follow through with his aunt's (perfectly reasonable) wishes. He should be ashamed of himself.
Be sure to add, do not take me to a Catholic Hospital or Nursing Home.
The hypocritical church and religion need to stay out of people's personal business. Isn't it illegal to go against someone's legalized directive? This happened to my father who has signed a directive and when our family would leave the nursing home, they would force feed him. Because of this, he choked on some food which ended up in his lungs and he ended up dieing of pneumonia instead of ending it naturally which would have happened soon enough. I am very sorry we did not sue them.
How horrible.... you definitely should have sued.... not so much for the money factor... but to prevent them from doing it to someone else... maybe its not too late?
As a cradle Catholic, I say that force-feeding is wrong (sinful), because it violates God's will. Only He can give life, therefore only He can take it away. It is NOT artificial prolongation of life to insert a feeding tube or breathing tube, in the hope of a miracle, including sudden advancement of science to the point of a cure. My advance directive prohibits heroic acts, including the belief that feeding, normal hydration, and the equivalent of over-the-counter pain killers are not heroic measures. nwnative should have sued that "nursing" home to their last penny. Putting food in the mouth of a patient who can clearly not chew is no different from murder. Check to make sure it's not too late.
The Catholic Church has no right to interfere.
And my message to Norman Fields is this - you can make decisions about what you want for yourself, but you can't make decisions for anyone else without their permission. A feeding tube is an artificial means of feeding, just as a breathing tube is an artificial means of providing air/oxygen.
It's up to every individual to decide whether or not they want to wait for a miracle, and if they don't, then it's between them and God.
Dachs, I agree with you. I do not try to make decisions for you. Furthermore, a breathing tube is no more an artificial means of providing oxygen than is an oxygen mask for a fighter pilot.
My wishes and that of my family supercedes those of any institution.
Period.
This is DISGUSTING. Laws are laws, and individuals have the right do choose ANY path they wish within the law. To be subjected to this fanatic nonsense is an outrage, and any institution that violates a patient's rights and legal, documented wishes should be shut down or at least have ANY funding not from the "church" be yanked immediately.
The church using guilt??? and shame????
Heavens no!!!
The catholics haven't changed one bit from the days of the Spanish Inquisition. They're twisted sadists and just love to torture and see people suffer.
Dew
Catholics have changed. The church hasn't.
I'm Catholic and what you describe isn't me or any Catholic I know.
Be careful how you throw your accusations.
I am a traditional Catholic, married to a physician. For us, the Church teaching and directives will always supersede an ever changing government policy on "ethics".
It is my belief that if you can't be Catholic and follow the teachings and ethics of your church, then you should find a different religion. I can't imagine being Catholic, yet disagreeing with what the Catholic church preaches.
That said, I'm wondering if allison-1391898 realizes that she put CHURCH TEACHING ahead of DIRECTIVES. Does that mean that your husband, the Doctor, would ignore my wishes over those of the Catholic Church?
Has anyone considered that if the ill person dies, the Catholic Church won't be getting any more money from them? Could that be reason enough to keep the person alive?
This wouldn't be the first time that the Catholic Church misled their followers. Those who eat fish on Friday during Lent think they're following the church in its lesson of abstinence, when in fact, that's not the reason why they're eating fish ever Friday.
According to a bishop that we met at the Vatican, there was a time when the local fishermen were huge supporters of the Catholic Church. The more money the fishermen made, the more they gave to the Church. Thus, because Catholics followed the teachings of the church, they ate fish on Friday. The fishermen made a lot more money, and they turned a good portion of that money over to the Catholic Church.
The Catholic Church is a horrible example of morality and ethics.
Catholics obviously have no such thing as free will anymore. This just about makes them less than human.
For all you whining liberals about it being the patent's rights (nwnative, GoldenGateMami, JM387), you don't HAVE to go to a Catholic hospital. It's pretty simply.
Just because something is legal does not mean that a doctor HAS to abide by your wishes. You can't force a pro-life doctor to give you an abortion. Same thing applies here, except its in the case of passive euthanasia. Get over yourselves, really.
You don't HAVE to go to a Catholic hospital - but sometimes it is the most expedient option. I live about 2 miles from a large Catholic hospital, about 10 miles from secular hospitals. I can easily envision a situation where I ended up at the Catholic hospital because it is closer and easier to get to in an emergency. Yes, should my wishes be against Catholic doctrine, I could then ask to be transferred once the emergency has passed ... but this is not always feasible or easy with a sick patient, not to mention it is traumatizing, expensive, and risky.
Not all areas have multiple hospitals to choose from!
In some areas the Catholic Church has bought out the hospitals in the region so you have no choice but to use them. Insurance companies won`t even pay for you to travel to a secular hospital.
These hospitals should be prohibited from not following legal documents brought in with the patients. If they are unwilling to follow US laws then they should have to sell the hospitals to those that will conform to US law.
Rex is 100% correct. The Catholic Church owns Catholic Hospitals. They write policy based on church teachings. Always have, always will. It is not a city run hospital with ever changing "ethics". The Diocese answers to Rome who in this case is the OWNER of the hospital system. This is not a hard concept to grasp. It's like any business, except the "CEO" in the Pope. We are a Catholic, physician family. Trust me, stable patients can be transferred to another hospital by family members. It's done all the time.
Who doesn't want their personal medical decisions being made by an old guy in Rome with zero medical training?
Or being told how to live their sex lives, and what is morally right and wrong, by allegedly celibate pedophiles?
Or being told that evolution is just a crackpot "theory" by the followers of the Catholic Church which only acknowledged that the Earth was round in 1992, when Pope John Paul officially sanctioned Galileo's theory that the Earth revolves around the Sun, contrary to what the bible tells us.
It takes them a few centuries to catch on to some of these things....
Excellant point, Andrew.
Always good to see the Church sticking its nose into what is a very personal and private decision.
Masturbation is also a personal and private decision. Doesn't mean i have to let you come into my house and do it.
Whether I agree with the policy or not (which I don't) I do believe that the Catholic Church has a right to set their own policies at their own property. If you don't like it, you have the right to go someplace else. If I'm in pain and want to die, I simply won't admit myself to a catholic hospital. Problem solved, directive adhered to.
Not sure what jerking off has to do with my directive that I do not want a Feeding tube...and yes I would go elsewhere if it is possible, in many small towns there is not always a choice.....
I agree, but its dangerous for us to start enforcing our morality and ethics onto others. Isn't this exactly what they accuse pro-lifers, anti-gay marriage, religious, etc. of doing?
The problem here is they are performing a procedure when a patient doesn't want it done. Sticking a tube down someones throat when they've asked you not to is assault. Their moral code doesn't supersede the laws of the land.
Rex, if you have the availability of a non-Catholic hospital AND the ability to make your wishes known, choosing a non-Catholic hospital is a perfectly reasonable option. Unfortunately, that is often NOT the case. If you are unable to communicate, you may find yourself transported to a Catholic hospital in an emergency ... and for many people it is the only reasonable option based on location.
I am a Catholic and my mother has an advance directive that states that I would be in charge of medical decisions if my father were unavailable. Knowing this, we have spoken about what she would want in case she were unable to make decisions for herself, although she is in good health and expected to live a long life.
I know that no one can be completely prepared for a worst case scenerio, but at least it is out in the air and I know that my mother's decisions are sound. Basically, she doesn't want to kept alive artificially. Also, she wants a closed casket or to be cremated so that the last images of her are not one of a corpse in a box. This could be called vanity, but I can respect the fact that she wants to be remembered as a living person and not as a corpse.
Also, my grandmother (housed at a Catholic facility) died of Alztimers (mispelled) and at the end of her life she didn't want to feed herself. I don't think she was force fed and she finally passed away naturally and in her own time. I don't know what she was feeling, but indications were that she really didn't want to live. Given that she was very ill and suffered from very, very severe dementia, I wouldn't be suprised. Sometimes people are very ill and want to die, rationally or not. Lumping all terminally ill people together and tells them that they have to live at any cost is cruel and makes no sense.
Will he Catholic bishops' directive change an individual's mind on end of life decisions? I don't think so. Will some people use it to try and keep their loved ones alive, despite their relative's wishes? I do not doubt it. In most cases I think the villian is going to be the relative that can't let go and honor the patient's wishes.
The Bottom Line: No matter what facility is involved, a caregiver must be to prepared to honor and defend their relative's wishes, even if medical professionals disagree.
Rex
You get over yourself.
Get off your high horse.
I'm not on the high horse. You are the one stating your wishes supercedes everyone else's ethics and personal morality. Delusional much?
I said an institution's wishes.
Did I say EVERYONE else's? No. And not every Catholic lives and breathes by the dogma the church tries to shove down our throats.
Yes and my wishes or that of my parents do supercede those of any church's edicts.
You don't like.......too bad.
If you wish to pussy yourself out to someone else that is your prerogative it isn't and doesn't have to be mine.
Your wishes do not supercede that of a Church's edict when you are on that churches property asking for their help.
It has nothing to do with agreeing to their dogma, it has to do with giving them to right to decide. You want your right, yet refuse to give them theirs.
Again, just go to a different hospital. I'm sure there's a thousand places in the country that would just love to watch you die.
LOL
Rex take off the collar. It's choking you.
If the Church thinks doing this is a way to keep their flock.......they're as deluded as you are.
I doubt they are doing this as a means of trying to keep their flock. They have many other ways of scaring their followers into that.
And when did belief in private enterprise and property rights make someone deluded? This country is really going to hell if that's the prevailing opinion.
Can I ask, why you would want to be associated with a belief system that needs to "scare it's followers, to keep them"...?
V, I infer your comment means you believe the Church tries to scare its followers to keep them. I say the Church simply tells people what the truth is, and lets them make up their own minds. I've never once experienced the Church's putting a gun or knife to my back and saying, believe this, or else. If no force is used, if only arguments are used, no one can claim the Church is trying to force its beliefs down anyone's throat; it's simply saying, this is the truth.
I was simply replying to rexinauld's statement directly above mine, it was HE who said that, I was only asking him to explain further....
First of all, "truth" is subjective... The church is telling people IT'S version of the truth, (which I may add has changed drastically over the centuries, and some things it nows accepts as truth, it persecuted and murdered people for declaring in the past).
They don't put a gun to your back, true... but they ARE encroaching into the policies of our government, and in this case medical care... This country was founded with a STRONG, and extremely wise policy of SEPARATION of church and state... no laws, or policies regarding the welfare of it's citizens should be influenced by religion.
V-The Catholic Church owns Catholic Hospitals. They write policies based on Catholic teaching. Always have, always will. It is not a city run hospital. Rome owns it. The CEO is the Pope. This is a simple thing to understand. They are not going to change policy to bend to the ever changing "ethics and morals" of our society, when it comes to end of life issues. There are many, many hospitals to choose from or be transferred to. It is done all the time.
V, I don't agree that truth is subjective. It is, however, obvious that people's perceptions of "truth" have changed drastically. For instance, Galileo was forced to recant the heliocentric model of the solar system to conform with dogma; the big bang theory, however, was accepted by the Pope immediately, because it matched the beginning of Genesis. They do not encroach on the policies of our government; they can't, unless they are given the power of the veto over U.S. policies. They can, however, like any other citizen (I'm talking about U.S. cardinals and bishops), express their views on any subject. Just because their views agree with Rome's does not mean the Church is involved in U.S. politics. That is not interfering with U.S. politics any more than Bertrand Russell's "war crimes trial" of the U.S. government in the 1960s was interference in U.S. politics (even if some of our government officials thought it was). The laws and policies of any country are influenced by the religions of its officials; it cannot help but be so. The only cure for that is a Constitutiional separation of church and state, as we have.
For all you whining liberals about it being the patent's rights (nwnative, GoldenGateMami, JM387), you don't HAVE to go to a Catholic hospital. It's pretty simply (rexinauld)
What the heck has liberal or conservative got to do with this? The issue is the patient's end of life wishes were being set aside by a relative wielding his silly religious power. It's not a political ,or for that matter, it shouldn't be a religious issue either. Neither politics nor religion should be involved in end of life decisions unless the patient wants that involvement. The nephew needs his head pinched off.
Thank you.
Amen.
Then don't go to a RELIGION BASED HOSPITAL if you don't want religion involved in your end of life decisions. Why is this so hard to comprehend?
Rex, the aunt had had a stroke and presumable was unable to communicate, otherwise they wouldn't have moved on to her advance directive and health care proxy.
Not to mention that the article discusses the lack of communication of many hospitals of this policy. Even if the aunt could have requested treatment at a non-Catholic facility, chances are pretty good it would never have occurred to her that the church (and her nephew) would preempt her clear wishes on religious grounds.
I happen to work at a Catholic Hospital, and what's ironic about your statement is that the majority of the doctors that would have to abide by that Catholic Bishops rule are in fact Jewish.
As a side note Rex... Since you felt compelled to somehow equate those speaking out against this as "whining liberals"....
I would like to point out to you that the catholic hospital where I work, which has served the community of lower Manhattan for 160 years, and which took in the majority of the injured people on 9-11... has been forced to lay off several hundred workers, and will very likely be closing it's doors permanently in a month or so, thanks mostly to the economic failings of the Bush and Cheney legacy (although Haliburton, and Bush's friends in big oil are doing great in case you were wondering)...
Whether I go to a Catholic hospital, a Scientology center, the Mayo Clinic, or a Gwar concert I have the right not to be assaulted. Sticking a tube down my throat when I've told you not to is assault. If the hospital isn't willing to abide by the patients wishes not to physically assault them then they need to deny them service at the door. A patient of sound mind has the legal right to refuse services, the crazy religious beliefs of the hospital don't take precedence.
I agree with Andrew. Most hospitals I've used have a patient's bill of rights statement in the ER, which says the patient has the right to appropriate stabilizing care in an emergency. The patient may then be transported to another facility for appropriate care. As to whether it's the only facility in the area, that's a different question. As to "the crazy religious beliefs," which religious beliefs would you consider not crazy?
The Diocese owns a Catholic Hospital. The Diocese accepts the rules for running a Catholic hospital from the organization that owns all Catholic hospitals (unless it has been sold) and has the last word on policies. That owner in this case, is the Vatican/ Catholic Church/Vicar of Rome. This is not a complicated thing to understand. ALL businesses are run this way. Hospitals are businesses too. Someone makes policy. We are a Catholic, physician family. Trust me, if your hospitalized family member is stable, they can be removed from a Catholic hospital and transferred to whatever hospital you like by private ambulance. But the Church has the last word in their own hospitals. This can't be that hard to grasp in our Capitalist society.
Of course the Church has the last word in her facilities. It's pathetic that anyone should believe it should not be so. As to you, physician, I admire anyone who can do anything medical, because I figured out long ago that I could not handle losing a patient, even if I could not have helped it. God bless you that can.
You're missing the point... To some people Christian beliefs are just as foreign, or "out there" as scientology, or some other religious offshoot may be to you.
If, (by your logic), a hospital was instead owned by Scientology, or some even wackier religion... and their policy for determining whether to keep a brain dead patient alive artificially was done by celestial observances, or whether or not a crop circle had appeared that particular month... they would rightly be accused of whacko medicine, and playing with life and death via unproven belief systems, that the person who lives or dies, has no interest in. If that person is brain dead, they can't opt for themselves to go to another hospital, as you suggestted. Perhaps the separation of church and state, should carry over to the hospitals that must adhere to so many other state and federal regulations anyway.
Maybe that's the problem... maybe healthcare should not BE a business in the first place. Maybe it should be a service just like police, fire fighters, etc... Maybe Doctors shouldn't be charging a patient with no insurance $7,000.00 for a surgery that if they had insurance like GHI or something would pay the Doctor about $1,200.00 or less, and the doctor accepts that as paid in full.... Maybe the prescription drug industry shouldn't be charging $60.00 for something that costs $0.60 to make
The healthcare system is broken, and serves the wrong people.
.
Healthcare isn't just any business, it's a highly regulated business, and sticking a tube down someone's throat when they ask you not to violates the law. You can't break the law and then say, oh it's okay, I'm Catholic. It doesn't work that way. If your religious belief violates the law you're out of luck.
Sometimes you may not have a choice as to whether or not you go to a Catholic hospital. In the suburban Toledo, Ohio area all of the hospitals are Catholic, the closest non-Catholic one is many miles away and in a different state. If I'm not Catholic, I shouldn't be forced to abide by their doctrine when I have no other hospital to chose from. Of course, a can of worms that needs to be opened is what about people that are organ doners? Does it mean the Catholic church is saying someone with no possiblity of recovery is more important than someone that needs a liver, heart or other organ to continue a productive life?
Toledo Hospital isn't catholic. Just go there to die. And if you are going into a place asking for their services, you have to take what services they offer. You can't go into a Pizza Hut, even if starving to death, and demand they make you a whopper.
Rex - you are missing the point. Pretty sure Toledo proper and suburban Toledo are two different places - hence the different hospitals. Just as suburban LA is way different than West LA and the like. I shouldn't have to travel 30+ minutes to a hospital for medical treatment because ones that are closer refuse to honor my legal rights. Doctors take medical oaths as doctors to care for and honor the wishes of their patients. Period.
To say that the Catholic Church is hypocritical is a vast understatement. They can override a person's wishes in their institutions because they claim to be "pro-life", yet sentence millions of people to death (Pope Benedict's directive in Africa for Catholics there not to use condoms, thereby spreading the AIDS pandemic.) The Church is a dangerous cult, like any other.
If Catholic Health Care Facilities are going to force treatment on patients against their will, the facilities should pay 100% of the cost of their care. If the Church wants to waste its money keeping people alive artificially and against God's will, it will run out of money to pay for priests who sexually abuse children.
My father recently passed away after suffering from dementia for the last several years. His faith in the God dictated how he wanted to spend his last days on this earth. He DID NOT want to be force fed or receive liquids to prolong his life. He left it to God to choose when to take him back to heaven.
It was heart wrenching to see him in the last hours of his life but I know that God and the angels were with him, comforting him and preparing him and our family for his death.
And yes my father was Catholic.
Another reason why I want to stay out of Catholic hospitals.
Once again in the Catholic Church, dogma trumps decency.
Hey rex. What if the ambulance took you to the hospital that felt you were too much trouble to save? Remember, their property, their rules. Right.
It seems simple enough, even the stupid haters and bigots on this site should understand. If you want grandma's money sooner rather than later, don't take her to a hospital with the words "Saint or Holy" in the name. Duh.
There's a middle ground somewhere between the religious nuts who want to "pray away" sickness while their children die at home, and between these Bishops, who don't give equal weight to "the will of God". My first prayer in years goes like this: "God save us from religion... Amen"
Peace...
Don't use Catholic facilities. Period. This would ultimately put them out of business. The Catholic Church is hypocritical, not in sync with modern times and the closest thing to a cult that there is.
Nothing surprises me about what those yahoos think up . Its my decision not theirs. Who died and made them God ? and dont say Jesus.
It is not their place to dictate to anyone, catholic or not, this is between the individual god. NO ONE ELSE. The catholic biahops seemt to think that they are necessary to communicate with god. I will see to it that no one I know uses a catholic facility. they have no place in this - they are not even the original church because the church that was created by their belief in jesus and god is what is called the orthodoxy, the orthrodox catholic church. rome broke away and declared itself the one and only and infallable significantly after the beginning. PHONIES and USELESS THEY ARE.
It is not their place to dictate to anyone, catholic or not, this is between the individual god. NO ONE ELSE. The catholic biahops seemt to think that they are necessary to communicate with god. I will see to it that no one I know uses a catholic facility. they have no place in this - they are not even the original church because the church that was created by their belief in jesus and god is what is called the orthodoxy, the orthrodox catholic church. rome broke away and declared itself the one and only and infallable significantly after the beginning. PHONIES and USELESS THEY ARE.
The last line in this article sums up the teachings of the catholic church, “It feels like someone is trying to guilt and shame them.”