Read the Ethical and Religious Directives for Catholic Health Care Services, Fifth Edition, Part Five - Issues in Care for the Dying. Are the directives ethical? Why or why not?
Due June 1, 2012
The directives can be found on the class BlackBoard site.
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The ethical validity of the directives is questionable in my opinion. To treat one with respect and love and the option of faith is admirable. It is no longer admirable if this is contingent upon whether or not the ill person is a massive burden or overly expensive to care for, in which case all is forgiven if you want to give up on life. I was myself raised Roman Catholic, and what this says to me is it’s not a sin for them to stop treating me (in other words, assisted suicide) if I become expensive or cumbersome to others.
Directive 59 states the withdrawal of life sustaining procedures at a competent patient’s request should be followed unless of course it goes against Catholic moral teachings. These teachings are not disclosed in a footnote, nor an example is given. This leaves a very big gap for those giving permission to interpret moral teachings to their liking. The person being treated may not be up to date on such things and therefore feel that they are being treated against their will.
My first read through these directives I was in agreement with their ethical value. It wasn’t until my second look that I began to look deeper and question what they were really saying. Perhaps I am reading too much into them, but when we are talking life and death I think we should look more closely at what is being presented to us.
In reading the Ethical and Religious Directives for Catholic Health Care Services, Fifth Edition, Part Five- Issues in Care for the Dying, I found that the directives were not ethical. There were parts of the directives that seem to be ethical, but they kept bringing it back unethical. When they talked about PVS (persistent vegetative state), on page 31, number 58, they mention keeping a person alive indefinitely with food and hydration. They do not mention if a person has a Do Not Resuscitate request. This to me shows that they do not honor the request to not resuscitate. It also shows that the family does not have the right to take someone off of life support if it is the right thing to do. These are all ethical matters which are ignored for the Catholic Health Care Directives need religiously for the people to die only by their definition of natural causes. Proof of this is on page 31 as well, number 59, where it states:
“The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.”
On page 33 it goes into directive number 66, which says that they will not use tissue from an abortion for helping anyone or anything ever. This is completely unethical. Even though they condemn abortion, it would be a positive spin on the matter to have some good come out of abortion. They insist on proving that abortion is horrible by making others suffer that could use the tissues in research and help keep other humans alive.
There are some ethical parts to the directives, don’t get me wrong. On page 32 it talks about keeping the patients pain level down, but also giving the patient the right to be conscious, which is very ethical when followed. Also, it discusses the death being decided by someone not involved in the donation of the organs, which is ethically positive as well.
It seems to me that some of the directives have ethical value, but most are clouded with stubborn religiosity. Because of this, I take the stance that the directives are unethical. Even if there is some positivity sprinkled in, it does not make up for the many negatives happening in these directives.
That was very interesting to me but i think that having someone whos gone but you are still feeding them and breathing for them is not giving them thier rights if their gone like that i think thats just making the suffer even more.
i think its not right. I also think the family should have a bug say so in what happens to a person if he or she is uncapable of coming back to life normally like brain dead. that is no way to live and just because of certain religious beliefs it should not be justified.
After reading the Ethical and Religious Directives for Catholic Health Care Services, Issues in Care for the Serious Ill and Dying, I felt that the directives were ethical. The underline premise for these directives is that life is a precious gift from God and that we do not have absolute power over life. We have a duty to preserve our life and to use it for the glory of God but that we may reject life-prolonging procedures that are insufficiently beneficial or excessively burdensome. As stated in the article, the task of medicine is to care even when it cannot cure. In the directive #55 the appropriate medical information in addition to appropriate spiritual support should be offered to all patients. Directive #56 the use of proportionate mean of preserving life is defined as those mean that are reasonable but that are not excessively burdensome to the family. Directive #57 the patient may forgo extraordinary means of preserving life if they feel that it does not offer reasonable hope of benefit. In general I think that modern medical technology has advanced to a point where many patients can be kept alive even when there is absolutely no chance of recovery. I think these directives give the patient and the family an opportunity to make their own decisions in terms of extraordinary measures of preserving life. I believe that this is very different from someone asking for assistance in committing suicide such as in euthanasia. The example of one to forgo extraordinary means to preserve life is an example of letting one die a natural death. This is very different then requesting help in assisted suicide, which would not be letting one, die a natural death. Directive #58 simply states that one should provide patients with food and water who cannot take food and water orally. In other words this simply stating patients should not be starved to death if they simply cannot take in their own food and water. The underlining premise is that we do not have absolute power over life. And finally on directive #56, which says, that they will not use tissue from an abortion is reasonable because the Catholic Church does not condone abortion. And the fact is abortion is not performed in Catholic healthcare systems and therefore they would not even have the dead babies tissues available. I think with all legal and as well as ethical questions the language used is always a little vague so that there is room for interpretation and discussion. For the most part I think these directive are inline with teachings of the Catholic Church.
Part Five - Issues in Care for the Dying. Are the directives ethical? Why or why not?
After reading this part five that talks about issues in Care if the Dying few times, I came to the conclusion that the directive were ethical. In 59 for example, it clearly states that as long as the withdrawal of life-sustaining procedures are not against the catholic moral teaching and its coming from a competent patient then his or whishes should be honored. When it comes to Euthanasia, I find the directive to be ethical because I don’t know of any religion that would approve it. I respect other who chose to do so but I don’t a religious health care facility should stand by the choice they make. I actually agree with the fact that the patients who are suffering and have no hope of survival nor relief should receive loving care and all means of support which by personal experience eases the suffering and give hope and love to continue to be patient. Spiritual support on the other hand gives strength to the patient to believe in a bigger power which helps patient to endure the suffering until he or she dies naturally. I understand that many people might feel that it is unethical but we need to understand that we are dealing with a Catholic Healthcare institution and patients need to respect what the institution stands for. 63 talks about patient who desire to donate their organs and bodily tissues and the Catholic health care institutions support this cause in respect of considering the purposes and also to the time of the organ removal. I believe that this directive is ethical because it specifically says that the removal of the organs cannot be permitted unless the patient is medically declared dead.
At the end, this reading talks about the fact that Catholic health institutions should not make use of human tissue by direct abortions not even for research and therapeutic purposes. I also feel that this direct is ethical because of the fact that abortion is against the catholic belief therefore the use of human tissue obtained through abortion should be unaccepted.
In conclusion, I feel that all the directives discussed in the reading are ethical because of the fact that we are dealing with a Catholic Health Care institution and I kept this fact in mind the entire time I was reading it. I might have opposing opinions but I feel that due to my religious background, I feel that I have a duty to respect what religion ask of us especially when dealing with such delicate issues. All directives I feel were fair and to the point. There couple of things that were not very clear and wished to have more details in order to form a better decision.
After reading the Issues in Care for the Dying directives, I am torn on my opinion for whether or not they are ethical. I definitely do not think they are all ethical as a whole. For example, I do beleive that Directive #58 is unethical. It states: "In principle, there is an obligation to provide patients with food and water,
including medically assisted nutrition and hydration for those who cannot take food orally. This
obligation extends to patients in chronic and presumably irreversible conditions (e.g., the
“persistent vegetative state”) who can reasonably be expected to live indefinitely if given such
care." To me, this suggests that the patient could live years upon years and be brain dead. To me this is almost like torture for not only the patient, but the family as well. If you had a loved one who was brain dead and would never be themselves again, never be lively and spend their time hooked up to machines and laying in a hospital bed for years, wouldn't it be more sad to keep them around than to just let them go? Quite personally I would rather remember that person in their good healthy years than have years of memories visiting them in the hospital and seeing them like this. I feel it is more humane to let the person pass away if the feedings are stopped, than it is to keep feeding them knowing they will never return to us again.
One example of a directive i do beleive is ethical, is #61 which states: "Patients should be kept as free of pain as possible so that they may die comfortably
and with dignity, and in the place where they wish to die. Since a person has the right to prepare
for his or her death while fully conscious, he or she should not be deprived of consciousness
without a compelling reason. Medicines capable of alleviating or suppressing pain may be given
to a dying person, even if this therapy may indirectly shorten the person’s life so long as the
intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be
helped to appreciate the Christian understanding of redemptive suffering." I feel that this is very humane, because if the patient is going to die for sure and there is nothing else doctors can do to bring them back, then keeping them comfortable does seem like the next best thing. I am talking about patients who are conscious and dying of termina illness, or patient who have sustained severe injuries in which will lead them to death. I feel as long as the pain is alleviated, that patient can still converse with family and enjoy the last few days they have with family until they die naturally. The family will still have good memories of them and can use the time to come to terms with the loss of their loved one and prepare for their departure from Earth.
I was having a hard time deciding if the directives are ethical or unethical when I first read the directives. I was raised in a Roman Catholic household. I understand the teachings of the Catholic Church. But I started to relate some of what I read to things I had learned growing up.
I recently lost my Grandmother after several Cardiac episodes and 2 strokes. My Grandmother was a strong woman who was very in control of every part of her life. She attended morning Mass every morning until 6 months ago when she had her first stroke. At the very end, she decided she was done, she refused to eat or drink anything for the last 5 days of her life. She made that decision. But according to Directive 56, my Grandmother had "a moral obligation to use ordinary or proportionate means of preserving her life". I can't see how that can be viewed as ethical in the eyes of the Catholic Church.
I also took an issue with Directive 59. It states "the free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teachings." So we are allowed to make informed decisions about how we want to be treated medically, as long as it doesn't interfere with the Church.
Growing up in the church, we were always taught that we will be called "home" at our time and that God would always have a plan for us. We are taught that we may receive blessings during our illnesses and even proceeding death. But I don't see these things that we were taught clearly reflected in these directives.
The last directive I want to touch on is Directive 61. The directive talks about "redemptive suffering" which is defined as "the Roman Catholic belief that human suffering, when accepted and offered up in union with the Passion of Jesus, can remit the just punishment for one's sins or for the sins of another." So in one sentence they are talking about making patients as comfortable as possible, and then it states that if a patient cannot be made comfortable, they should be "helped to appreciate the Christian understanding of redemptive suffering." In researching redemptive suffering I found that Christians believe that the suffering they are experiencing will lessen their "penalty" due for their sins.
Reading these directives has opened my eyes to how unethical these directives really are. I had to do some additional reading while trying to interpret these, so that I could understand some of the statements made. This gave me the ability to learn more about Catholic Healthcare directives.
After reading and trying to understand thats you are only trying to keep someone alive based on your beilefs, i believe it is unethical. I was raised in a christian home and believe a person decides when it is he or she's time to go. It is not up to another person to keep that person alive for the benefit of their beliefs or because someone is unable to let go. YOu are only hurting the person who is trying to leave this world by keeping them alive attached to machines, when they could already be gone.
In the beginning I agree with a lot of what the Catholic health care ministry beliefs.I do believe that we the duty to preserve our life and to use it for the glory of God. As I read on there were things that I began to question for example it mentioned that there are two extremes are avoided "an insistence on useless or burdensome technology even when a patient may wish to forgo it" and "withdrawal of technology with intention of causing death is not".So to me that says a patient wishing to try technology to try and save their life may not because the decision has been made for them that is would be useless, but a person wishing to stop the use of technology to presume a "natural death" may not. How is that when they speak so highly of natural death? How is it a "natural death" when technology is keeping the patient alive.
I'm kind of on both sides of the fence when it comes to assisted nutrition and hydration. i do believe that it is our obligation to provide patients with food and water. As far as it not being obligatory for patient's with very limited ability to prolong life or provide comfort I find that to be unethical. No matter what the condition may be they should be treated with as much respect and dignity as the next patient who may be in a better state. The reason I say I'm a little on both sides is because after doing clinicals in a long term care facility you see how much food and water goes untouched by many of the patients and sometimes you wonder why am I still bringing this patient meals everyday.
Number 65 and 66 also got my attention, I found it unethical to say that infants who die a natural death may have their organs and tissues donated for beneficial reasons or research parents may do so, but a baby that is aborted may not. Who's to say that the aborted baby can not provide the same research or organs that can provide the same help as a infant that died from natural causes. Why should one have more rights than the other?
After reading "Issues in Care for the Seriously Ill and Dying" (directives)I believe that the Catholic health care institutions are ethical.
One of the first things that the Catholic health institutions believe in is informing the patient of their condition and giving them and their family the opportunity to prepare for death and provide spiritual support as stated in directive 55 which i believe is very important rather than "sugar coating" the situation or not being completely honest not giving time for the patient and family time to cope with the situation at hand.
In directives 56 thru 59 address the subject of proportionate and disproportionate means of preserving life. I personally had to read this section a few times to see what they were really saying here. Directive 56 states that they have a moral obligation to preserve life if it does not impose a excessive burden or expense on the family or the community, but they may forgo those means of preserving life if it did impose a excessive burden or expense on the family or community. My first thoughts on the matter were that if it imposed a burden or expense to the family they would choose not to treat them?? After combing thru the text it states proportionate and disproportionate means are those that in the (key word) "patients" judgement do or do not offer reasonable hope of benefit. As far as directives 58 and 59 they address the life sustaining procedures like medically assisted food and water for persistent vegetative state patients which they do provide if the patient would live indefinitely given the care but would be optional if there was a fatal condition or once again become excessively burdensome. The text states "as a patient draws close to inevitable death" , i think it depends on how you interpret "close" i agree that if there is nothing you can do and close is a couple of hours ... there is no reason to become burdensome before the patients death i dont think with the directives stating peaceful and natural death that they would allow dehydration or starvation to be the cause of death .With my personal understanding of the text i believe that they have the patients best wishes in mind when formulating the patients care.
Lastly the Catholic health care institutions do not believe in assisting in suicide or euthanasia.
I believe that this is ethical because they do provide comfort and pain management until death and dont put life and death in a persons hands it should happen naturally. Instutions also dont belive in using tissue or organs from an infant for reaserch or therapeutic purposes if their death came from an abortion. I believe that is also ethical because what word would it send if your are against humans ending another life ... it would make you think that you condone that and people would make it seem like them murdering a child has good benifits. (research)
After reading the Ethical and Religious Directives for Catholic Health Care Services, Part 5, Issues in Care for the Dying, I found the directives to be very unethical. In number 55, it states the Catholic Health Care Institution offering healthcare to people in danger of death from illness, advanced aged, or similar action and gives them appropriate opportunity to prepare for death.
I think this is very unethical. I really do not want to think of death and trying to find the appropriate opportunity for death. Do you?
In directives number 58, medically assisted nutrition and hydration becomes morally optional when a person cannot reasonably be expected to prolong life. I think this is very unethical. It should be an obligation to provide food and water to those that are in suffering. What if their condition changes and their health recovers and they get better and survive.
Caring for the dying is something that scares most people to have happen in their lifes. I have had to deal with family members dying, some abruptly and some without warning.
I believe that the article is ethical in it's own right. I truly believe that the best decision is that made by the patient. If they understand that the end is near and make a choice- it should be honored. If there is a reasonable chance that recovery is near, then any necessary medicines will be used. This is a respectable rule of thumb, but the question falls on whether or not assistance will happen if there is no chances of survival.
It sounds as if it is insensitive to the patient, but none of us have been in that situation. If prolonging the inevitable is a burden or is painful, would you want to continue?
It only makes sense to stay comfortable for a few reasons. One would be for the patient obviously. Make the transition to death as comfortable as possible. Next would be for the family. There is a level of guilt that strikes you when your loved one is in pain while dying. It soothes your own pain if your loved-one is not suffering. It just seems to be the humane way about things.
We never want to see someone suffering or appear to be suffering. It makes our dealing with death bearable if there is no guilt with their passing.
Catholics have such a firm stand on death and abortion that it makes it hard to argue otherwise. Comfort is key and respect is a must. If there is a different standard that people have, it is okay to excercise that belief and understand where others stand.
I think the directives in "Ethical and Religious Directives for Catholic Health Care Services, Fifth Edition, Part Five - Issues in Care for the Dying" are made with good ethical beliefs, but are contorted by religious views. The main viewpoint made apparent by the Catholic Health Care Service is that we do not own our own lives. Instead, life is given to us by God and we are not allowed to take this life from him. Therefore suicide, euthanasia, and destruction of a human body for self gain is sinful and malicious as pointed out by directives 60, 62, 64, and 66.
If you set aside the directives that are centralized on biblical beliefs, like the ones listed above, and focus on the rest (exempt #58), you will see that the directives are sensible and push no ethical boundaries. The non-biblical directives underline proper death care. They show no absurd procedures/guidelines like the other directives.
Being of protestant religion, I do support most of these directives except number 58 and number 66. Directive 58 seems to me like a scape goat for health care professionals that do not want to properly take care of their patients. It seems like directive 58 was made to excuse their laziness. Directive 66, in my opinion, is harmful. Simply stated, "[abortion obtained material should never be used in anyway for research or therapeutic ways]". This directive is somewhat ignorant, because people who follow these directives are ignoring the fact that we learn from taking samples/observing. If we can not properly analyze any gathered material from the abortion, how are we to progress with abortion technology?
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