The Ethical and Religious Directives for Catholic Healthcare Services reiterates that a person has moral obligations to use means of preserving life that offer a reasonable hope of benefit and do not entail an excessive burden. A person may forgo treatments and procedures that do not offer reasonable hope of benefit, or that entail excessive burden (Nos. 56, 57).

Fr. Richard Mc Cormick, SJ, a Catholic theologian, wrote that we must walk a balanced middle path between medical vitalism and medical pessimism.[1]

Medical vitalism is the view that preserves life at all costs. It permits no cessation of efforts to prolong life. It views that life is the greatest possible value and should be sustained at all costs. Medical pessimism is the other view that “kills when life seems frustrating and burdensome.”[2]

Dr. David Kelly, a Catholic bioethicist also uses the term subjectivism to describe an absolute, autonomous choice of an individual to pursue or cease treatments or procedures. 

Subjectivism is a phenomenon common in a society where there is extreme individualism and when every choice is good so long as it has the permission of the autonomous agent. The subjective view does not consider the moral implications of specific treatments and decisions.[4]  What is important for the person is the emphasis on autonomy, and the ability to satisfy individual preferences. The extreme position of subjectivism is the permission of active killing based only on the subjective choice of an individual.[3] 

The Roman Catholic Tradition has rejected vitalism, negativism, and subjectivism. The Church teaches that life is indeed a basic and precious good, but a good to be preserved precisely as the condition of other values.[5] However, life should not also be prolonged under all circumstances.

Extending life at all costs may be prevalent in our day and age when advances in medicine and technology are available to treat medical conditions and prolong life.  In turn, what we often encounter is the prolongation of the dying process. Death may be conceived as an antagonist of medical science, and we have the view as a technologically advanced society to do everything at all costs to avert death.

 The dignity and sanctity of life must be respected until the end.

Family members need to have a conversation and understanding of the importance of end- of-life care. It may be helpful to seek spiritual direction/counseling from a clergy, therapist, or social worker, especially when we are deciding for someone else. Fr. Richard Mc Cormick wrote, “The meaning, substance, and consummation of life are found in human relationships, and the qualities of justice, respect, concern, compassion, and support that surround them.”[6] We should all strive to keep relationships in the family and in the community even though we are struggling with illness and health crises.[7]

Death is something that everyone must face. We need to confront it with openness and love. Our proper understanding of the purpose of medicine, the meaning of life as well as the Church’s teachings on both the sanctity and the quality of life will guide us in preparing an advance directive. This attitude and practice help ensure friendship and unity with our family, and most of all, with God, who is the creator of our lives.

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[1] McCormick, Richard, How Brave A New World? (Garden City, New York: Double Day and Company, Inc., 1981), 345.

[2]  McCormick, How Brave A New World, 345.

[3] David F. Kelly. Medical Care at the End of Life: A Catholic Perspective. Washington DC: Georgetown University Press, 2007, 5.

[4] Matthew P. Lomanno, Healthcare Proxies, 2017.

[5] Richard Mc Cormick, How Brave A New World, 345.

[6] McCormick, How Brave a New World?, 346.

[7] McCormick, How Brave a New World?, 346.