ETHICS AND END OF LIFE CARE
SUBMISSION BY TERESA LYNCH TO CICIAMS ETHICS COMMITTEE OCTOBER 2017 ON THE RIGHT TO LIFE
'Christian medical ethics (like the Ten Commandments) is applicable not only to convinced Christians, but to all men and women . This is because it embodies truly human values , based on an accurate picture of human nature and of what brings true hapiiness. It is founded upon the natural law , the dynamic law written by the Creator in the human heart. If we obey this divine law, we grow to our full moral stature . A sound medical ethics has universal application' Marsden,F ,Fr. (1998) Medical Ethics,Birmingham,Maryvale Institute,p.14.
"With ethics there must be certain ground rules. Instincts and emotions are not always reliable pathfinders. The particularly vulnerable nature of the sick allows for the possibility of exploitation, which is why the medical and nursing professions are bound by ethical codes which serve to emphasise the expressive needs of the patient as equally important as the technical requirements. Despite differing views from the professions about the rights and wrongs of strike action, all doctors and nurses must be aware that a patient is not a means to an end, but an end in him or herself".
Teresa Lynch MSc RGN RNT, Association of Catholic Nurses/CMA/ Founder of Nurses Opposed to Euthanasia
CARE NOT KILLING WEBSITE NEWS UPDATES ON PROPOSED CHANGES TO EXISTING LEGISLATION ON ASSISTED SUICIDE
ASSOCIATION OF CATHOLIC NURSES STATEMENT OF CONCERN - THE LIVERPOOL CARE PATHWAY
CATHOLIC CHURCH ENGLAND AND WALES-PRACTICAL GUIDE TO THE SPIRITUAL CARE OF THE DYING PERSON
NURSES OPPOSED TO EUTHANASIA
WHAT IS PALLIATIVE CARE BY DR YOLANDE SAUNDERS
MEMORANDUM OF THE ASSOCIATION OF CATHOLIC NURSES 2004 TO THE HOUSE OF LORDS SELECT COMMITTEE ON ASSISTED DYING FOR THE TERMINALLY ILL BILL INTRODUCED 9TH NOVEMBER 2005(JOFFE BILL)
CLICK LINK ABOVE FOR FULL TEXT OF STATEMENT ON THE UK PARLIAMENT WEBSITE
As an organisation we are grateful for the opportunity to comment on the above Bill, and hope our thoughts will assist the committee to produce a balanced conclusion whilst ensuring the continued sanctity and dignity of all human life.
The Association of Catholic Nurses for England and Wales (formally the Catholic nurses Guild) has been established for over 100 years and is a member of the International Committee of Catholic nurses and Midwives (CICIAMS). As an organisation it is concerned with the professional life of nurses on a spiritual and ethical level, dedicated to the care and respect of human life.
The Catholic Church teaches us that life is given to us by God and is to be respected and cherished by all, from conception to death, and that only God has the right to take that life away.
2. BELIEF AND CONCERN
The Association agrees all attempts should be made to relieve the suffering and distress of those experiencing terminal illness, to receive the expert help and advice of palliative care experts, hospice care and given appropriate pain relief and alternative therapy. This care should be ongoing and in agreement with the patient.
Our concern is raised when measures beyond those of adequate pain relief are considered in full knowledge that the measures considered would end life.
3. INDIVIDUAL REQUEST
Individuals expressing a desire for assisted death due to terminal illness have the right to expect analgesia for the purpose of pain relief, so they may be kept comfortable. The same as they have the right to be cared for with compassion and love by professionals, trained to deliver that care. However it is believed measures that go beyond the accepted level of analgesia with the purpose of ending life is wrong in the eyes of the Catholic Church. This is a belief shared by many Christian and non-Christian beliefs; we therefore do not stand alone in our aim to preserve life.
4. COMPETENT ADULT
Competent adults should, and currently are, able to decide on whether to accept treatment extending their life through the direct intervention of healthcare professionals. This would include the right to have, or not to have further tests, artificial ventilation or feeding. There are currently many cases whereby professionals, because of the patient's distress, weakness or the disease process, question the competence of the adult. With the assistance of the psychiatrist these decisions often remain unclear, and professionals are left battling with their conscience. It is feared this could be the case with those wishing to take part in the assisted death of the terminally ill and may leave some questioning their professional knowledge and moral integrity.
5. PROTECTION FOR THE PHYSICIAN AND OTHER MEDICAL PERSONNEL
Concern is raised over pressure that may be put upon the consultant physician from professional colleagues, or relatives to support the action should they feel it is in the best interest to assist them to die. This pressure could easily be exerted on other health professionals, who work closely with the patient, and we see nurses very much in this group, to persuade the physician on behalf of the family. It is understood all physicians will be clear about their right to refuse to participate in this, however in emotive situations they may become vulnerable and open to persuasion.
You will be aware nursing staff are often questioned on ethical issues, and these questions, with increasing frequency, relate to whether something had been "done" to the patient to speed the death because of service pressures. This we know is not the case, but the question will become more common place should this bill be passed.
It is the belief of the Association of Catholic Nurses this Bill should not be passed in order to protect the vulnerable and preserve the sanctity of all life. It is believed God gives life and should only be taken by God at His Choosing. The terminally ill should be treated with dignity and respect, with all aspects of care attended to, to the highest standard, but no one has the right to choose the time of their dying.
RESPONSE FROM THE CONGREGATION FOR THE DOCTRINE OF THE FAITH TO CERTAIN QUESTIONS RAISED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS CONCERNING ARTIFICIAL NUTRITION AND HYDRATION
September 14th 2007
The replies were approved by the Holy Father during an audience granted to Cardinal William Joseph Levada, prefect of the congregation. The text of the responses has been published in its Latin original and in English, French, Italian, German, Spanish, Polish and Portuguese.
"First question: Is the administration of food and water (whether by natural or artificial means) to a patient in a 'vegetative state' morally obligatory except when they cannot be assimilated by the patient's body or cannot be administered to the patient without causing significant physical discomfort?
"Response: Yes. The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.
"Second question: When nutrition and hydration are being supplied by artificial means to a patient in a 'permanent vegetative state,' may they be discontinued when competent physicians judge with moral certainty that the patient will never recover consciousness?
"Response: No. A patient in a 'permanent vegetative state' is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means."
An English-language note accompanying the responses indicates that: "When stating that the administration of food and water is morally obligatory 'in principle,' the Congregation for the Doctrine of the Faith does not exclude the possibility that, in very remote places or in situations of extreme poverty, the artificial provision of food and water may be physically impossible, and then 'ad impossibilia nemo tenetur.' However, the obligation to offer the minimal treatments that are available remains in place, as well as that of obtaining, if possible, the means necessary for an adequate support of life. Nor is the possibility excluded that, due to emerging complications, a patient may be unable to assimilate food and liquids, so that their provision becomes altogether useless. Finally, the possibility is not absolutely excluded that, in some rare cases, artificial nourishment and hydration may be excessively burdensome for the patient or may cause significant physical discomfort, for example resulting from complications in the use of the means employed.
"These exceptional cases, however, take nothing away from the general ethical criterion, according to which the provision of water and food, even by artificial means, always represents a 'natural means' for preserving life, and is not a 'therapeutic treatment.' Its use should therefore be considered 'ordinary and proportionate,' even when the 'vegetative state' is prolonged."