Palliative Care Issues: Planning for Advanced Care

Editor 's note: This is one in a series of articles explaining the Church's teachings on end-of-life and palliative care issues, and 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 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, New York.

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. Father Vavonese also 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 sick, and significantly expanded the number of individuals who may receive the sacrament. 

This article illustrates the ways that Catholics use medical forms to communicate their preferences for advanced medical care should they become unable to make these decisions for themselves.

 

Health Care Proxy or Durable Power of Attorney for Health Care

Since there are times when individuals are not able to make medical decisions, the law permits them to empower a trusted person to make these health care decisions on their behalf. In some states this designation is called a health care proxy; in other states it is called a durable power of attorney for health care.

Naming a health care proxy or durable power of attorney for health care is important because we cannot anticipate our ability to make end-of-life decisions for ourselves in the future. When a patient is incapacitated, this agent is legally empowered to make decisions for the patient by applying Catholic moral principles to his or her specific medical circumstance. The health care proxy or durable power of attorney for health care 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 this type of agent.

When selecting someone to serve as your agent to act in this capacity, 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 a health care proxy or power of attorney for health care, a discussion with that person is needed to ensure that he or she is willing to act in this capacity.

It is generally not necessary to enlist the assistance of an attorney to complete a health care proxy form, but since state regulations vary, check with the requirements for your state.

 

Helping your health care proxy or durable power of attorney understand your end-of-life wishes

For your health care proxy or power of attorney to be able to accurately act on your behalf, it is essential that you communicate your end-of-life preferences. 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, power of attorney for health care, and family.

In addition to discussing medical treatment(s) with your health care proxy, it is advisable that you prepare a written advanced 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 advanced care directive should indicate that you are Catholic and wish to be treated according to the tenants 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.

 

Exceptional Resources

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 advanced directives, euthanasia and physician-assisted suicide. This guide includes a sample health care proxy and advanced 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 $3.00. It is advisable to share this guide with your health care proxy, and to attach the guide to your health care proxy form and advanced care directive.

 

Ethicist-on-Call 24/7

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 a day, 7 days a 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.

 

Summary

This article illustrates the importance of the health care poxy or durable power of attorney for health care and advanced care directives, guided by Catholic morals and teachings, in giving instructions for your medical care should you become unable to make those decisions on your own behalf. It also provides additional resources made available by the National Catholic Bioethics Center (NCBC) for end-of-life moral decisions.