Editor’s note: The following is a letter from The Most Reverend Bishop David Kagan regarding the Catholic teaching on end-of-life care and directives.
As we have celebrated our greatest feast–Easter, the Resurrection of the Lord Jesus from the dead–our hearts are filled with that joy and gratitude which come from knowing how much God loves each of us.
The Father loves us so much that, in spite of our terrible sins, He sent His Son Jesus to take our sins on Himself and to accept the punishment we deserved, and to die for us.
But, there is more to the Father’s love for us! The suffering and death of Jesus was not the end, but the beginning of life truly transfigured by the Resurrection of Easter Sunday.
The Passion, Death and Resurrection of Jesus radically changed not only our earthly lives, but also our own suffering and death. Because Jesus suffered and died for us and then rose from the dead, our suffering and death have an eternal value.
The message of Easter is that God lives and we do as well! Our lives are to be a preparation for eternity. Because of Jesus, the suffering and difficulties (physical or spiritual), which we carry, are not obstacles to life, but moments of grace for us to live our lives as fully as we can, growing in holiness. Our sufferings in this life are not a punishment, but an opportunity to draw closer to Jesus, Who loved us to the end and into eternity.
In spite of this good news of God’s abundant mercy to us all, in our present times we are witnessing the terrible effects of faith, hope and charity abandoned in favor of secularism. It is subtly, but definitely, working to convince us to see ourselves as mere objects in relation to others, when in fact we have been created by God for ourselves in order to be happy with Him in heaven. This truth gives each of us a dignity, which neither we nor anyone else may injure, disrespect, remain indifferent to or deprive ourselves of.
One specific circumstance in which this serious matter is evident is what is called the “end-of-life issues.” The health care professions are being pressured by government and other outside agencies to become more and more financially efficient in treatments and use of medical resources. This pressure to premise medical treatment on the bottom line always works against the common good of us all and places our human dignity in grave danger. As a result, so many sick persons are asked to make life and death choices about their treatment at precisely the moment when they are least able and most vulnerable, when they are seriously sick. The sick person or that person’s family members are expected to make final decisions about medical treatment or the termination of medical treatment.
Admittedly, this can be a very complicated matter and because it is, the North Dakota Catholic Conference of Bishops has issued an excellent teaching and guide in just such matters pertaining to what is often referred to as advanced directives. A summary of that document can be seen on page 3 of this issue. I urge you to go to the website to read and to copy these for yourselves:
What is of paramount importance for us to remember in all such situations, it is never morally permissible to do anything, which directly causes our own death or that of another. Conversely, it is never morally permissible to omit to do what is ordinary and reasonable for ourselves or another who may be gravely ill. We all must exercise the greatest vigilance over this area of our lives so that we do not intentionally or unintentionally usurp what belongs only to God Himself. God’s will to call us or another out of this world must be respected. Respect for a person in a terminal situation will involve allowing him to suffer and die in the most dignified way possible. Yet, the U.S. Bishops remind us that “even the most severely debilitated and helpless patient retains the full dignity of a human person and must receive ordinary and proportionate care.” (
Ethical & Religious Directives for Catholic Healthcare Services
In this light, the Church teaches that there is, in principle, an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally. As St. John Paul II explains “the administration of food and water, even when provided by artificial means, always represents a natural means of preserving life, not a medical act.” (International Congress of Scientists, 2004) Its use is thus considered ordinary and proportionate medical care, and is therefore morally obligatory to the extent to which, and for as long as, it is shown to serve its life-preserving purpose for the patient.
There are exceptional situations that may exist in which this is not the case, such as when a person is no longer able to assimilate nourishment, or when death is so imminent that withholding or withdrawing food and water will not be the actual cause of death. Yet, in no case should food or water be removed with the intent to cause death or when the removal itself would be the direct cause of death. For such an act is never true compassion, but rather its opposite.
Dear friends, in the merciful light of the Resurrection of Jesus from the dead, our lives with their joys, sorrows, sufferings, pains, and limitations, have been transformed so that we realize every life has a dignity and value far beyond this world. It is in living our earthly lives as Jesus lived His, that we obtain heaven. Jesus did not go looking to suffer, but He knew this to be the will of His Father. He accepted His suffering and death as the way to His Resurrection. Let us do the same in our own lives, trusting in His eternal merciful love for each of us!
Let us continue to pray for each other and may we continue in this Jubilee of Mercy to obtain His abundant graces for eternal life.