From the Catholic Herald of the Archdiocese of Milwaukee, the bishops of Wisconsin warn about an important health care issue:
Wisconsin’s Roman Catholic bishops issued a warning against the use of POLST, Physician (or Provider) Orders for Life-Sustaining Treatment, in a statement issued Wednesday, July 25.
In “Upholding the Dignity of Human Life,” the bishops wrote that the use of POLST has grave implications for the dignity of human life and they “encourage all Catholics to avoid using all such documents, programs and materials.”
“The POLST form should not be regarded as the standard model for designating treatment preferences,” read the statement signed by Milwaukee Archbishop Jerome E. Listecki, Madison Bishop Robert C. Morlino, Green Bay Bishop David L. Ricken, La Crosse Bishop William P. Callahan and Superior Bishop Peter F. Christensen.
Upon issuance of the pastoral letter, Archbishop Listecki told your Catholic Herald, “This is an important issue. As a church we are concerned about the dignity of the human person at every stage of life – from conception to natural death.”
[…]
Because use is on the rise and because increasingly Catholics are questioning the morality of this end-of-life document, Wadas said the bishops felt it was time to address the question.
A major concern regarding the form, according to a press release issued by the WCC, is the “form presents options for treatments as if they were morally neutral.
In fact, they are not. Because we cannot predict the future, it is difficult to determine in advance whether specific medical treatments, from an ethical perspective, are absolutely necessary or optional.”
“A POLST oversimplifies these decisions,” wrote the bishops, “and bears the real risk that an indication may be made on it to withhold a treatment that, in particular circumstances, might be an act of euthanasia. Despite the possible benefits of these documents, this risk is too grave to be acceptable,” they wrote.
[…]
Wisconsin Catholic Conference HERE.
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I wonder if the real problem lies in the document, or the way people might be tempted to fill it out. Presumably (I haven’t seen it), the document would also allow a series of options which would together mean ‘treat me always’. I fail to see how that could be morally problematic. Of course, if one would select other options, various grave pitfalls may occur.
Also, be careful about emphasising the means (the document) too much. Here in the Netherlands, one would actually need documentation to ensure treatment is continued, rather than the other way around. Just saying what’s in store….
It would be nice if the USCCB or some reliable Catholic group could come up with a form, or at least suggested language, that would give soundly Catholic answers to the “options” so there would be no doubts if that document were in the patient’s records. But it might be too difficult, as different as state laws can be, to find language that worked everywhere.
Their excellencies have a point in so far as their discussion pertains to a patient signature for the form. Indeed, it surprises me that a Wisconsin POLST does not have one since other states seem to have them.
As far as the conscience clause goes, will those individuals and organizations pick up the tab if they provide health care services against the expressed wish of the patient? As my father-in-law once observed, when one gets sick, the doctors and hospitals drive a 24″ main into your bank accounts and pump until they are dry.
One of the reasons we are burdened with documents like this is because our over-litigious society more or less requires them if one hopes to preserve a legacy for the upcoming generations and if one hopes to have any chance at all of having ones wishes followed.
As a lawyer, I can say that Legisperitus is correct- different states and provinces have different laws relating to these documents. A standard form isn’t possible on a nationwide basis because of different laws.
It is possible to do these documents so that they are ethical, moral and in accord with Church teachings- the difficulty comes in finding a lawyer who understands (or can have the position explained) well enough to draft it in compliance with the law and the client’s wishes. If you can find a lawyer to do that, you absolutely should so that you can protect yourself. If you can’t find a lawyer to do it, keep searching and DO NOT fill out a “standard form” or the “usual form” that your doctor/nursing home/lawyer etc suggests- at least not without lots of in depth explanation of what it really says.
I do not know what the Wisconsin form looks like, but the standard form used in my province does not in any way comply with Catholic teachings.
The National Catholic Bioethics Center in Philadelphia has a fabulous website, and offers a solution to the problem being discussed:
http://www.ncbcenter.org/page.aspx?pid=1204
A Catholic Guide to End-of-Life Decisions
An Explanation of Church Teaching on
Advance Directives, Euthanasia, and Physician Assisted Suicide
I purchased this kit and signed both an Advanced Medical Directive and named a Durable Power of Attorney for Health Care. I took these documents to my attorney when he updated my Will and he said that the forms would be regarded as “binding” in my State. The pamphlet also goes into wonderful detail and it is comforting to know that have one of these.
Deo volente
It is important to reaffirm that not all POLSTs are the same. The one used in Utah is well written and if used properly fits into the Catholic understanding of end of life issues quite well. One of the dangers of all POLSTs is that they are Doctor’s Orders and not necessarily self-directed documents. In my experience they are used most effectively when a patient is unable to make decisions for himself. In Utah it requires the approval of the admitting physician and the legal agent of the patient. Like most things, it can be abused. However, a well written and considered POLST can be a good thing.
I think most people are better off giving someone a medical power of attorney, someone whom you trust and who supports you beliefs and wishes. It’s better to avoid to leave specific written instructions, because no matter how clear and precise you think you’re being, you’re always liable to have your words misinterpreted. Of course, if there’s no one you can trust with the job, then you do the best you can with advanced directives, but in my opinion, it’s better to rely on a person who knows you than a document that’s subject interpretation.