by Mary Jo Dangel
Twice in the last eight years, I—ve been involved in making end-of-life decisions regarding my two adult sons, Tim and Ritch, who were born with cystic fibrosis (CF), an incurable hereditary disease. Although these decisions were the most difficult I—ve ever made, knowing the boys— wishes and the Church—s teaching on the subject, as well as having faith in the promise of eternal life, made it all easier, but not easy.
Our immediate family was aware that our older son, Tim, got his legal affairs in order before he and Holly married in 2000. In addition, we knew that he had signed his organ- and tissue-donor card.
In 2001, while waiting for a lung transplant, Tim, age 33, was admitted to the Intensive Care Unit (ICU) with life-threatening problems. Initially, his condition was serious but hopeful.
Tim was receiving nutrition and medications, and was hooked up to a respirator and other types of life support. His treatment fell under what the Church calls “ordinary” means: efforts that
offer more reasonable hope of benefit to the patient than burden. The Church teaches that such “ordinary means” must be used.
Tim took an unexpected turn for the worse. He became unconscious, and his vital signs were deteriorating. Although I prayed for miraculous healing, I knew that Tim—s situation was becoming hopeless. As I looked at my son, hooked up to all those tubes and machines, I thought of Mary as she watched Jesus hang on the cross and wondered, How long will Tim hang on his cross?
I wasn—t surprised when the compassionate CF specialist who had been treating Tim and Ritch explained why the medical team was recommending that we sign a do-not-resuscitate order. Through her tears, she explained that, if they tried to resuscitate him, broken ribs could puncture his diseased lungs. In addition, Tim—s weakened heart was likely to stop again.
Resuscitating Tim under such hopeless conditions falls under what the Church calls “extraordinary” means: efforts whose potential benefits do not correspond to the burdens they impose. Break the word apart and think of it as extra-ordinary (beyond ordinary). The Church permits allowing death to happen through withholding extraordinary means, but it condemns the willful taking of life through euthanasia and assisted suicide.
Thankfully, our family agreed that the only thing more painful than signing the do-not-resuscitate order would have been making Tim endure more suffering without any benefit. Although Tim wanted to be an organ and tissue donor, the condition of his body made him an unsuitable candidate.
Tim—s death convinced Ritch to get his own legal affairs in order. And the well-publicized disagreement among Terri Schiavo—s family in 2005 regarding removal of her feeding tube motivated me to bring up the subject of end-of-life wishes when our family gathered for dinner one night. We each explained our wishes before many witnesses.
Ritch, age 36, had a rare liver condition associated with CF. In 2006, he passed out due to internal bleeding and was admitted to the same ICU in which Tim had died. Ritch—s condition soon became hopeless: He was barely clinging to life despite blood transfusions and other life-support efforts. Fortunately, our parish priest visited and assured us that discontinuing life support in Ritch—s case was in line with Church teaching.
Ritch had signed his organ-donor card but, like Tim, his organs were unsuitable for transplantation. However, his tissues (skin, bones, tendons, etc.) could be used to save and improve the lives of many people. We said yes.
The same CF specialist who had been at the hospital when Tim was near death rushed to be there when Ritch—s life-support systems were discontinued. Again, we cried together, and I thanked her for taking care of my boys. Our immediate family stayed with Ritch until his heart stopped.
I can—t imagine how much more difficult it would have been to make these decisions if we hadn—t known Tim—s and Ritch—s wishes or if there had been disagreement among us. Death often happens unexpectedly. That—s why it—s vitally important to have one—s legal affairs in order, understand the Church—s teaching and discuss one—s wishes with loved ones and physicians.
The American Bar Association has information regarding health-care advance directives (living will or health-care power of attorney) and other related legal issues at abanet.org/aging.
The Pro-life Activities Web site of the U.S. Conference of Catholic Bishops (usccb.org/prolife) offers a comprehensive explanation of Church teaching on end-of-life issues.
Both John Paul II and Benedict XVI have spoken in support of organ and tissue donation. Pope Benedict, a registered organ donor, said, “To donate one—s organs is an act of love that is morally licit, so long as it is free and spontaneous,” reported Zenit International News Agency. In the Catechism of the Catholic Church, we read, “Organ donation after death is a noble and meritorious act and is to be encouraged” (#2296). Instead of focusing on what they did to “harvest” tissues from my child, I remind myself that each donor can help as many as 50 people. Today, there are over 100,000 candidates on the waiting list (organdonor.gov).
The deaths of Terri Schiavo in 2005 and of Eluana Englaro in Italy (2/9/2009) have brought the debate concerning artificial hydration and nutrition into our living rooms. Catholic teaching says: “A person in a —permanent vegetative state— is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care with includes, in principle, the administration of food and water even by artificial means” (Congregation for the Doctrine of the Faith, 8/1/2007).
Making end-of-life arrangements in advance reminds us of the dignity and value of our earthly lives and the eternal reward that awaits us in the next. Although these decisions are always difficult, drawing comfort from our faith and knowing our loved ones— wishes and the Church—s teaching can make it easier, but not easy. We will always miss Tim and Ritch, yet we find some peace in knowing we were able to honor their lives and wishes as they entered eternal life.
Permission to Publish received for this article, “Facing Life—s End With Faith,” by Mary Jo Dangel, from Rev. Joseph R. Binzer, Vicar General, Archdiocese of Cincinnati, 1-20-2009..
How do I feel about my own death? the death of a loved one?
How do my faith and the Church—s teachings influence these feelings?
Commit to having an honest discussion with loved ones, sharing feelings about death and the Church—s teachings about it.
Tuesdays With Morrie
by Frank Frost
Dealing with dying has always been difficult. But modern medical technology can make it even more so. Technology offers the extension of life beyond limits we had simply accepted in previous generations, often asking us to decide when to stop prolonging a life and let it end. Tuesdays with Morrie suggests a fruitful way to think about death and dying. Morrie, played by Jack Lemmon, tells Mitch (Hank Azaria), “When you know how to die, you know how to live.”
Based on a popular autobiographical book by Mitch Albom, the story tells how Mitch, a successful sportswriter, reluctantly pauses in his frenetic life to visit an old professor he learns is dying of ALS, or Lou Gehrig—s disease, only to get drawn into the life and lessons of the old teacher who insists they have one last thesis to write. At first Mitch shows extreme discomfort in the face of infirmity and impending death, but over time adjusts his attitude and his lifestyle in response to what he learns from Morrie. Morrie—s first lesson: “Death is just one thing to be sad about. Living unhappily, that—s another matter.”
Living unhappily is on Mitch—s mind. His girlfriend of six years is splitting up with him because his
priorities always put his love for her in second place. The course of their relationship parallels changes in Mitch, based on lessons he learns from his visits to Morrie each Tuesday.
We, too, can learn lessons from this movie. They suggest that the larger questions about what it means to live need to be answered before the legal questions that face many families when it—s time to die. Love and forgiveness enable us to instill life with meaning and to embrace death without undue fear.
Next time you watch Tuesdays With Morrie, ASK YOURSELF:
■ Notice the evolution of Mitch—s body language from his first visit with Morrie to his last. How can I grow out of my discomfort with infirmity and fear of death?
■ Morrie shares many aphorisms such as “Death ends a life, not a relationship.” What difference might these make in accepting the death of a loved one?
by Joan McKamey
“Jesus and I will be right here with you until the end. You won—t die in pain and you won—t die alone” is what Sister Mary Giovanni says to patients in her care. A Felician Franciscan for 45 years and a registered nurse for 35 years, Sister Giovanni founded Angela Hospice Home Care, Inc., in Livonia, Michigan, as a result
of her special love and concern for the terminally ill.
Angela Hospice opened in 1994 as the first freestanding inpatient hospice facility of its kind in Michigan. While the hospice concept is built on the idea that the family will give basic care for the terminally ill person in the home, this isn—t possible in many cases. The Care Center has 16 private patient rooms, family rooms and a family kitchen. Those being cared for have many of the same choices they would have at home: control over time of meals, baths and morning wake-up.
The heart of Angela Hospice remains its Hospice Home Care program which provides professional care to patients in the familiar surroundings of their own homes. Services have been expanded to include seriously ill children and their families. An extension of this effort is the development of the Prenatal Hospice team to serve families facing the birth of a baby who may not survive or may be born with a life-limiting illness.
Sister Giovanni tells Every Day Catholic, “As a young Sister, I saw the wonderful care our Sisters received as they were dying and how the spiritual care added to their peace. When I went to work at a hospital I could see how the [dying] patients were moved to the end of the hallway, the door was kept closed and hardly anyone went to see them. It was really sad. Nor was there any formal pastoral ministry in those days. Things have slowly changed for the better over the years.”
The third of 12 children, Sister Giovanni says, “My first real experience with death was when my brother Michael died the day after he was born. He was the seventh child. I remember my mother coming home from the hospital. We were so happy to see her, but she was so sad. This experience taught me how important grieving is and how one life can impact so many people. I drew many lessons from this to initiate our grief counseling at Angela Hospice.”
“Death is a new life. I have seen so many people die, and it is such a sacred moment when you can see that life has left the body and now their soul is before God for all eternity. What is difficult is the time between now and then. Our patients endure so much before their deaths. A cancer patient has been through all the chemotherapy treatments. The stroke patient may not be able to communicate. So it is up to us to show them that their lives have purpose yet. It is up to us to embrace them as Jesus would and to love them into their new lives.”
by Jeanne Hunt
Papa and five-year-old Marissa spent Wednesdays together. They—d go to the park and always end their time with a story. Suddenly, Papa died, and Wednesdays will never be the same for Marissa. Her sadness and confusion worry her parents. How should they explain her grandfather—s unexpected death to her?
Parents can help ease the grief of children. First, don—t shield them from the funeral. Allow them to attend a
portion of the event as suits their age. Give them a chance to be part of this closing chapter. Be honest and use the correct language: “Papa has died.” Saying that he has gone on a long trip builds mistrust.
Talk to children about our beliefs concerning death. Telling them that we will all see each other again in heaven gives them a comforting message of hope. Invite them to imagine their deceased loved one saying, “I love it here! Someday I want you to be here with me.”
Encourage children to write a good-bye letter or draw a picture. Place these with the other remembrances at the funeral or even in the casket.
Children often fear that they will also die. Parents should stress that death is a natural part of life and that most of us will live a long time. Use other moments of death—stories in which a character dies or the death of a pet—as natural lead-ins to discussions of feelings and beliefs about death.
After a family death, it—s good to keep photos of the deceased and stories about them in the forefront. Let children know that it—s good to share our memories. There is wisdom in an Irish wake: The joy of remembrance heals grief.
Finally, a word of caution: If a child—s mourning seems prolonged or the child is morose, it—s time to involve psychological support. A more skilled professional may need to help the child cope with the loss.
Marissa still misses Papa very much. She put his picture on her dresser and talks to him about how she misses him, especially on Wednesdays. Mommy and Daddy are helping her to understand. That makes her feel good inside. Daddy is sad too and says that whenever Marissa needs to snuggle or cry, he would love to hold her. Mommy says that Papa is with Jesus now and that heaven is a good place. Marissa feels like she has a Band-Aid on her broken heart, but soon she will be better.
by Jeanne Hunt
(for praying alone or with others)
Preparation: Place a white cloth, a lighted Christ candle, pictures of deceased family members and enough smaller candles and holders for those present on a prayer table.
A Taiz— Alleluia (or other reflection hymn)
O God, you are water for our thirst and manna in our desert. We praise you for the lives of [Name those remembered] and bless your mercy that has brought their suffering to an end. Now we beg that same endless mercy to raise them to new life. Nourished by the food and drink of heaven, may they rest forever in the joy of Christ. Amen. (adapted from Order of Christian Funerals)
2 Corinthians 4:16—5:1
LEADER: Let nothing trouble you. Let nothing frighten you. Whoever has God lacks nothing. God alone is enough. (St. Teresa of Avila)
ALL: Let nothing trouble you. Let nothing frighten you. Whoever has God lacks nothing. God alone is enough.
LEADER: You are invited to come forward and light a candle from our Christ light. As you place the
candle in the holder, proclaim the name of the one you remember.
After everyone has come forward, sit in silence and listen again to a Taiz— Alleluia.
LEADER: Let nothing trouble you. Let nothing frighten you. Whoever has God lacks nothing. God alone is enough.
ALL: Let nothing trouble you. Let nothing frighten you. Whoever has God lacks nothing. God alone is enough.