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Mike Humphrey wrote:
Stephen William Humphrey Jr., my very good father.

For the past three to five years up until May 28th, 2007 our family dealt with something we never had to deal with before: the death of a loved family member, my father, Stephen William Humphrey Jr. who I privately refer to St. Stephen of North Sudbury. (Note: I overlook the last few years where he really didn't have his mentals.)

I can now appreciate the anxiety and variety of emotions among family members that go along with the death of a loved one when he/she is near death; probably more than I experienced because we are a pretty closed-knit family.

The main thing I prayed for was that my father have a Catholic death.

I wanted to share with you some of my struggles during this period of time. Although at times I felt like an emotional basket case, the Lord blessed my heart and mind to dialogue about the Church's teachings on "End of Life" issues, with my colleague, Richard Chonak, who lost his temporal mother a few years back.

Although he was unaware of it, my dialogue with Richard was immensely helpful when my non-practicing Catholic mom came to me personally asking about how to deal with the doctor's question:

Mrs. Humphrey, Do you want to give us permission for a DNR (No Not Resuscitate) order?

For this reason he has permitted me to share our dialogue via e-mail below.

Mike

{ On the passing of my father — dialogue and reflections. }

Mike replied:

Sat 5/19/2007 4:33 PM

Hi guys,

I forgot to tell you that my temporal father is on a respirator and not responsive to anything.
The doctors have been starting to ask my mother "those" questions about whether we want them to resuscitate.

My mom, who is not a religious person, asked me, and I think I put it in a simple manner.

  • If you are not the Author of Life, why should we give any doctor the OK to be the Author of Death?
  • Why should we give any doctor the OK to break their Hippocratic oath?

I can appreciate the difficulties that families go through during this period of time, with the evil ones placing anti-life thoughts on their minds.

In my opinion, this period of time is a mystery of faith. Why?

Because as I sat there, praying and watching his vitals, with my worldly eyes and maybe some secular ideas, I had said that things seem hopeless.

Nevertheless, the Catholic faith side of me was saying, that my father, like myself, has (present tense) a specific purpose in life and even though I can't communicate with him, he is fulfilling that purpose in a way I can't understand but I know is ordained by Our Lord. (Maybe through a redemptive suffering, though he didn't seem to be in pain.) My job as a faithful son, to pray and be with him. After all he is breathing, his heart is beating and he does have some blood pressure.

To those that have little or no faith, they wouldn't be able to see this "mystery of faith" because they don't understand that as long as Our Lord ordains that my father lives another hour he is fulfilling the purpose he was created for from the beginning of time.

I am familiar with what is required and not required in these situations by the Church.

All I'm praying for is a holy Catholic death .. if this is his time. I said the St. Michael exorcism prayer to ward of the demonic spirits several times last night before I left the hospital at 5:30am.

He wasn't suppose to make it through the night :)

Pray that we can stand up to the "culture of death" mind set these doctors appear to have and maybe a miraculous recovery?

Mike
Father: Stephen William Humphrey Jr.
Mother: Dorothy Mae Humphrey
Brothers: Stephen and Mark
Steve's Family: Wife Denise
Mark's Family: Wife Pam: Kid: Katy, Brain, Justin, Stevie

Richard replied:

Sat 5/19/2007 4:43 PM
Hi, Mike —

Don't be stricter than the Church here: not all treatment, including resuscitation, is mandatory.

The National Catholic Bio ethics Center (an orthodox organization) puts it this way:

"We are also free, however, to refuse treatment that is of dubious benefit or when its burdens are clearly greater than its benefits."

A Catholic Guide to End-of-Life Decisions

If it helps any, it might be worth considering the example of Cardinal Cooke of New York, who was diagnosed with cancer in 1965, and after some years of treatment, eventually turned down further therapy and died in 1983. Fr. Groeschel is promoting his cause for sainthood.

— RC

Mike replied:

Thanks Rich,

I'm aware of what you sent but don't be less strict than the Church.

I'm trying to approach it the way Our Lord would want me to. I don't see what's wrong with that.

Mike

Richard replied:

Mike,

You are right to say that a doctor should not be an "Author of Death".

We must not act so as to *cause* death.

  • Refusing food and water would cause illness and death directly.
  • Refusing simple treatments or common medications would be bad, too: that would cause illness and death by negligence.

However, using extraordinary treatments such as respirators is not required. If a patient (or his family) declines to use such treatments, that is simply accepting death when it comes.

If a resuscitation would help your father return to consciousness, and remain alive indefinitely without a respirator, those would be clear benefits that would make resuscitation worthwhile, perhaps even a duty.

But if you don't expect a resuscitation would lead to any stable improvement, it is not required; there is no duty to hold off death for another six hours or two days by performing a resuscitation.

But I trust you are spending time with your father during his last days and hours, as Our Lady and St John did at our Lord's side.

If you're concerned that my advice on this is less strict than the Church, please let me know.

— RC

Mike replied:

Hi RC —

I thought these specific paragraphs addressed the issue pretty well.

Obligatory and Optional Medical Means
Specific Moral Teachings of the Church

My dad's condition would obviously be no burden on me at all and I'm not going to let any doctor break their Hippocratic oath. I personally don't want any of my family members nor doctors killing my father either.

If they removed the status quo (current life support), that's what they would be doing **PERIOD**.

Pius stated: "Life, health, all temporal activities are in fact subordinated to spiritual ends."

I'd agree with him here.

Among family members, these issues over time have to be addressed if they critically effect **their** spirituality and spiritual needs.

I still may have a bone to pick with Pius XII, and I think I'm allowed to as a Catholic because this is not a dogmatic or doctrinal issue, but only moral **guidelines** issue when he says:

"Normally one is held to use only ordinary means-according to the circumstances of persons, places, times and culture-that is to say, means that do not involve any grave burden for oneself or another."


  • Because I think my dad is extraordinary, I think he deserves extraordinary measures.
  • Plus, I didn't know a respirator was considered extraordinary.
  • Also, back in Pius's time there was not a culture of death as much as there is today. I'm not buying into any "culture of death" mind set.

Why not let the Author of Life decide when my father's purpose in life is fulfilled?
Certainly Pius isn't going to disagree with that! Is he Richard?

Back to the point Pius and I agree on: My older brother and mother are not as strong in the faith spiritually as I am. I can see where over time, it would become a burden to them. Especially, my non-practicing mother.

I fear, but would accept God's will, that this "could" lead down to an Audrey Santos/Terri Schiavo "type" of path.

I was able to put the five-fold scapular I had been wearing on my father last night. The Catholic nurse understood and was helpful.

No reply needed. Just say some prayers for me and our family.

Mike

Richard replied:


I had to look into these issues a few years back at the time of my mother's last illness, so it's still kind of fresh for me. As things worked out, Mom passed away during an operation despite being on life support at the time, so we were spared any complicated moral decisions to make; I only regret now that I encouraged her to accept the doctor's advice and have the operation — she probably would have lived a few months longer at home in reasonable comfort without it.

About respirators: there isn't a hard and fast rule to define what medical techniques constitute extraordinary (and therefore optional) means of treatment. As technology advances over time and across countries, more techniques change from being extraordinary (complex, expensive, burdensome in themselves) to ordinary (routine, modest in cost, relatively safe).

I still count respirators as "extraordinary" because they are burdensome (stressful on the body and harmful over the long haul), they are complex (using sophisticated high-tech machinery), and costly (even if most of the cost is being paid by insurance).

— RC

Mike replied:

Hi RC —

I visited my father tonight and while driving home, I was thinking about the argument that you were putting forward for Pope Pius XII.

I think the reason I'm having a hard time, "logically" swallowing your argument is because the Church has always presented the Truth to the faithful in black and white colors, but in this instance it's giving the faithful two blacks (one modified) and a possible white.

The Church prohibits the taking innocent life from the moment of conception (to natural death.)

the first black: natural death is the best because (you are allowing the Author of Life to decide when a person's specific purpose in life has been concluded.)

the second black: we are changing "the first black" so that:

(we are determining) when we think, with our limited finite minds, the person's specific purpose in life has been concluded.

This second black above appears to be what you and Pius are arguing.

It's like: If we get impatient with God, we will play God. (Sounds like a white, or a morally incorrect view.)

As I said earlier:

Nevertheless, the Catholic faith side of me was saying, that my father, who is unconscious, has a specific purpose in life and even though I can't communicate with him, he is fulfilling that purpose in a way I can't understand but I know is ordained by Our Lord. (Maybe through a redemptive suffering, though he didn't seem to be in pain.)

See my point?

Any way, Mom called tonight and asked if he had received Last Rites and I told her he has received it twice last Thursday and Friday.

I don't know what's going to happen. They may go ahead and do something without my knowledge.

I'll keep you informed.

Mike

Richard replied:

HI Mike,

You said:
I visited my father tonight and while driving home, I was thinking about the argument that you were putting forward for Pope Pius XII.

What a compliment: the idea that I'm helping Pope Pius out with making his case! :-)

You said:
It's like: If we get impatient with God, we will play God.

The decision does involve making a judgment call, but it shouldn't be a judgment on the person's merits. We certainly don't have a right to say "you've lived long enough, now please go die".

But we do have to make judgment calls about the proposed treatments and whether they are likely to be effective for the patient, and for how long. And you have to weigh that against the burden imposed by the treatment — harmful side effects, pains, and even costs.

If a treatment is going to be totally futile, then it would be wrong to even attempt it. If it has some possibility of success, then it can be acceptable to do it, and if it is certain to give the patient a
major benefit, it may even be a duty to do it.

But here we're thinking about cases where the results, good and bad, are uncertain.

Our old friend the "principle of double effect" comes into this. If a proposed course of action has both good and bad effects, you have to check some points:

* What is the proposed action (or omission)?
* What is the good effect of the action?
* What is the bad effect of the action?
* Are the bad effects of the action *disproportionate* to the good effects?
* Do we intend to directly bring about the bad effect?
* Does the bad effect *cause* the desired good effect?

If any of these last 3 questions has a "yes" answer, then the proposed action is not acceptable.


* What is the proposed action?

To omit an extra resuscitation attempt and stop treatment if the patient's vital signs fail.

* What is the good effect of omitting resuscitation?

It avoids prolonging the burdens of the resuscitation and subsequent treatment on the patient: pains, stresses on the body. Based on the doctors' prediction/opinion, the patient or his representatives make an estimate of what those burdens are, and how certain or uncertain they are.

* What is the bad effect of omitting resuscitation?

The patient will not get any possible benefits of the resuscitation, so the patient is likely to die shortly. Here you and the doctors have to make a rough prediction of how much probability of health improvement and how much longer life would come from doing a resuscitation and additional treatment.

* Are the bad effects of omitting resuscitation *disproportionate* to the good effects? Or does the good at least balance out the bad?

This is where the issue of "extraordinary" means may come in: Are the treatments particularly stressful, complicated, or costly, in comparison with the expected health benefit and its duration, for this particular patient?

At that step, we're not in a black-and-white case: We don't really know the future, but we have a duty to use reason and the limited human knowledge we have. So we're using estimates of what benefits and burdens the patient would get from resuscitation. Furthermore, weighing the two against each other isn't exactly a science.

Judgments can even vary from place to place and through time: Treatments considered rare heroic efforts in one era may become more common in another.

* Do we intend to directly bring about the bad effect? Do we intend to cause the death of the patient?

This proposed action does not take life. While we do expect the patient to die, we do not desire it or intend to promote that. The patient's death is caused *directly* by his disease, and only indirectly by the failure to resuscitate him.

In Catholic Christian morality, we must not intend to directly harm another person. (See Germain Grisez's book "Beyond the New Morality".) An unintended, indirect harm is tolerable, provided that the "double effect" criteria are met.

* Does the bad effect *cause* the desired good effect?

We must not attempt to do good by means of harming others. — No, the bad effect does not cause the good effect. As soon as you act — as soon as you stop attempting resuscitation and treatment — the burdens of more treatment are avoided. That is the desired good effect, and it happens immediately, even before the patient dies.

(If it happens that the patient's death is already established before you get to the point of attempting or not attempting a resuscitation, then the resuscitation is already not possible, and the whole question is moot.)

Sorry this is so long. It's late / early.... :-)

— RC

Mike replied:

Hi RC —

Thanks for the late night reply. It is appreciated.

For situations where Our Lord, for some reason, does not wish to take my father's life naturally, your reply below was very helpful and timely.

Less then an hour after I read your reply, my mother wanted to talk to me privately at my apartment. The social workers and so-called lady "chaplain" had talked to her about giving the OK for DNR (Do not resuscitate). She was very honest, saying that she had one son who was a religious freak :)

I took it as a compliment.

She wanted my view on the issue.

I tried to explain to her the balance of making a good decision based on two questions:

What is the probability that dad's health will be restored to a normal lifestyle if we DO resuscitate?

What are the spiritual, emotional and financial burden on the family if we DO resuscitate?

I shared with her my personal view: that although I would have a hard time accepting a (DNR) decision, I could live with it. [What I didn't say: The reason: Due to my concern for the spiritual well-being of other family members. ]

I also shared with her that either decision would be OK with the Church. (my assumption being a respiratory is a extraordinary circumstance.)

Her main concern was whether I would hold her decision against her forever, if she gave the OK for DNR.

I was emphatic that I would never turn away from her or hold anything against her due to any decision she made in this area. Why?

She's my mother and I love my mother! Without her, I wouldn't be here!

I went on to say that I would be at peace if two things happened:

  1. That my father dies with the five-fold scapular I put around his neck last week AND
  2. If there is an OK for DNR, that the doctors and staff don't do ANYTHING purposely to bring about that situation.

To you, the only remaining question I have left is:

Why God through the Church allows its members to be put in certain situations to play God themselves?

  • If the Lord wanted to: All deaths could be nature?
  • That does fit within His job description doesn't it :)

Mike

Richard replied:


I think that's how things turn out generally.

Families end up worrying about awful contingencies and scary scenarios, disagreeing about what should be done, and then things change — for worse or better! — and most of the time the complicated scenarios just disappear.

RC

Mike replied:

Hi RC—

I've been thinking about that question:

Why would God put families in stressful prolonged "life situations" that can burden many families, when he could just take their life naturally and have my father die at the hospital on his own without a respirator?

I think this is doable and I think this fits God's job description :)

As I was driving home, the only answer that came to mind is this:

To test how WE value life OR importantly to test how ** I ** value life.

Pray that I pass the test.

Take care,

Mike

Richard replied:


That's beautiful.

I hope it'll help your Mom get through your father's illness over the next days.

— RC

Mike replied:

Mike said:

The committee of doctors met to talk about my father and they told mom that a decision on DNR (Do not resuscitate) would not be needed because they foresee him dying on his own.

My brother Mark called today and said that based on what he heard from mom, our talk went over REALLY well. He gave me a Kudos :) despite the fact that no decision on DNR was required.

Mike


{ On the passing of my father - dialogue and reflections. }

Over the weekend, the doctors called my mother and told her that Dad was breathing on his own and that it was not recommended medically to keep my father on the respirator.

Neither my mother nor I liked the idea of taking my father off the respirator because we thought he would die within minutes. They had called us on a Saturday and he passed into eternal judgment/life on Monday; on exactly his 84th birthday, except this time it was into eternity.

Mike replied:

Hi RC—

During our conversation today, my mother asked if I would say something at a future funeral. She didn't want to.

I personally think this is because for the past 3-4 years he had lost his mentals and was very arrogant and pushy toward her. I tried to explain to her, that was not the real husband she married.

Mike

Richard replied:


A little talk at the funeral really should not say much in praise of the departed: that would make it a eulogy, which is not what the Church wants there.

Here's what I wrote for my mother's funeral, in case it helps:

The main things were:

  • to thank people outside the family who had been good to her;
  • to express faith that she is now among the faithful departed *on the way* to God — not perfect yet; and
  • to thank people for adding their prayers for her.

Short, and in simple, gentle words, very restrained and (I hope) dignified.

— RC

Final Note:


Speaking for Richard, we hope you have found this dialogue helpful.

Mike

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