"Whether
in Life or in Death, We are the Lord's" Romans 14: 7
Most
Reverend John J. Myers
Archbishop of Newark
I.
Introduction
Many of us have
experienced the sadness and suffering of standing close by as the life of a
loved one fades and comes near the end of the time ordained for this world. My
father, my sisters and brothers and I knew this ordeal when we had to make a
variety of decisions as my mother's life faded and she underwent a series of
medical emergencies. The occasions and the discussions were difficult, even
wrenching. Fortunately, the family is close and our relationships have remained
good. Finally, in God's time, He took her to himself. We have been deeply
comforted by the faith which we shared with her, and which she nurtured in us.
In this spirit,
I wish to share some reflections with those in the Archdiocese of Newark who may
now or sometime in the future seek comfort in Jesus Christ's victory over sin
and over death.
The words from St. Paul's letter to the Romans, in the title, direct us toward
the very heart of Christianity. Jesus is sent by the Father to reveal the
Mystery of God as a community of persons in a relationship of loving communion.
As the revelation of the Father, Jesus, through His humanity, shines light on
what it means to be a person created in the image and likeness of God, what it
means to be truly human. By His death and resurrection, Jesus redeemed us and
made us His own, giving us the means necessary to experience here and now what
we will live fully when we have passed from death into eternal life. The Gospel
celebrates the truth that "Whether in life or in death, we are the Lord's."
For the Christian people, Jesus remains "the glory of man fully alive." Christ
alone completely reveals what it means to express the love from which and for
which we were created. Through the Church, God continues to reach out to us in
the person of His Son. Through the power of the Holy Spirit, God enables us to
understand just what it means to live as men and women created in the divine
image. The invitation of Christ is a call for all men and women to encounter the
Divine Presence. This encounter affords us the opportunity to bring the most
troubling and heart-wrenching questions of human existence to the One who
provides us the way to understand and to address the most difficult
circumstances of life.
The revelation of God proclaimed by Jesus was expressed most perfectly and
definitively through His own willingness to suffer and to die. Jesus is,
therefore, precisely the one to whom we should turn when we find ourselves
confronted by the reality of death in our own lives or in the lives of those we
love. He didn't simply talk about suffering and death; He endured them and He
prevailed over them. Jesus teaches us not only what it means that "in life and
in death, we are the Lord's." He also enables us to live the truth of the words
St. Paul has spoken.
II. What
We Must Ask Ourselves
Earlier this year, our nation, indeed the world, watched with stunned
fascination the unfolding of death in the life of one American family. The death
of Terri Schiavo saw unparalleled media scrutiny. Although we may not know all
the facts, we do know that many questions remain, including, for some, confusion
about Church teaching in these matters. At the center of our confusion lies a
set of important questions:
• What is the nature and meaning of personhood?
• What is our moral responsibility to provide food and water to those who are
unable to care for themselves?
• What is the role of competent medical authority in assessing the condition of
those who seem incapable of human response?
• What are the obligations of a democratic society to safeguard the lives of
those most vulnerable and in need of care?
In order for all of us in the Church to be able to make informed and morally
licit decisions when our own health is seriously diminished or death is
imminent, we need to review the Church's teachings on these important questions.
Every day in our country, feeding tubes are removed or refused without garnering
even local media attention. What set the case of Terri Schiavo apart, what
indeed made this situation so unusually tragic, was the struggle between two
groups. One group considered Terri as a person who existed with them in loving
relationship; the other group considered that her personhood had ended long ago.
One group felt that the loving thing to do was to continue caring for Terri; the
other group seemed convinced that it was an act of love to move her from life
with God here to life with God in heaven.
In the midst of the overwhelming media coverage of Terri Schiavo's dying and of
her death, many of us perhaps stopped seeing her as a person but rather as an
idea or as a cause, or in a worst-case scenario, as a political tool. In the
midst of this confusion, we cannot allow ourselves to forget that beneath all
the arguments was a living human being.
We all need to keep in mind that Terri Schiavo was and is a person, a sister in
our faith. Though much that transpired in the process of her death was
disordered, she is with the Lord and she has become, in a sense, a symbol of the
confusion in America over the tension between individual autonomy and communal
responsibility. Certainly, this experience underscores the need of making one's
wishes known in writing and in a form which is recognized in particular
jurisdictions.
III.
Death is Our Reunion with Christ
We need to remind ourselves that death is not an evil that should be feared. In
the words of the ancient preface of the funeral liturgy, "Lord, for your
faithful people, life is changed, not ended; and when the body of our earthly
dwelling lies in death, we gain an everlasting place in heaven." Death is not
only an end to "earthly" existence; it also is the passageway to eternal life.
Unnecessarily prolonging death, clinging at all costs to this life, can be an
attempt to reject what our faith boldly proclaims, "Death has no more power over
Christ!"
It is a virtuous practice to pray for a happy death, and many Christians have
implored St. Joseph to obtain for them what each priest and religious prays for
every night, "a peaceful death." While we should not hasten our death, we must
not fear it either. St. Benedict reminds us to pray for death each day, as if it
were to come tomorrow; for we know neither the time nor the hour of its
approach. Our hope is not to live our mortal lives without end, but to live for
all eternity with God.
The mystery that shrouds death causes fear for many. Faith nonetheless
strengthens what is lacking in our human frailty and gives us the courage to
embrace what we cannot change. Faith also recognizes the necessity to be
fearless in the face of death. "Where I am going you know the way," Jesus tells
His apostles. We must live with confidence that Christ is preparing a place for
us and will indeed return to unite us with Himself.
While we live as God's children now, we long for the moment when we shall become
like Him and see Him face to face. The way we respond to the suffering and death
of those whom we love, the way in which we embrace our own mortality, speaks
volumes about the way in which we have accepted that Jesus Christ is Lord of the
living and the dead. The inability to accept that suffering is redemptive, or
the inclination to immediately end the pain of those who are suffering, reveals
that we have not yet accepted the Way for us to live the fullness of our
humanity. Likewise, the refusal to accept that death comes to all, shown by
attempts to maintain biological vitality at all costs, also reveals a failure to
place our hopes in Christ. Christians always must embrace life here and now with
their hearts and minds set on a world that will never end, a world in which
every tear will be wiped away.
IV.
Forming End-of-Life Decisions
Our attitude toward death must be an extension of our attitude toward life.
Living now for God will determine how we will face the moment when we pass from
this world to the next. In order to help the faithful put in place appropriate
and clear legal and medical directives, the Church has articulated a set of
principles derived from the most fundamental teachings on the dignity of the
human person and the inherent dignity of each human life. Just as every
individual human life is unique and unrepeatable, from conception until natural
death, so too the physical suffering and medical condition of each person is
unique and cannot be generalized. The following ethical principles of the Church
respect this aspect of our individuality as children of God. They are meant to
serve as a helpful guide to end-of-life decisions, allowing us to embrace
suffering and death in freedom, and with peace of mind.
Our
Obligation for the Proportionate Means of Preserving Life
Life is sacred, for it is a gift from God. As recipients of this precious gift,
we are always morally obligated to use ordinary means for maintaining and
insuring physical health. "Proportionate means" describes those medical remedies
and procedures that in the judgment of the patient and competent medical
authority, in light of the Christian understanding of the dignity of human
persons, offer a reasonable hope of benefit. Many of us employ this principle
without much thought as we consider to what extent we wish to experience the
side-effects of over the counter remedies for such common ailments as the flu, a
cold, a sore throat, a headache, or muscle pain. At times we forgo a remedy in
favor of letting the illness "take its course" because we do not wish to be
hindered by the side-effects of the remedy being considered.
This common-sense approach to illness, one with which we are all familiar, is to
be applied to those illnesses that are more severe and life threatening. Our
reasonable hope in the benefit of a proposed treatment should not reflect an
attitude of preserving life "at all costs."
The Presumption in Favor of Providing Nutrition and Hydration
As members of the human family, every man or woman, regardless of age or
socio-economic condition, requires a set of fundamental human goods, among which
are those required for maintaining life: food, air, and water. Without these
primary goods, other basic human needs become inconsequential.
To insure that the human dignity of every person is respected, there must always
be a presumption in favor of food and hydration, even for those patients who
require assistance for the delivery of those goods. When specific medical
conditions indicate that a medical treatment may place excessive burdens on the
patient without a sufficient benefit, the decision not to undertake such a
treatment can be morally licit. When such a decision is made, continued care
must be extended, including offering food and water to the extent to which the
patient is able to receive them.
The presumption for food and hydration must also be carefully weighed, however,
in consideration of both perceived benefit and excessive burden. This is
especially true when a feeding tube has already been inserted. Depending upon
the assessment in light of proper ethical principles and in consultation with
proper medical professionals regarding the condition of the patient and the
capability of human response, it may be morally licit not to undertake
artificial nutrition and hydration, providing that the intention is not to bring
about the death of the patient and that basic care is continued. For instance,
if the food and hydration in fact harms the patient, then capping or removing
the feeding tube would be a prudential judgment to relieve unnecessary pain and
suffering. The patient himself or herself or the designated surrogate are the
proper persons to make any required decisions.
Forgoing
Extraordinary or Disproportionate Means of Preserving Life
Often when it is time to make a decision to forgo extraordinary means of
preserving life, families and loved ones are overwhelmed by the situation at
hand. They may be pressed for decisions on whether or not to harvest organs,
whether or not to remove life support or assisted respiration, or whether or not
to accept a diagnosis of "brain death." In such moments, when there is little
time to work through the facts and the emotions of the situation, it is
important to realize that the Church's teaching is not "life at all costs." A
discussion of reasonable hope and excessive burden is not a denial of love and
care for the person who is suffering.
Whether or not a proposed medical procedure is "extraordinary" or
"disproportionate" can only be determined with reference to a specific medical
condition of one given individual. Not all cancer patients, not all
non-responsive individuals, not all persons facing imminent death can be
assessed under a predetermined protocol. An informed judgment can only be made
by the patient or legal surrogate in close concert with medical professionals in
the light of Church teaching.
The intensity of emotion can inhibit our ability to assess either the hope of
benefit of the proposed treatment or any potential burden that treatment might
inflict on the patient and on those responsible for providing the care - the
family, doctors, nurses, and aides who are tied in love and charity to the
patient. It is essential to establish a loving human relationship between the
medical caregivers and the patient in order to insure that the dignity of that
person is appropriately respected. Always, provisions should be made that the
person receive the sacraments of the Church, including the Apostolic Blessing
reserved for those near death. The family and friends should have the benefit of
the ministry of the Church, and representatives of the Church should encourage
them with prayer and by sharing our faith in Jesus and the salvation He offers.
The
Importance of Making a Free and Informed Judgment
In order to assure a patient or a chosen legal surrogate that the decisions made
regarding the end of life are licit and expressive of faith in Jesus Christ, the
Church encourages all the faithful to seek guidance from medical professionals
and from pastoral caregivers.
An informed decision should include competent medical authority. We must welcome
and embrace all that has been learned by those who practice the medical arts as
a vocation of human relationship. The development of this relationship will help
remind all parties involved that the decisions to be made are always moral, as
well as scientific.
No one should feel alone or incapable of deciding what best respects the
individual dignity of the person suffering. When fully informed by the teaching
of the Church, each Christian's prudential judgment regarding end-of-life issues
is an exercise of that same freedom we experience in our sacramental union with
Christ. It is the same freedom we feel having celebrated the sacrament of
Penance, the same freedom we feel receiving the Eucharist, and the same freedom
we feel in the loving company of those whom Christ has gathered around him in
friendship.
On the
Nature and Meaning of Human Personhood
Those whose lives are dedicated to the medical arts can also help us understand
the Church's teaching on the nature and meaning of being a person. The advances
in our knowledge of the workings of the mind and body as a compact unity affirm
that which the Church has always held: being a person is a gift of having been
created in the image and likeness of God. While all created reality serves God's
purpose, only human beings are able through their physiology and spirituality to
participate with God in the work of creation. Likewise, the medical arts are a
supreme example of our ability to work with nature as we journey toward our
completeness in physical health and through a "long stretch of days." Medicine,
when rightly practiced, seeks to insure that all men and women can experience
their humanity with vitality and fullness.
While all living creatures reveal the mystery of God in a way unique to each,
only human beings reveal the mystery of God in a way not determined or limited
by physiology alone. Only human beings can act in such a way that their life in
the body conforms to their hearts, their minds, and their wills. This is why a
human being is rightly called a person, for human beings are more than the
aggregate of physiological integrity. They have a spiritual life as well, and
are capable of thought and decision, even though in the embryo or fetus these
abilities are present potentially.
When assessing the mental state or physical condition of a developed human
being, competent medical authorities seek to determine the extent to which
everything physically required for an individual to express him - herself,
beyond merely bodily response, is functioning appropriately. Our medical
professionals try to ascertain whether or not, in some appreciable measure, the
individual is capable of communicating, "I am present." While this diagnostic
communication is taking place, we should all encourage our doctors to be open
and honest with us as patients, family, and friends. Participating in a genuine
relationship with our doctors requires that we trust their professional
judgment, especially when the situation is deemed life-threatening.
When facing end-of-life situations, we should never forget that personhood and
human life are inextricably bound together. The Catholic Church teaches that the
dignity of personhood is an innate dimension of being human. Personhood and
human life can never be separated, for they are a unity willed by God. The
Church looks to the advances made in the medical arts to understand better those
situations in which the unity willed by God is no longer viable.
Each human person, therefore, is always more than the sum total of biological
integrity. While it is true that human beings can be physically and mentally
disabled by imperfections of the mind or body, it is never true that the
physical or mental diminishment of a human being means that an individual is no
longer a person. Personhood must never be thought of solely as a judgment
imposed by others. Being a person is the ultimate gift of having been created by
God in such a way that one can choose to share God's life. To make such choices,
we must first have a degree of mental and physical health that enables us to do
so.
On the
Question of Euthanasia
Many, many Catholics have shared the experience of tending to their loved ones
in their last days and know the complexity of the emotions and questions which
can arise. Their love for the Creator and His will offers sure guidance and
comfort in protecting life appropriately, even when the situation is beyond our
understanding.
We must be careful as a nation that the laws we enact to promote and protect our
prudential judgments over end-of-life issues do not intentionally or
unintentionally allow for the direct termination of a human life. What a person
experiences in embracing suffering and death informs and instructs others about
the responsibility we have to one another in love. Human life will only be
cherished and sacred to the extent that the commitment we make to respect, care
for, and love one another is unwavering.
V. The
Sacrament of Presence
For the Catholic faithful, the gift of each life is essentially a "sacrament" of
presence. This teaching emanates from the fact of God becoming man in the person
of Jesus. The abiding sign of the Church's belief in the dignity of the human
person is the belief in the real presence of Christ in the Blessed Sacrament. By
Jesus' words and the power of the Holy Spirit, the Eucharist is the means by
which Jesus' real presence remains with us until the end of time. Through the
power of the Holy Spirit, the goods of creation are used to permeate the whole
of human history with the Presence of divinity. What appears as simple bread and
wine communicates a Presence that transcends our human senses.
In the same way, human life is able to communicate a Presence that transcends
what we sensibly perceive. Through the power of the Holy Spirit, individual
human lives are incorporated into the life of Christ in such a way that they
become the means by which his Presence is encountered and experienced in the
world. Just as we cannot reduce the elements of the Eucharist only to that which
we are capable of sensing, we must likewise never reduce a human life to what is
merely biological.
Every human life bears the dignity of the Creator. No human life is ever
considered to be the mere sum of biological and physiological processes. These
natural processes ordered toward and directed by the brain, allow a person the
sense of being present. Because of advances in medical technology, the precise
time of death can be difficult to ascertain. Both ethical and medical criteria
should be applied, often in dialogue with those with special training. Again,
the patient or proper surrogate should make any decisions, fully informed of the
teaching of the Church.
For the Christian people, baptism empowers the original dignity of personhood to
become an active and innovative sign of God's love as a present reality. That is
why the Church speaks of the "quality" of a human life as something greater than
one's emotions or reflexive responses. The quality of each human life lies in
the fact of its presence as a living, existing reality that remains an incarnate
sign of the God who created all things.
Therefore, special and loving care must be extended to each human being,
especially those no longer experiencing life as the compact unity that God
intended. For them and for those who have died, we have a singular
responsibility to insure that our treatment of them is worthy of the dignity
they possess as having been created in God's image and likeness. Whether in life
or in death, every one of us matters.
Veneration for and care for the body does not end with death. Since the body is
integral to the human person, Christian believers have, from the earliest days,
accorded the body special respect. It is preferable that the body be buried with
due solemnity and with prayers for the deceased. Together, after all, we look
forward to its resurrection and to our more complete sharing in the Life of
Christ.
VI.
Conclusion: Keeping Vigil with the Dying
To stand with others and keep vigil while they suffer and die is the greatest
gift of love a human being can experience. It also provides the greatest
opportunity to learn. Those who suffer and those preparing to die have much to
teach the healthy and the living about the mystery of our humanity and the
dignity that is ours through our relationship with God. Every human life is
valuable. Those who keep vigil with the dying are familiar with the overwhelming
beauty of this truth.
We witnessed this recently through the unfolding death of John Paul II. While
the world watched the controversy surrounding the last days of Terri Schiavo,
this great man offered his life as a testimony to what the Church believes and
holds sacred. His choices about how he would die embodied the way he chose to
live: of and for the God who had called him to the priesthood and eventually to
stand as Peter. In life and in death, John Paul II made it clear that he lived
for God. Through his own slow demise, he became an icon of human dignity and a
sacrament of the inherent worth of each individual person.
Christ demonstrated this for us on the Cross. He allowed the experience of His
physical condition to become an opportunity for others to learn what only those
who are dying are capable of teaching. Like the crowd of people who stood and
kept vigil, we are challenged to find our place near "the Cross" of other
people's suffering and death.
The grace of keeping vigil touched the lives of the men who were present only
out of duty and obligation. It was the job of the soldiers to stand and keep
vigil. What Jesus revealed through His suffering and death changed the lives of
many of those men; they experienced something beyond what they were used to or
what they expected. It was because of the way that Jesus embraced the dignity of
His personhood through the reality of His tortured and diminishing humanity that
one of the men was forced to say, "Truly this was the Son of God." At the moment
of the Cross, humanity and divinity were perfectly one in a glorious way.
Others were moved to be present for varying reasons, some out of genuine human
compassion. They were affected in ways they could not have anticipated. Their
willingness to keep vigil opened their eyes to the revelation of Divinity that
was only possible through the diminished physical body and limited human
responsiveness of Jesus. That afternoon they walked away with a deeper insight
into the dignity of their own fragile and vulnerable humanity because they
recognized in the suffering and death of Jesus the real presence of God.
Those who had felt such a presence throughout Jesus' public ministry were also
there that day. Foremost among them was John, the beloved friend who had left
everything to come and see the one who just might be the messiah. No one can
imagine what John felt as he kept vigil with Jesus dying on the Cross. We can
say with utmost certainty that the moment of the Cross defined everything John
thought about Jesus and every experience they shared. For Pope John Paul II, one
of the greatest gifts he received from Christ was that many kept vigil with him
while he died.
Next to John at the foot of the Cross was Mary, the Mother of Jesus. She
experienced the grace of keeping vigil with the dying in a way unlike any other.
What she learned through the suffering and death of her only Son was a gift
entrusted to the Church at its inception. It remains a gift preserved by the
Church to this day. Mary's insights about suffering and death, her solidarity
with those whose lives are physically and mentally diminishing, are a great
consolation to all of us who will one day pass from this life to the next. What
Mary is able to teach us can help us in the decisions we make about how we will
approach the end of our lives. Let us ask her to assist us now and at the moment
of our deaths in order that we may see with greater clarity how to live both our
life and our death as she did: for the Lord.
Given at my
Chancery this 8th day of September, 2005, The Nativity of the Blessed Virgin