CONCERNS AT THE END OF LIFE

DEFINITIONS

PATIENT SELF-DETERMINATION ACT - A 1990 federal law that requires health care facilities to inform patients of their right to accept or refuse medical treatment and to formulate advance directives. The act does not require that a patient have a directive.

HEALTH CARE PROXY - A legally binding advance directive that specifies a “proxy” or “surrogate” who will make medical decisions on behalf of a person should that person become incompetent.

INFORMED CONSENT - A decision freely made in the full possession of one’s mental facilities and with adequate knowledge of all relevant moral and medical consequences.

DEATH - The natural and inevitable end of biological life.

SUICIDE - The intentional and deliberate taking of one’s own life. The Catholic tradition rejects suicide as a permissible way to escape suffering.

EUTHANASIA - A physician (or other) intentionally administers treatment (usually injection) to cause the patient’s death.

“an action or omission which of itself and by intention causes death, with the purpose of eliminating all suffering ... euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person” (John Paul II, The Gospel of Life).

MERCY KILLING - “Mercy Killing” is another name for euthanasia.

PHYSICIAN-ASSISTED SUICIDE - A physician provides an agent (usually drugs) to a patient with the intent that the patient will use the drugs to commit suicide.

PRINCIPLE OF DOUBLE EFFECT - A moral principle that provides guidance when an act or omission will have two consequences, one of which is moral and intended, the other evil but not intended, even though foreseen. In palliative care, treatment that seeks to alleviate pain but which also has the foreseen but unintended consequence of shortening life would be morally permissible.

KILLING/ALLOWING TO DIE - To kill is to be directly responsible for causing death. “To allow to die” refers to stopping treatment that is burdensome or offers no reasonable hope of benefit so tha the underlying pathology eventually causes the person’s death.

PROPORTIONATE MEANS - Medical treatments that offer a reasonable hope of benefit and do not involve an excessive burden.

DISPROPORTIONATE MEANS - Medical treatment that either does not offer a reasonable hope of benefit or imposes an excessive burden. We are not obligated to use disproportionate means to maintain life. To forgo them is to accept natural death, not to commit suicide.

PALLIATIVE CARE - The easing of pain and total care of patients for whom the goals of cure and prolongation of life are no longer possible or appropriate.

HOSPICE - A coordinated program of palliative and supportive services provided in both the home and inpatient settings that provides for physical, psychological, social and spiritual care of dying persons and their families.