What to do about living wills?

Toronto -- At the meeting of the lay organization Witness at St. Monica's parish, on September 17, Catholic lawyer Geoff Cauchi delivered a brilliant address on the subject of living wills and power of attorney for personal care. He warned that living wills might give a green light to euthanasia.

Catholics must use all ordinary means of care and both suicide and euthanasia are morally forbidden. Cauchi explained the Catholic teaching on how to judge whether a treatment is ordinary or extraordinary. Ordinary treatment must not be stopped.

On March 20, 2004, Pope John Paul II, in an address to participants in the International Congress on Life Sustaining Treatments taught that artificial nutrition and hydration (ANH) is not medical treatment but basic care whose purpose is nourishment. He stated that it should be provided to patients in a persistent vegetative state, but that in a particular case, hydration and nutrition may be extraordinary and disproportionate, and therefore, morally optional. Unfortunately, many Catholic theologians and bioethicists have misled Catholics, suggesting that ANH may be refused, withdrawn, or withheld if a patient is cognitively impaired.

Mr. Cauchi advises that in writing a combined power of attorney for continuing care and advanced directives, one should resort to written wishes to receive food and water by whatever means until they can no longer be assimilated.

One should avoid statements that could be misinterpreted as permission to withhold or withdraw treatment or nutrition/hydration. One should state one's Catholic values and beliefs and declare full consent to Church teaching, including that on ANH. One should specifically reject "futile care theory." One should also reject the use of a "best interest test," which could reject treatments because they were deemed not consistent with the patient's "best interest" or "well being" or "quality of life."

"Futile care theory" holds that patient autonomy is limited to the right to refuse treatment, and that medical care can be denied regardless of a patient's wishes. It further holds that the physician is not obligated to give the patient or the attorney the option of agreeing with, or disagreeing with, the physician's futile care decision.

For details of Mr. Cauchi's recommendations, contact: Alliance for Life Ontario, 22 Cork St. Suite 205, Guelph, ON, N1H 2W7. Tel: [phone].