Are Living Wills Accepted by the Catholic Church?

by Admin · Published September 3, 2024 · Updated September 3, 2024

Question: Can Catholics make a Living Will giving instructions for end-of-life care?

Answer: A Living Will is a written, legal document that provides instructions for your medical care or the termination of medical support, particularly the use or discontinuation of life-sustaining treatments, in the event that you become incapacitated and are unable to communicate your preferences due to conditions such as being in a coma, on life-support, or unable to communicate rationally.

Living wills cover instructions about resuscitation, hydration, nutrition and other life-sustaining measures. In principle, a living will that speaks for you in terms that are consistent with the Catholic Church’s moral teachings are considered morally good.

Obviously, a living will may not serve as a mechanism for euthanasia, which the Church condemns. Beware of pro forma living wills which might include directives that are contrary to Catholic principles. It is important that your living will is based on thoughtful consideration and adherence to Catholic teachings.

A living will is complicated — an instruction to “just pull the plug” obviously does not work — and there are many details which cannot be dealt with in this response to your question. Take time to understand the principles of Catholic bioethics and end-of-life care. You may seek guidance from a priest, deacon or other spiritual advisor. Discuss your intentions with them and seek their insights on Catholic teachings related to end-of-life decisions.

Ordinary vs Extraordinary

In making a living will, use precise language to express your preferences regarding medical treatments. Be clear about your desire for ordinary care (proportionate interventions) versus extraordinary care (burdensome treatments). Only extraordinary artificial means of treatment to keep a patient alive may be withdrawn.

But there are no clear answers for what treatment qualifies as proportionate and what constitutes extraordinary care, because circumstances can differ vastly. For example, imagine you have been in a traumatic accident. You are on a ventilator that breathes for you. It may be that there is absolutely no chance of your recovery, in which case the treatment may be considered extraordinary, and (in consideration of all other factors) may be discontinued.

But of there is a possibility of recovery, the burdens of treatment are proportionate to the benefit provided to the patient, and therefore the ventilator treatment must not be discontinued. It is the same treatment but with different outcomes.

The baseline is that the Church objects to any intervention intended to bring about premature death. The distinction between ordinary and extraordinary care is explained at wholeperson.care/ordinary-and-extraordinary-care

The proxy option

In making a living will, don’t forget to include sacramental provisions. For example, specify that you wish to receive the Anointing of the Sick and the Commendation of the Dying (last rites) when the time comes.

The document must be printed and signed, but also communicate your wishes to your family, trusted friends, priest, and healthcare providers.

However, no matter how thorough you are and how many health scenarios you detail, no living will can account for every possible situation. Therefore it is highly advisable to designate in writing a healthcare proxy (also known as a healthcare agent or surrogate).

This person — it can be a family member or a trusted friend — will have the power of attorney to make medical decisions on your behalf should you become incapacitated. Ensure that your proxy has a comprehensive understanding of the Catholic teachings and your wishes, and is instructed to convey these to the medical staff concerned.

While the Catholic Church accepts a living will — provided it conforms to Catholic bioethical teachings and principles — there is no law in South Africa to validate such advance directives. A living will, therefore, is not legally enforceable. However, the South African Medical Association and the Health Professions Council of South Africa have both issued guidelines stating that patients who have living wills in place have the right to have their directive to be honoured.

A Catholic living will reflects your faith and values, emphasising the sanctity of life while allowing for compassionate care at a time when you cannot speak for yourself. There are online resources available — such as a pro forma Catholic Living Will — though it is important to note that these are designed to address the legal and ethical conditions specific to the countries of their origin.