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Links United States Conference of Catholic Bishops National Catholic Bioethics Center Center for Healthcare Ethics, Saint Louis University Loras Bioethics Resource Center Neiswanger Institute for Bioethics and Health Policy Minnesota
Catholic Health Care Directive - NEW Kathleen M. Theisen |
February
4, 2007 The Minnesota Catholic Health Care Directive Fr. Tom Knoblach Consultant for Healthcare Ethics The national prominence of the Terri Schiavo case and continual progress in the technological capabilities of medical science to prolong life have led to a resurgence in interest in advance directives for health care. These legal instruments have taken various forms since the 1970s and have enjoyed only partial success. But they can be one helpful tool for both families and medical professionals who are regularly faced with the question: "What should we do for this person who is very sick?" At their December 6, 2006 meeting, the Catholic bishops of Minnesota approved a "Minnesota Catholic Health Care Directive" (MCHCD). This document is recommended by the bishops as a resource and guide for Catholic persons in our state who wish to prepare an advance directive. Like all such advance directives, this MCHCD provides information on the preferences and goals for care in the event of illness or injury that prevents the person from expressing them at the time when decisions must be made. It meets all the state's legal requirements for health care directives. However, the MCHCD also reflects and informs about Catholic teaching on the use of life-sustaining medical technologies. It includes an accompanying "Guide to Health Care Directives" that answers commonly-asked questions, both about advance directives in general and about Catholic teaching on these matters. Specifically, the Guide discusses six fundamental principles that are to guide health care decisions. These principles are summarized from the broader Catholic tradition that is also succinctly expressed in the U.S. Bishops' Ethical and Religious Directives for Catholic Health Care Services (ERD). The principles the Guide relies upon are:1) human life is a precious gift from God;2) we have the right to direct our own care and the responsibility to do so according to Catholic moral teaching;3) suicide, euthanasia, and any acts that intentionally and directly cause death by action or omission are never morally acceptable;4) death is a beginning, not an end, so that extraordinary means to prolong life are not morally obligatory;5) there should be a strong presumption in favor of providing nutrition and hydration, as long as it is capable of sustaining life and alleviating suffering;6) we have the right to comfort and relief of pain. In accord with state law, the MCHCD provides both the option of providing specific instructions regarding future care preferences and the option of naming a proxy or "health care agent" who would speak on behalf of the incapacitated person. Both research and long experience demonstrates that the second is the most reliable, valuable, and preferred form of advance directive: to name a trusted, capable, and committed person to make decisions in accord with one's own wishes. No instruction directives can ever foresee every possibility, or predict what specific conditions or technologies will be in question at some future date. No matter how detailed or precise a directive is worded, interpretation of those words and weighing all the factors of the current situation will always be required. For these reasons, the best form of health care directive is to name a willing health care agent you believe you can trust to speak in your best interests, and to discuss clearly and specifically what your own values, goals, views, and preferences are regarding life-sustaining treatments. Persons who already have a health care directive do not need to use this new MCHCD, but they certainly may replace their former directive with this one at any time. It is a good idea to review and update directives periodically at any rate. The Minnesota Catholic Health Care Directive is available on the Minnesota Catholic Conference's website or by calling the Conference at 651-227-8777. The Diocese of Saint Cloud is working on plans to make them available locally as well. Click the link in the left column to access the Minnesota Catholic Conference website for these resources and other links to healthcare topics. HEALTHCARE ETHICS The Diocese maintains the position of Consultant for Healthcare Ethics to assist with information, education, resources, referrals, and consultation on bioethical matters related to the field of health care. The Consultant is available to assist healthcare institutions and systems, the clergy of the Diocese, other diocesan offices, parishes, organizations, ethics committees, and individual members of the Diocese in ethical discernment on questions related to health care and bioethics issues. The Consultant also assists other dioceses and the general public at their request. As appropriate, the Consultant will address questions and assist in ethical reflection by phone, e-mail, or in person. The Consultant is also available to conduct educational sessions on various topics related to bioethics. The position of Consultant for Healthcare Ethics is currently staffed by Father Thomas Knoblach, Ph.D. Father Knoblach can be contacted at: Mailing Address and contact information:
Abortion Under development: Common areas of ethical reflection in healthcare ethics include:
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