A Planned Catholic Death: An Ethical Analysis of Advance Care Planning Through the Lens of the Catholic Moral Tradition
Noah Dimas, PhD student, Duquesne University
Within the realm of healthcare, one very respected de facto principle is that of “respect for autonomy.” Made most prominent by Beauchamp and Childress, this de facto principle is based within the philosophical concept of autonomy. Derived from the Greek “auto” and “nomos”, this concept generally states that a person is entitled to make decisions for oneself. As applied to medical ethics, it regularly includes the right for a patient to make independent, informed decisions regarding one’s care, i.e., the ability for a patient to request or refuse medical interventions while also being provided sufficient information to make such an informed decision.
An extension of this autonomy is to provide patients with the ability to make decisions in advance for one’s care; more generally known as advance care planning (ACP). This can consist of a general discussion about end-of-life (EOL) preferences, or be formalized into a more binding document, such as an advance directive. However, healthcare seems to be at something of a crossroads when it comes to the usage of ACP. There exist a strong majority of patients that wish to participate in ACP. Yet, many healthcare providers are hesitant to initiate the conversation to begin the ACP process. Some are hesitant from a position of sensitivity to the patient, others from a fear of retaliation, still others are generally uncomfortable in discussing EOL with patients.
Furthermore, there exists even more hesitation and antagonism against the Catholic Church and her teachings on ACP. Within the greater healthcare system, there exists something of a diminishing population of Catholic healthcare professionals who wish to practice the morality of Catholicism. This diminishing proportion of faithful practitioners has led to a poorer understanding and communication of Catholic teaching on ACP from the part of the lay faithful. As such, this essay seeks to rectify some of these misunderstandings and provide recommendations about how Catholic healthcare ethics can advocate for ACP in Catholic healthcare organizations. To do so, this essay aims to define common forms of ACP, provide appropriate information on the Catholic position on ACP, detail the various ethical dilemmas that surround Catholic ACP, and further inform how Catholic ACP can contribute to the broader concept of a “good death” in the modern era of medicine.
An extension of this autonomy is to provide patients with the ability to make decisions in advance for one’s care; more generally known as advance care planning (ACP). This can consist of a general discussion about end-of-life (EOL) preferences, or be formalized into a more binding document, such as an advance directive. However, healthcare seems to be at something of a crossroads when it comes to the usage of ACP. There exist a strong majority of patients that wish to participate in ACP. Yet, many healthcare providers are hesitant to initiate the conversation to begin the ACP process. Some are hesitant from a position of sensitivity to the patient, others from a fear of retaliation, still others are generally uncomfortable in discussing EOL with patients.
Furthermore, there exists even more hesitation and antagonism against the Catholic Church and her teachings on ACP. Within the greater healthcare system, there exists something of a diminishing population of Catholic healthcare professionals who wish to practice the morality of Catholicism. This diminishing proportion of faithful practitioners has led to a poorer understanding and communication of Catholic teaching on ACP from the part of the lay faithful. As such, this essay seeks to rectify some of these misunderstandings and provide recommendations about how Catholic healthcare ethics can advocate for ACP in Catholic healthcare organizations. To do so, this essay aims to define common forms of ACP, provide appropriate information on the Catholic position on ACP, detail the various ethical dilemmas that surround Catholic ACP, and further inform how Catholic ACP can contribute to the broader concept of a “good death” in the modern era of medicine.