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 the Church’s teachings on end-of-life and palliative care issues, and also explore potential practical applications of these teachings.
Dr. Paul Fiacco is the president and medical director of CNY AIM, a clinically integrated network (CIN), at St. Joseph’s Hospital Health and is also the medical director of the Trinity Health Integrated Care ACO. He is also a full-time family physician at CNY Family Care in East Syracuse, and a parishioner at Holy Cross Church in DeWitt.
Father Charles Vavonese is a retired priest of the Diocese of Syracuse, and still assists on weekends at Holy Cross Church in DeWitt. He is also the associate chaplain for the Syracuse Region of the Order of Malta, and the author of “I Am the Resurrection and the Life,” a resource booklet dealing with end-of-life moral issues, which is no longer available. Father Vavonese also currently serves patients receiving palliative care as the chaplain for the St. Joseph Health Mobile Integrated Services Team.
The previous article explained that the Sacrament of the Sick continues the healing ministry that Jesus entrusted to the Apostles. The Sacrament has developed significantly over the centuries. Most recently, the Second Vatican Council (1962-1965) restored the original intent of the rite as Anointing of the Sick as a reaffirming of the healing nature of the Sacrament and significantly expanded the number of individuals who may receive it.
This article illustrates the ways that Catholics use forms to communicate their preferences for medical care should they become unable to make these decisions for themselves.
Health care proxy
Since there are times when individuals are not able to make medical decisions on their own behalf, the law permits us to empower a trusted individual to make these health care decisions for them. In New York State and some other states this designate is called a health care proxy. In other states it is called a power of attorney for health care.
Naming a health care proxy is important because no one is able to anticipate one’s ability to make end-of-life decisions for themselves in the future. When a person is incapacitated, the health care proxy is then able to apply Catholic moral principles when making difficult medical decisions on the person’s behalf. The health care proxy is the preferred means for Catholics to communicate end-of-life moral instructions. Since a person can become incapacitated at any age, it is important that everyone designate a health care proxy.
When selecting a person to serve as your health care proxy, it is important that the person has good moral character, knows you well, is familiar with your Catholic beliefs and values, and operates well under stress.
Before one can appoint someone as a health care proxy, a discussion with that person is needed to ensure that he or she is willing to act in this capacity.
It is not necessary to enlist the assistance of an attorney to complete a health care proxy form.
Helping your health care proxy understand your end-of-life wishes
To be able to accurately act on your behalf, it is essential that you communicate your end-of-life preferences to your health care proxy. For some, this may be a difficult conversation. The website theconversationproject.org provides a variety of resources to assist individuals in guiding end-of-life discussions with their health care proxy and family.
In addition to discussing medical treatment(s) with your health care proxy, it is advisable that you prepare a written advance care directive. There are a number of names for this type of document, but they all serve the same function: to provide your health care proxy with more specific information about how you would like to guide your health care proxy’s actions when making medical decisions on your behalf. The advance care directive should indicate that you are Catholic and wish to be treated according to the tenets of your faith. Decisions by the proxy should be guided by The Ethical and Religious Directives for Health Care in the United States and the Catechism of the Catholic Church.
The National Catholic Bioethics Center (NCBC) has developed A Catholic Guide to End-of Life Decisions, which is a succinct summary of Catholic end-of-life moral teaching. It also explains Church teaching on advance directives, euthanasia, and physician-assisted suicide. This guide includes a sample health care proxy and advance care directive. It is available for download from www.ncbcenter.org/store/catholic-guide-to-end-of-life-decisions-english-pdf-download. The cost to download is less than $3. It is advisable to share this guide with your health care proxy, and to attach the guide to your health care proxy form and advance care directive.
In emergent situations, we may need a Catholic moral opinion unexpectedly. To meet this need, the National Catholic Bioethics Center offers an ethicist-on-call service that is available 24 hours per day, seven days per week. To access this service, dial (215) 877-2660 and follow the prompts. One of the members of the NCBC team will respond to your call promptly. Since we cannot anticipate when we might need this service, it is advised that this phone number be included among your contacts and your health care proxy’s phone contact list.
This article illustrated the importance of the health care proxy and advance care directives, guided by Catholic morals and teachings, to give instructions for your medical care should you become unable to make those decisions on your own behalf. It also discussed additional resources made available by the National Catholic Bioethics Center (NCBC) for end-of-life moral decisions.