End-of-Life Planning For Catholics

End-of-life decisions pertain to medical care at the end of your life. These decisions are both foundational—in so far as they ought to be made by all competent adults, regardless of individual familial and financial situations—and of particular interest to older generations.

Importantly, decisions made now will only apply if you lack the capacity to decide in the future. Stated differently, estate planning does not restrict your legal right to direct your own healthcare.

The Default Situation

Why should all competent adults make end-of-life decisions in advance? The answer to this question becomes obvious after examining the default situation.

When default decision-making authority is allocated to multiple individuals who may not agree—for example, multiple adult children—the stage is set for lasting resentment and disagreements that require a legal solution. Even for the married, spouses may discover that they do not have unfettered access to the other’s medical records.

Beyond the disagreement or inconvenience associated with the default situation, those close to you may be required to make difficult decisions without the benefit of actionable guidance. Further, there is no guarantee that decisions made on your behalf will be consistent with Catholic moral teaching.

Planning for end-of-life decisions, which begins with a living will, is the solution. The Kentucky statutory living will (available on the state attorney general’s website) addresses the administration of artificial nutrition and hydration (ANH) and the use of life-prolonging treatment.

Alternatively, it enables you to designate a health care surrogate to make these decisions on your behalf if you lack capacity in the future.

Catholic Moral Teaching

When executing a living will, you should understand a Catholic’s duty to preserve life and the Church’s position on euthanasia. Let us briefly discuss both.

First, according to the United States Conference of Catholic Bishops, the duty to preserve life entails a moral obligation to take actions that you judge to offer a reasonable hope of benefit and that do not entail an excessive burden. Such actions are called ordinary or proportionate means. In contrast, you are not obligated to take action that imposes an excessive burden.

Second, euthanasia is morally impermissible but needs to be distinguished from palliative care. Thus, a dying person’s pain may be alleviated, even if doing so may indirectly shorten that person’s life, provided the intent is not to hasten death.

This is an application of the principle of double effect, which was first articulated by St. Thomas Aquinas, the Church’s universal doctor.

Catholic Use of the Statutory Living Will

Unfortunately, adhering to Church teaching and your own wishes via the check-the-box options of the statutory living will, as applied to an unknown future medical situation, may prove difficult.

Thus, it is preferable to designate a health care surrogate who understands the Church’s teachings (or who has access to someone who does) and with whom you have discussed your own wishes about ANH and life-prolonging treatment. It is also important to name a successor surrogate.

If this is not possible, then the Kentucky statutory living will is not optimal. In these cases, a customized living will should be executed.