The month of November is moving along, and the call for believers to remember and pray for their beloved dead continues. It is not an easy task. Such a remembrance brings both sorrow and sobriety. It reminds us of those who have gone before us, while also reminding us that we will one day face death ourselves.
As we reflect upon our own deaths, we should prepare well for that day and discern the spiritual and moral realities that will accompany the end of our lives.
As Christian believers, we declare that our lives are not our own, as Saint Paul declares: “For to me to live is Christ.” And so we are called – again quoting Saint Paul – to give the “obedience of faith” throughout our lives, which includes the dying process.
With the above in mind, we can approach some principles from which we can ground our end-of-life discernment.
Our first principle of discernment is the recognition of our Creator and, more immediately, the objective order of moral truth beyond us. It is “objective” in that it is beyond the subject, which is our own person. It’s beyond us because we didn’t create it, we can’t change it (without moral peril), and if we want a good decision, one that brings peace, we must discern and decide according to it.
One example of this objective truth is our dignity. In making end-of-life decisions, some will say, “But I just want to die with dignity.” And they will. We all do. Our dignity is not given by our health, autonomy, laws or government, or even by ourselves. Our dignity is given to us by our Creator.
It is inalienable. No one, nothing, can take it away. Therefore, this inalienable dignity demands respect. It is the foundation of our human vocation, our call to live as full human beings, cherishing, respecting, and flourishing within our own dignity and that of others.
This means that in terms of end-of-life planning, while we must discern many things in the realm of treatment, we have boundaries. Our personal will, or the desire for autonomy, are not sovereign. These must be placed within our human dignity and the objective order of moral goodness, which is binding on all people of good will (and is seen as a manifestation of God’s will by believers). This shows us that we cannot take our own lives or cause willful harm to our well-being.
Our second principle of discernment is the consideration of the specific areas of our particular vocation, such as the state of our souls (i.e., are we in grave sin or in an irregular marriage), our duties and responsibilities toward others, our talents and skills, our financial arrangements, our opportunities and authority, and our capabilities and roles in society and in the care of others. Our discernment is never just about us. It always involves our relationship with God, but also with our neighbors.
Relying on the two principles above, our third principle is the distinction between ordinary and extraordinary care. These are the two expressions that are used to clarify what we are called to do.
Ordinary care is that care which is morally obligatory.
Extraordinary care is that care which is morally optional.
The distinction between the two is essential for our discernment since ordinary care is the summons of the Lord. It would be severely regrettable if a person were to have lived their entire life as a faithful Christian but then abandoned the cross and the demands of discipleship at the end of life. In order to prevent this scandal, each of us is obliged to enter into serious discernment, seek counsel, and to do whatever the Lord asks of us.
The distinction between ordinary and extraordinary care involves some practical elements, such as the possibility of survival or benefit to one’s person, the degree of possible side effects, the extent of the proposed treatment, our capacity for pain, our responsibilities to other people or society, and our financial means. Within the boundaries set by objective truth, we have to add these other factors into the arena as we decide whether we are obliged to accept treatment or not.
Since our discernment follows our particular vocation, it is possible that a medical procedure or treatment is obligatory for one person, while optional for another. Following the state of affairs within the boundaries set by our human vocation, we cannot solely identify a specific medical procedure or treatment as ordinary or extraordinary. While the medical community may do so and use the same terms, the Church uses these terms far more holistically and calls for us to consider many areas of our life and not simply the medical invention that is being proposed.
As Christians, we seek to know what the Lord is asking of us and then, like the apostles, to generously respond with trust and confidence in the ways of God. The Lord will never overwhelm us or abandon us. He will only give us what we can carry. But in order to carry what he gives us, we must discern well and make decisions that reflect moral truth and goodness.
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