How to Respond to Suffering from Illness
In his second article on euthanasia and assisted suicide, MELESE SHULA explains the pros and cons of “advance directives” and offers a Christian response to suffering
Last week I outlined the reasons why euthanasia and assisted suicide are incompatible with Catholic teaching and ethics, and why properly applied palliative care offers an alternative to an unnatural death.
In this second article, I hope to shine a light on how we can prepare for being in the potential situation where we are unable to choose the course of our treatment, on what the Church says about suffering, and how we can accompany those who are suffering because of illness.
What are Advance Directives?
“Advance directives” are a living will or a durable power of attorney.
Some people choose, for the benefit of family members and medical personnel, to indicate in advance what should be done in the event that they become incompetent due to an accident or sickness. This can be done through an instructional directive (often called a “living will”) or a proxy directive (often called “durable power of attorney” or “mandate”).
Instructional directives indicate in advance the level of medical treatment a person wishes to receive in situations where they are unable to communicate.
According to some specialists, instructional directives are risky because it is so difficult to anticipate all possible scenarios, so the language almost never fully communicates the wishes of a person.
Also, the doctor making the decisions may be unaware of the ethical values of the person concerned and could misinterpret the document to go against the individual’s wishes.
Furthermore, this type of document is often distributed by organisations favouring euthanasia which use vague language that can easily be interpreted in favour of euthanasia.
A proxy directive is a more reliable way to ensure that our end-of-life decisions are respected. This is a legal document, either notarised or signed by a person in the presence of witnesses, whereby a family member or friend who knows our values and respect for human life is chosen as a health care proxy.
When the time comes, that proxy will be responsible for making decisions about the type of care we should be given or not, or whether this care should be interrupted.
It is best to avoid making a blanket statement rejecting certain types of care in all circumstances — unless death is imminent or treatment futile — but rather to leave enough latitude for our agent or doctor to offer appropriate care for our condition.
It is important to be very clear about the meaning of the words we use, to review our directives periodically, and to make sure our proxy or our doctor and whoever else needs to know, is aware of these instructions.
Does the Church think it’s good for people to suffer?
The Church does not see suffering as a good in and of itself, and we all have a duty to do everything in our power to eradicate or at least alleviate it. We need to discover how to be compassionate, how to enter into and share the suffering of others.
There is no doubt that suffering challenges the very core of human life. Sometimes, in the face of overwhelming suffering, we must humbly acknowledge the limits of our capacity and the human condition. This is not easy to do in our technologically-driven society where we are accustomed to getting what we want, when we want it.
The Church recognises that suffering can have great meaning and redemptive power in the lives of those who are suffering and those around them. When suffering has meaning it can help to make it bearable.
Christians believe that Christ brought human beings back to God through his Passion, Death and Resurrection; each person is invited to freely accept this reconciliation.
Christians also believe that those who unite their sufferings to Christ’s with love participate in this work. Their feelings of anger and discouragement are replaced by quiet hope, and even joy. Suffering is no longer pointless.
They find in God, especially by receiving the Body of Christ, the courage and strength to live fully all the days of their lives in anticipation of the eternal life for which God created us all in his love.
The alternative is to provide people of all ages, particularly those who are seriously ill or disabled, including those in a terminal phase, with the utmost personal attention. This may include the best home care or palliative care, along with the best pain control and alleviation of suffering.
Such an approach involves the greatest respect for all the needs of the person who is suffering or dying—emotional, physical, social and spiritual—until his or her natural death. This type of care keeps a sick person from feeling abandoned and asking for euthanasia.
Where a person requests euthanasia out of deep loneliness, we would talk about a case of “social” euthanasia.
Although palliative care cannot eliminate all suffering in all cases, it is an excellent way of affirming the life of the person who is dying. This is what is meant by death with dignity.
We need to encourage governments to devote more resources towards palliative care in hospitals, homes and hospices and for the education of health professionals and the public about palliative care.
The desperate cases
What about the people whose pain cannot be controlled, and what about those whose pain can be alleviated but they just can’t bear the loss of control and fear losing their dignity?
It is obviously important to direct more resources into research for better methods of pain control. However, experts in palliative care state that only a very small proportion of people suffer from intractable pain, and even then there are means to keep them as comfortable as possible.
It is not hard to empathise with those who feel they have lost their dignity. Yet human dignity lies not in the exercise of control or even in the quality of life, but rather in the simple fact that they are human beings made in the image of God, made for life with one another.
We also give life dignity by the way we respond to it—by reaching out to the dying person with compassion and attending to their most basic needs. We need each other in death in the same way that we need each other in life.
This form of accompaniment can be painful and intense, but it is also full of possibilities for expressing love and gratitude, for spiritual growth and for reconciliation with God and one another.
Could you not watch one hour with me?
Sheila Cassidy, an English palliative care physician and author, challenges us as a society and as individuals to be more involved in the care of those who suffer: “Those enduring great distress know that the cup cannot be taken away from them, but they value the presence of someone to share, however minimally, in their suffering — someone to watch with them during their agony.
Jesus himself, when wrestling with his fear in the Garden of Gethsemane, begged his disciples to stay with him: “Could you not watch one hour with me?”
How will each of us answer this question?
Melese Tumato Shula is a pastoral care officer at Catholic Healthcare Association of South Africa (Cathca) in Johannesburg. This concludes the two-part series on euthanasia and assisted suicide.