Implications of the RCC PVS Clarification

In parallel with the previous thread, I'd like to investigate the implications
of the 'morally binding' instruction.

Let's say your father is dying of an incurable cancer. Let's suppose that,
at this point, he is fully conscious and of sound mind and in some pain,
but not severe. The doctors predict that in a few weeks, the pain will
increase markedly and persist for several months until he dies from
the trauma of being in pain.

He wants to refuse food and drink so that he can die of starvation before he gets to this point. As a good Catholic, should you compel him
to eat? Should you wait until he is too weak to argue and force feed
him through IV?

Nemesio

Originally posted by Nemesio
In parallel with the previous thread, I'd like to investigate the implications
of the 'morally binding' instruction.

Let's say your father is dying of an incurable cancer. Let's suppose that,
at this point, he is fully conscious and of sound mind and in some pain,
but not severe. The doctors predict that in a few weeks, the pain will
increase marked ...[text shortened]... Should you wait until he is too weak to argue and force feed
him through IV?

Nemesio

Euthanasia. Letting the guy starve to death is hypocrisy.

Originally posted by Nemesio
In parallel with the previous thread, I'd like to investigate the implications
of the 'morally binding' instruction.

Let's say your father is dying of an incurable cancer. Let's suppose that,
at this point, he is fully conscious and of sound mind and in some pain,
but not severe. The doctors predict that in a few weeks, the pain will
increase marked ...[text shortened]... Should you wait until he is too weak to argue and force feed
him through IV?

Nemesio

Let's say your father is dying of an incurable cancer. Let's suppose that, at this point, he is fully conscious and of sound mind and in some pain, but not severe. The doctors predict that in a few weeks, the pain will increase markedly and persist for several months until he dies from the trauma of being in pain.

This is actually close to the case with my father, who died at age 59 of cancer. He had lapsed to unconsciousness (though he could still experience pain; he could no longer communicate). In fact, he died of—if I recall correctly—a poisoning of the blood that was a consequence of his particular cancer (again if I recall correctly, calcium poisoning: the cancer had been eating away his bones). The doctors could have continued medication to prevent that—in which case he would’ve died of the cancer itself, which they assured us would be a much more painful and prolonged death. We, as a family, opted to discontinue that medication, and he died a few days later quite peacefully.

My father had a big thing about dying with dignity. I think our decision was in accord with that.

EDIT: This was 24 years ago; I don't know if there is medical technology today that would've given another option.

Originally posted by Nemesio
In parallel with the previous thread, I'd like to investigate the implications
of the 'morally binding' instruction.

Let's say your father is dying of an incurable cancer. Let's suppose that,
at this point, he is fully conscious and of sound mind and in some pain,
but not severe. The doctors predict that in a few weeks, the pain will
increase marked ...[text shortened]... Should you wait until he is too weak to argue and force feed
him through IV?

Nemesio

I'm glad you posted this as there were a couple of phrases that I hear a lot. The first was "dying of pain." No question that pain is involved in most cancers, but people, for the most part, can get really good pain control these days. The other thing is that when the disease takes its usual course, people tend not to want to eat. Family members struggle with this as they 1) don't like the idea of their loved one "starving: and 2) food is so engrained in our culture as helpful and necessary that it is hard to move away from that thinking. In reality, the person is not dying of starvation. They are dying from cancer. Eating at that stage only feeds the cancer so it can be more aggressive.

The informed Catholic can take comfort in "man does not live by bread alone" thinking. Emotional food is the medicine of choice at this stage. And morphine too.

Originally posted by kirksey957
I'm glad you posted this as there were a couple of phrases that I hear a lot. The first was "dying of pain." No question that pain is involved in most cancers, but people, for the most part, can get really good pain control these days. The other thing is that when the disease takes its usual course, people tend not to want to eat. Family members strug ...[text shortened]... e" thinking. Emotional food is the medicine of choice at this stage. And morphine too.

[B]The other thing is that when the disease takes its usual course, people tend not to want to eat.[/B]

I never knew that.

Once again you remind us, dear Kirk, that no matter how much we speculate on here in the abstract about moral considerations and such, these situations are always very much in the concrete: real and immediate in the lives of real people.

What if keeping the dying person alive will cost a large amount of money which his relatives are not easily able to afford? Are they still morally obliged to spend it even though it will not make much difference to the dying person?

Originally posted by twhitehead
What if keeping the dying person alive will cost a large amount of money which his relatives are not easily able to afford? Are they still morally obliged to spend it even though it will not make much difference to the dying person?

Insurance usually covers most of their expenses, but I often see expensive treatments being used that will have absoutely no bearing on improvement. Here's one example. A guy has inoperable lung cancer and his doctor wants to see if it has moved to his brain. An MRI might cost $5,000. If it has spead to his brain, so what? What is the benefit of knowing? He' is going to die anyway. Sometimes the doctors and not the patient or their family are the ones that have a hard time with doing nothing and letting the person die.

Originally posted by vistesd
[B]The other thing is that when the disease takes its usual course, people tend not to want to eat.[/B]

I never knew that.

Once again you remind us, dear Kirk, that no matter how much we speculate on here in the abstract about moral considerations and such, these situations are always very much in the concrete: real and immediate in the lives of real people.

Kind of think about deep sea fishing and you are so sea sick you are putting more in the ocean than taking out. Those waves are just relentless. You are green and heaving. No worse feeling in the world. And some well meaning fool brings you a pastromi sub with grilled onions and horse raddish sauce to make you feel better.

Originally posted by twhitehead
What if keeping the dying person alive will cost a large amount of money which his relatives are not easily able to afford? Are they still morally obliged to spend it even though it will not make much difference to the dying person?

I think once a dying person exceeds a cost of, oh I don't know, lets say $10,000 we pull the plug, so to speak. Now all dying persons are worth no more than that amount. Think of the money we can save with in medicare!!

Originally posted by kirksey957
Insurance usually covers most of their expenses, but I often see expensive treatments being used that will have absoutely no bearing on improvement. Here's one example. A guy has inoperable lung cancer and his doctor wants to see if it has moved to his brain. An MRI might cost $5,000. If it has spead to his brain, so what? What is the benefit of know their family are the ones that have a hard time with doing nothing and letting the person die.

You raise a disturbing problem within medicine in that increased tests/surgeries often equate into greater $$$ for medical personelle. The question then becomes where is the line drawn between being a patient advocate and being an advocate for thier own personal portfolio? I'm sure its not hard to rationalize that perhaps this test of this procedure will help us help the patient while all the while the main motivating factor is financial gain for themselves and the hospital even though they continue to insist that they are being a patient advocate.

Originally posted by whodey
You raise a disturbing problem within medicine in that increased tests/surgeries often equate into greater $$$ for medical personelle. The question then becomes where is the line drawn between being a patient advocate and being an advocate for thier own personal portfolio? I'm sure its not hard to rationalize that perhaps this test of this procedure will he ...[text shortened]... es and the hospital even though they continue to insist that they are being a patient advocate.

Generally in such cases where the doctor wants to perform a test that seems not to have any particular benefit it's so that the doctor can basically perform research so that in the future they can deal with future sufferers of a particular disease in a better way, though they should be required to be upfront that it's research they're performing and not necessarily healing.

Originally posted by kirksey957
Insurance usually covers most of their expenses, ....

In some countries maybe, not everywhere. The only time I have had medical insurance is when it was required in order to get a work permit. My parents have never had medical insurance as far as I know.

Originally posted by whodey
I think once a dying person exceeds a cost of, oh I don't know, lets say $10,000 we pull the plug, so to speak. Now all dying persons are worth no more than that amount. Think of the money we can save with in medicare!!

Are you trying to avoid the question by being sarcastic?

edit
I understood from Nemesio that the Catholic Church says we are morally obliged to keep a dying person alive for as long as possible. I am trying to understand whether that includes 'whatever the cost'.
I know that money vs life is a morally difficult question but I don't think you have addressed it at all with your sarcasm.

Originally posted by agryson
Generally in such cases where the doctor wants to perform a test that seems not to have any particular benefit it's so that the doctor can basically perform research so that in the future they can deal with future sufferers of a particular disease in a better way, though they should be required to be upfront that it's research they're performing and not necessarily healing.

Should the dying person or his relatives pay for that research?

Originally posted by whodey
I think once a dying person exceeds a cost of, oh I don't know, lets say $10,000 we pull the plug, so to speak. Now all dying persons are worth no more than that amount. Think of the money we can save with in medicare!!

Stop being a moron. No one implied something like this.

The question is, if you believe that it is morally wrong for a medical proxy to refuse nutrition and
hydration to a patient in PVS (i.e., killing that individual), then do you believe that it is suicide for
an individual to refuse nutrition and hydration when they are in an urgent medical state?

Nemesio