Five Deadly Wishes: Signing Documents Before Entering a Hospital

January 30th, 2010 by Fr. Basil Cole, O.P. Print This Post Print This Post ·

Currently, in today’s healthcare world, there is a document for medical care that one can sign even before going into the hospital called, “Aging With Dignity: Five Wishes.”  There is a section in this document that asks a future patient the following: “If I wish to omit life-support treatment, I write this limitation in the space below,” which is very dangerous.  The problem with this request is that most of us are not good doctors to be able to give such directives.  As a result, it would be possible for us to die based on poor care that we authorized in the first place.  We never can know when new procedures for curing make be discovered, which if used, could give us years of a productive life.  Finally, it is possible that a poor and ambiguous sentence or two in this document could be used by a hospital to force us out so that the hospital can have the bed for another patient.

Another problem exists.  The document says, “If I am close to death,” I can choose to leave it in the hands of my doctor to continue “support treatment,” or I can simply say I do not want any life support.  What is support treatment?  It can mean any device or medicine to keep me alive, such as oxygen, feeding and hydration through a tube, CPR or cardiopulmonary resuscitation, a major surgery, blood transfusions, dialysis or antibiotics. The Church teaches that one is not obliged to extraordinary or disproportionate treatment or burdensome treatment, but one is obliged to ordinary treatment unless the ordinary treatment turns out to be very burdensome.  Each individual is different and so this issue needs a prudential judgment on a case by case basis.  Hence the need exists for a good healthcare agent or someone with durable power of attorney.

Feeding and hydration is not medical treatment.  It can be disproportionate if the tube that is used to deliver food and water leads to a painful condition, such as infections and the like.  But that again is a question of prudence of the moment to be made by one’s agent for healthcare or someone with durable power of attorney.  In a worstcase scenario, a doctor or a hospital or even the government could decide what is disproportionate for a patient, a decision that could lead to a painful death.  This would be legal if you signed an ambiguous document. If you are dying today, giving an antibiotic to wipe out an ordinary infection would be ridiculous but it would not be if you were not dying but just in a very sickly condition and no one really knows when you will be dying.  Withholding a simple pill could be euthanasia so that your bed could be made available for someone else who conceivable may have better health insurance.

These issues can be resolved by not signing any document that tries to help you “play” doctor. Now, if you must sign some kind of document to be admitted to a hospital with these and other ambiguous questions about your future care in case you are in jeopardy of some kind, then you must qualify each sentence with “as the Catholic Church teaches, and my healthcare agent consents if I am unable to consent.”  Otherwise, you could put yourself in great peril and die before it’s time.

Fr. Cole teaches dogmatic, moral, and spiritual theology at the Dominican House of Studies in Washington, DC, where he is a Professor of Spiritual Theology. He is also sub-prior of the community at the Dominican House of Studies. He has authored or co-authored several books including the following: Music and Morals: A Theological Appraisal Of The Moral And Psychological Effects Of Music (Alba House, Staten Island, NY 1993); Christian Totality: Theology of Consecrated Life (Staten Island, NY: Alba House, 1997) [with Paul Conner, O.P.], A New Catechism of the Consecrated Life: Help for Perplexed Postulants and Novices of the Third Millennium (Bangalore, India: Asia Trading Corporation, 1999) [with Paul Conner, O.P.]; Consecrated Life: Contributions of Vatican II, Dominic Hoffman, O.P. (+) with Basil Cole, O.P. (Ed) (Mumbai, India: St. Paul’’s Publications, 2005); The Hidden Enemies of the Priesthood: The Contribution of St. Thomas Aquinas, (Staten Island: Alba House, 2007).



2 Comments For This Post

  1. packingpadre says:

    Father Cole’s points are why I threw the Maine “living will” form in the circular file and drafted my own durable power of attorney with the help of my attorney and friend, who will be my health care proxy.

    I also had a long talk with my pulmonologist and critical care specialist about continuing food and hydration, except in the gravest of circumstances.

    The Very Rev. Canon Daniel P.H. Beegan MOB

  2. fishman says:

    This already happens and don’t think it can’t happen to you.
    My mother worked for years in Minnesota as a nurses aid and then a LPN in nursing homes. In the state of MN, you cannot qualify for government aid to be treated in a nursing home until you have liquidated everything you own. This for many people includes the family farm they had for generations and hoped to pass down to their children.
    If you are not smart enough to specifically request otherwise , all wards of the state are automatically ‘no codes’. According the the state , forced feeding of any kind, anti-biotic and oxygen are all ‘life support’
    It is typically for depressed patients ( having just lost everything they owned or hoped to give to their children), to stop eating. They can’t be force fed, that is life support. The lack of nutrition makes them get sick, they can’t be given simple antibiotics , that would be life support. They then die of pneumonia without even supplemental oxygen. Oxygen, BTW,in most cases, does nothing to make you live longer , it just makes you more comfortable.

    my mother eventually left working in the state nursing home because she was tired of watching people being euthanised and not being able to do anything about it.

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