Extraordinary Measures QUESTION from Jeff Campbell January 13, 2000
I think I recall reading somewhere that the Catholic Church allows, under certain circumstances, the refusal of extraordinary measures to prolong one's life. Did I misinterpret such a document (or was it one of many erroneous documents currently put out in the name of Catholicism), or did I understand correctly and, if so, what would constitute an extraordinary measure? Thank you for giving your efforts to this very necessary ministry. Jeff ANSWER by Mr. John Miskell on January 13, 2000
Dear Jeff, Thanks for your question. For me, extraordinary measures defines the difference between killing a patient medically and letting a patient die. We need not strive relentlessly to preserve the last vestiges of physical life. Ours is not a survival at any costs ethic. Indeed such an approach can well be due to therapeutic obstinacy, a refusal to face up to the limitations of healthcare and human mortality, a product more of despair than respect for life. Death is always an evil, but for many people it is also a merciful release, the end to a natural term of life, the door to eternal life. Good end-of-life care will only be given if we accept that death is near and that there is little more that human effort can properly do to postpone it. Some treatments will be withheld or withdrawn for good therapeutic reasons. Their continued use may be futile. Or their therapeutic value may be outweighed by the burdens they impose, such as pain, indignity, risk, cost etc. There are times when certain treatment(s) might be withheld from a dying patient. For example a new round of chemotherapy might be withheld if every reasonable treatment has been given and starting a new round would be essentially grasping at straws. This can apply to a whole host of situations and it's important that the family and physician be in tune with the moral responsibility. When doctors give, withhold or withdraw a treatment, and death results earlier than it might otherwise have done, hurrying up death may or may not be why they chose such a course of action. Encouraging death is often no part of their reason for such chosen conduct. Death may or may not be foreseen, but it is not intended; it belongs neither to the doctor's precise purpose, nor is it the means used to achieve that purpose. On the other hand, doctors may give or fail to give some treatment because they believe the patient would be 'better off dead', or others would be better off were the patient dead. In this case hurrying up the patient's death is certainly part or the whole of the reason for the chosen conduct. This, then, is where the difference between killing and letting die lies: not in the difference between acting and omitting to act; not in the quality of the motives, which may be good-willed in both cases; but crucially in the difference between intentionally bringing about a person's death (which is always a harm to both victim and killer, and always wrong) and taking a course of action possibly foreseeing but not intending a person's death (which may harm no-one and be quite right). I hope this helps. God bless you, John Miskell Back to Index Page