Editor note: This is the first in a series of articles that will explain and explore the Church’s teachings on end-of-life and palliative care issues.
Dr. Paul Fiacco is the president and medical director of CNY AIM, a St. Joseph 's Health clinically integrated network, and is also the medical director of the Trinity Health integrated Care ACO as well as a full-time physician at CNY Family Care in East Syracuse. He is a parishioner at Holy Cross Church in Dewitt, New York.
Father Charles Vavonese is a retired priest of the Diocese of Syracuse, associate chaplain for the Syracuse Region of the Order of Malta, and the author of "I Am the Resurrection and the Life, " a resource booklet dealing with end-of-life moral issues. He currently serves patients receiving palliative care as the chaplain for the St. Joseph Health Mobile Integrated Services Team. In addition, he assists on weekends at Holy Cross Church in Dewitt, New York.
Over the past few decades, the Vatican has emphasized the need to educate the faithful regarding end-of-life moral teachings and palliative care. Recently, Pope Francis has gone further and published a white paper on the topic: "Global Palliative Care." The Federal Association of the Order of Malta has taken up the Church’s mandate and initiated several end-of-life palliative care projects for its members. This series of articles that will appear in future editions of Malta Moments is one of those initiatives.
The goal of this series is to educate Knights and Dames about the interaction of spiritual and medical care, which will provide a holistic approach to the end-of-life decision-making process. By building on the foundation established in the Defense of the Faith Committee’s booklet, this series will communicate information in short segments that will make it possible for knights and dames to deepen their own understanding of the relationship between Catholic end-of-life moral teaching and palliative care interactions, and help them become comfortable sharing this information with others in their communities. This willingness to share information will empower Catholics to undertake a ministry of conversation that may enable others to avoid the choice of physician-assisted suicide.
One hundred years ago, most people died of infectious diseases; today, most people die of chronic diseases. While medical technology has extended our lives, it has also presented us with several moral and medical dilemmas. This series will guide readers through these dilemmas.
Why is this important?
This ministry is critical because many Catholics do not know, or fully comprehend, the end-of-life moral teachings of the Church. This lack of understanding extends to the areas (and concepts) of ordinary and extraordinary medical care, as well as to the use of pain controls.
Also, any discussion of end-of-life moral issues would be incomplete without information about palliative care, which is the care people should receive after they are diagnosed with a terminal illness.
Palliative care improves the quality of the patient's life by lessening the severity of terminal conditions by preventing, treating, and possibly relieving the symptoms of illness. In addition to supporting the patient, palliative care may also provide support to the patient's family during this critical time. Sadly, many people are unaware of the medical care and comfort available after they receive a life-threatening diagnosis.
Guidance from the Vatican
As we contemplate the many complexities of Catholic end-of-life moral theology, it is imperative that we consult the definitive resource for Catholic health care institutions, "The Ethical and Religious Directives for Catholic Health Care in the United States." A new edition of this document was approved by the Vatican Congregation for the Doctrine of the Faith in 2018. When referencing this document, this series of articles will use the abbreviation ERD, followed by a number denoting a specific section of the document (e.g., ERD #25). This document is available for download from the United State Catholic Conference website, www. usccb.org.
Some of the topics for future articles will include: ordinary vs. extraordinary care and their moral implications, the appropriate use of pain medication, instances when food and hydration must be provided, the treatment that palliative care uses to improve the quality of the life for patients and their families, and documents that are useful at the end of life.