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    • E. Christian Brugger, D.Phil. – E. Christian Brugger is a Senior Fellow of Ethics and Director of the Fellows Program at the Culture of Life Foundation in Washington, D.C. and the J. Francis Cardinal Stafford Professor of Moral Theology at St. John Vianney Theological Seminary in Denver, Colorado. He has Master degrees in moral theology and moral philosophy from Seton Hall, Harvard and Oxford Universities and received his D.Phil. (Ph.D.) in Christian ethics from Oxford in 2000.  Christian has published over 200 articles in scholarly and popular periodicals on topics in bioethics, sexual ethics, natural law theory, as well as the interdisciplinary field of psychology and Christian anthropology.  He lives on a farm in Evergreen, Colorado, with his wife Melissa and five children.
    • Helen Alvaré, J.D. – Helen Alvaré, J.D. is Honorary Fellow in Law at the Culture of Life Foundation.   Helen is an Associate Professor of Law at the George Mason University School of Law in Arlington, Virginia where she teaches and publishes in the areas of property law, family law, and Catholic social thought. Professor Alvaré serves as Consultor for the Pontifical Council for the Laity, Senior Fellow at the Witherspoon Institute where she chairs the Conscience Protection Task Force, is President of the Chiaroscuro Foundation and most recently Editor and Co-Author of Breaking Through: Catholic Women Speak for Themselves.From 2000 to Spring 2008, Professor Alvare taught at the Catholic University Columbus School of Law. Professor Alvare also lectures widely in the United States and Europe on matters concerning marriage, family and respect for human life. She is a consultant to ABC News and to the United States Conference of Catholic Bishops’ (USCCB) Marriage and Pro-Life Committees. In 2008, Pope Benedict XVI named Professor Alvare a Consultor to the Pontifical Council for the Laity.From 1987-2000, Professor Alvare was an attorney with the USCCB’s General Counsel Office and director of information and planning for the Secretariat for Pro-Life Activities. In these positions, she testified before the…
    • Jennifer Kimball Watson, Be.L. – Jennifer Kimball Watson joined Culture of Life Foundation as Executive Director in November of 2007. She is an Adjunct Professor of Bioethics at the Ave Maria School of Law in Naples, F.L.. Previous to her work with the Culture of Life Foundation Jennifer was a Wilbur Fellow of the Russell Kirk Center for Cultural Renewal located in Michigan. Jennifer earned a Licentiate in Bioethics from the Pontifical Athenaeum Regina Apostolorum School of Bioethics in Rome.  Her prior undergraduate studies were in International Administration and Government Policy at the Evergreen State College in Washington State.Jennifer’s areas of specialization include Eugenics in Artificial Reproductive Technologies, Heterologous Adoption and Transfer of Embryos, The Womb in Reproductive Technologies, and the Role and Significance of The Medical Act. She interviews with National Conservative and Christian Radio Syndicates as well as several foreign and secular reporters. Jennifer has spoken on the dignity of women and women’s social issues to various audiences since 1999 and has spent several years in advocacy work with various international organizations in the field of life sciences. From 2000 to 2006 she recruited and coordinated grass-roots social policy efforts that consisted of a public and private sector network of professionals and academics…
    • Margaret Datiles Watts, J.D. – Margaret Datiles Watts, J.D., is Culture of Life Foundation’s Associate Fellow in Law. Maggie is member of Washington, D.C. and Maryland bar associations.  She holds a B.A. in Philosophy (Phi Beta Kappa and Magna Cum Laude) and a Certificate in Classical Philosophy from the University Honors Program at The Catholic University of America. She earned a Juris Doctorate from Columbus School of Law at The Catholic University of America, where she served as a Research Fellow at CUA Law’s Marriage Law Project. She also studied Roman Law and EU Law at Magdalene College, University of Oxford, England.A former Fellow and Staff Counsel for Americans United for Life, Datiles co-authored an amicus curiae brief to the Supreme Court of the United States in the landmark partial birth abortion case, Gonzales v. Planned Parenthood, et al., companion case to Gonzales v. Carhart (2007). She also advised legislators, policy groups and the media (radio and newspapers) on abortion and bioethics laws and drafted pro-life model legislation.Her areas of research and/or publication include legal issues surrounding abortion, government funding restrictions for abortion, contraception, healthcare rights of conscience, stem cell research, artificial reproductive technology, population decline, physician-assisted suicide, euthanasia, and same-sex marriage.She currently publishes articles…
    • William E. May – William E. May is Senior Research Fellow of the Culture of Life Foundation and emeritus Michael J. McGivney Professor of Moral Theology at the John Paul II Institute for Studies on Marriage and Family at The Catholic University of America in Washington, D.C., where he taught the academic years from 1991 through 2008 after teaching for 20 years at The Catholic University of America. He is the author of more than a dozen books. The 2nd edition of his Catholic Bioethics and the Gift of Human Life was published by Our Sunday Visitor (2008), and a substantively revised 3rd edition is scheduled for publication in 2013. In 2003 Our Sunday Visitor published a revised and expanded edition of his Introduction to Moral Theology. Among his other books are: Marriage: The Rock on Which the Family Is Built (San Francisco: Ignatius, 1995; 2nd revised edition, 2009)); and, with Ronald Lawler OFM Cap and Joseph Boyle, Catholic Sexual Ethics (rev. and enlarged ed. Huntington, IN: Our Sunday Visitor, 1998; 2nd rev. edition, 1998; a 3rd edition, substantively revised by May alone, was published in 2011); Theology of the Body: Genesis and Growth (Boston: Pauline Books & Media, 2010) He has published more…
    • Frank J. Moncher, Ph.D. – Dr. Frank Moncher received his Ph.D. in Clinical-Community Psychology from the University of South Carolina in 1992, following which he spent several years on faculty of the Medical College of Georgia, with a focus on Adolescent Intensive Services. In 2000 he moved to the Washington, DC area to teach at a graduate school of psychology which had a mission of integrating the science of psychology in the context of the Catholic Christian view of the human person. Concurrent with this, over the past 12 years he has consulted with 11 different religious orders and 4 dioceses to provide psychological evaluations of aspirants and candidates, as well as consulting with different diocesan marriage tribunals.His research interests include the integration of Catholic thought into psychotherapy, child and family development issues, and integrated models of assessment of candidates for the priesthood and religious life. Frank is published in Families in Society: The Journal of Contemporary Human Services, Adolescence, Journal of Interpersonal Violence, Edification, and the Journal of Psychology and Christianity, as well as contributing to several book chapters on children, families, and religious issues.Since 2010, Dr. Moncher has worked for the Diocese of Arlington and Catholic Charities as a psychologist and consultant.  His…
    • Steve Soukup – Fellow in Culture and Economy Steve Soukup is the Vice President and Publisher of The Political Forum, an “independent research provider” that delivers research and consulting services to the institutional investment community, with an emphasis on economic, social, political, and geopolitical events that are likely to have an impact on the financial markets in the United States and abroad. Mr. Soukup has followed politics and federal regulatory policy for the financial community since coming to Washington in 1996, when he joined Mark Melcher at the award-winning Washington-research office of Prudential Securities. While at Prudential, he was part of the Washington team that placed first in Institutional Investor magazine’s annual analyst survey for eight years in a row. Mr. Soukup left Prudential with Mr. Melcher to join Lehman Brothers in the fall of 2000 and stayed there for two years, before leaving early in 2003 to become a partner at The Political Forum. While at Lehman, Mr. Soukup authored macro-political commentary and followed policy developments in the Natural Resources sector group, focusing on agriculture and energy policy. He also headed Lehman’s industry-leading analysis of asbestos litigation reform efforts. At The Political Forum, Mr. Soukup was initially the editor and junior partner,…
    • Dr. Pilar Calva, M.D. – Dr. Calva is a medical doctor specializing in Human Genetics with a Cytogenetics subspecialty from The University of Paris, France. In Paris, she was the under-study to the world-renowned Professor Jerome Lejeune, who is considered by some to be the father of modern genetics. In 1958, Lejeune discovered that an extra 21st chromosome is responsible for Down syndrome, or Trisomy 21. Lejeune dedicated his life tirelessly and unfailingly to defend the unborn, especially those with Down syndrome, testifying before scientific conferences and lawmakers. He was appointed by Pope John Paul II as the first President of the Pontifical Academy for Life. In Dr. Calva’s own words: When I arrived in France, I lived a life divided between faith and reason. I thought that from Monday to Saturday, I put on my white coat for my scientific tasks, and Sunday was the day I took off the white coat, put on my crucifix and dedicated myself to my religious duties. Professor Lejeune truly converted me, making me see that one can wear the white coat and the cross, at the same time. That is, one can fly with the wing of faith and the wing of reason. Inspired by the life…
    • Elyse M. Smith – Elyse M. Smith is an associate attorney with a northern Virginia law firm working in nonprofit and church law, estate planning, and civil litigation. Ms. Smith graduated magna cum laude from Ave Maria School of Law in Naples, Florida, where she served on Law Review and was published in the Ave Maria International Law Journal. She was named “Most Dedicated Editor” for her work on Law Review. Ms. Smith earned her bachelor’s degree in Foreign Affairs from the University of Virginia.  
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  >  Issue Briefs  >  Bioethics  >  End of Life Decision Making

End of Life Decision Making

Posted: February 2, 2016
By: E. Christian Brugger, D.Phil.
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WASHINGTON, DC, FEBRUARY 2, 2016 (zenit.org) . -You check into a hospital for a routine procedure.  They ask you if you have a living will.  You say no.  They slide a form in front of you with simplistic questions such as: Do you want to be resuscitated if you go into cardiac arrest?  Do you want mechanical ventilation if you are unable to breath?  Do you want nutrients and fluids supplied to your body if you’re unconscious?

Your gut tells you the questions are superficial.  If CPR could revive you and you could live decently for a while longer, yes, you’d want it.  If you’d die anyway an hour later, then no.  If ventilation was a temporary measure to help you overcome an acute condition, yes.  If you were permanently unconscious and never able to breathe again on our own, then perhaps no.  And food and water?  Of course you want to be fed.  What’s the alternative, starvation?

You don’t get much help from the check-in clerk.  And hospital healthcare managers give you ideologically-laden advice such as “think about your values…and what you feel would make your life not worth living” (from the Mayo Clinic website).  “Life not worth living!?,” you ask, “Where does that idea come from?  Not from Catholic faith.”

But you recall that your Aunt Agatha didn’t have an Advance Directive and she was subjected to aggressive and obviously-futile treatments at the end of her life and suffered unnecessarily.  You’re pretty sure that if she’d been asked she’d have said: “Enough’s enough.  Let me go to God!”  But she was unconscious.  You fear that if you don’t fill out the form, something like this might happen to you.  What should you do?

Advice for Catholics: If you can avoid using Living Wills and POLST (MOST) forms, by all means do so.  Their simplistic check-box format poses unacceptable risks from both the perspective of good medical decision-making and good ethical decision-making.  They risk binding the hands of medical professionals to non-treatment decisions that are not in the best interests of patients.

But this does not mean that Catholics should be unprepared for end-of-life crises.  I recommend that all Catholics who are able should do the following three things:

First, execute in writing a Health Care Power of Attorney (HCPA) assigning a proxy decision maker—sometimes called a “surrogate”—to act as your healthcare agent in the event that you become incapable of making informed decisions.  You can do this yourself without costly legal fees.  Just make sure that your HCPA is adequately specific and your signature is validly witnessed.  Here are a few things you might include.

Invest your proxy with full authority to make healthcare decisions on your behalf, including but not limited to the power to:

(1) consent to, or refuse, or withdraw consent to, any type of medical care, treatment, surgical procedure, diagnostic procedure, medication and the use of mechanical or other procedures that affect any bodily function, including, in appropriate circumstances, life-sustaining procedures. [*Note: this power does not extend to the refusing of properly “ordinary means” of care, defined in Catholic teaching as forms of care or treatment that promise a “reasonable hope of benefit” and are “not excessively burdensome.”  The Catholic Church teaches that the administration of food and water is always ordinary care unless and until one’s body no longer can assimilate them, at which time their administration becomes futile and is no longer obligatory];

(2) request, receive, and review any information regarding your physical or mental health, including but not limited to medical, hospital and other records; and to consent to or authorize the use and disclosure of such information;

(3) employ and discharge your health care providers;

(4) authorize your admission to or discharge (including transfer to another facility) from any hospital, hospice, nursing home, assisted living facility or other medical care facility;

(5) authorize that you be discharged from a medical facility and be brought home and cared for at home;

(6) take any lawful actions necessary to carry out these decisions.

You may also want to state that the authority of your agent is subject to no limitation except the law of God, the authoritative teaching of the Catholic Church, and your agent’s own conscience.

Second, ensure that your proxy not only is willing to direct all relevant medical decisions in accord with Catholic faith and morals, but understands what doing so means.  Frequently the limiting factor in legal disputes over end-of-life decisions comes down to uncertainty of the wishes of the patient.  Remove all uncertainty.  Make your wishes known both orally and in writing as clearly as possible to your proxy and to other loved ones.

If you are uncertain about Church teaching on end-of-life decision-making, speak to your parish priest, or an informed Catholic medical professional, or contact trustworthy groups like the Catholic Medical Association, or your diocesan moral theologian, or, if nothing else is available, directly contact your local bishop.

Third, in the event that you or your proxy are faced with a situation in which the judgment of a hospital ethics committee or other hospital decision makers seems to conflict with your faith or morals, don’t be afraid to mount a legal challenge in court.  If you are reticent because of the cost of legal representation, consult with a reliable Christian advocacy ministry such as Alliance Defending Freedom, Christian Legal Society, and American Center for Law and Justice.  You might even contact one of the 50 state affiliates of National Right to Life.

Some might find it difficult or even repugnant to initiate a forthright conversation with a loved one about treatment plans at the end of life.  I urge you to overcome this resistance.  Because a large majority of medical resources in U.S. healthcare are consumed on end-of-life treatments for the elderly, secular medicine, fueled by Obamacare, and with the support of the medical insurance industry, is investing enormous energy in publicizing and distributing secular tools for end-of-life decision making.  The tools are invariably skewed in the direction of refusal of life sustaining treatments.  Although flagrant examples of aggressive overtreatment still exist, U.S. healthcare is travelling rapidly and ineluctably in the direction of a culture of refusal.  Without conscientious advance planning, some will find the pressure to check the “refusal” box on these documents hard to resist.

***

Christian Brugger is Senior Fellow of Ethics at the Culture of Life Foundation and Cardinal Stafford Professor of Moral Theology at St. John Vianney Theological Seminary in Denver.

Readers may send questions regarding bioethcs to zenitbioethics@gmail.com

This entry was posted in Bioethics, Life by E. Christian Brugger, D.Phil.. Bookmark the permalink.
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