By Dr. Paul Fiacco and | Father Charles Vavonese

Special to the Catholic Sun

Editor’s note: This is one in a series of articles that will explain and explore the Church’s teachings on end-of-life and palliative care issues.

Dr. Paul Fiacco is the president and medical director of CNY AIM, a St. Joseph’s Health clinically integrated network, and is also the medical director of the Trinity Health integrated Care ACO as well as a full-time physician at CNY Family Care in East Syracuse. He is a parishioner at Holy Cross Church in DeWitt.

Father Charles Vavonese is a retired priest of the Diocese of Syracuse and the author of “I Am the Resurrection and the Life,” a resource booklet dealing with end-of-life moral issues. He currently serves patients receiving palliative care as the chaplain for the St. Joseph Health Mobile Integrated Services Team. In addition, Father Vavonese is a weekend assistant at Holy Cross Church in DeWitt.

The first article of this series discussed the empowerment of Catholics in a new ministry that will help others understand Catholic end-of-life moral issues, particularly the value of palliative care in order to help individuals avoid the senseless choice of physician-assisted suicide.

These articles aim to combine spiritual care with medical care; this will provide a holistic approach to the difficulties of end-of-life issues and decisions. We will also discuss the Catholic vision of life and how an understanding of this vision serves as a backdrop to assist individuals in making end-of-life decisions.

A moral road map

To begin, we as Catholics recognize that our ultimate destiny is to be with God for eternity. Further, we see life as a gift from God and that as such, we are stewards and not the owners of that gift of life. Catholic moral theology provides us with a road map for exercising that stewardship. It cautions us to avoid the two extremes of vitalism and subjectivism when dealing with end-of-life issues.

The first extreme, vitalism, holds that life must be preserved at all costs and that all available treatments must be used to keep the patient alive. This position is in conflict with Church teaching because we believe that our ultimate goal is eternal life. Thus, there comes a time in our illness when we must embrace our human frailty with profound hope in the life that is to come.

The second extreme, subjectivism, holds that life has value only if the individual person assigns it value. This position permits individuals to end their lives when the individual subjectively determines that their lives have no value. It is in conflict with Church doctrine because we believe that all human life is a sacred gift from God and we are stewards of that gift of life. Consequently, it is morally wrong to directly take our own lives or to administer direct euthanasia to the sick, to persons with disabilities, to the dying, or to any other person.

Catholic theology guides us between these two extremes as we deal with more specific dimensions of end-of-life decisions, while upholding our moral teachings.

Medical research

Questions frequently arise about where medical research fits in this roadmap. We begin by recognizing that a great deal of progress has been made as the result of medical research. The Church recognizes these advances and permits patients to participate in medical trials in light of the potential benefit the research treatment may have. To participate in such medical research, the Church requires that the patient must be thoroughly advised of the risks and benefits of the treatment. The patient must also give informed consent in order to participate in such research.


This article illustrates the Catholic vision of life, which recognizes that our ultimate destiny is to be with God for eternity. Catholic moral theology provides a road map to navigate the complexities of end-of-life moral dilemmas; it requires that we avoid the extremes of vitalism and subjectivism. The article also illustrates how medical research is integrated into this Catholic vision for life.

Next article

The next article will deal with one of the most important distinctions Catholics need to navigate between vitalism and subjectivism: the distinction between ordinary care, which is morally obligatory, and extraordinary care, which is not obligatory.

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