People live longer these days; many people in this country have about 10 more years of life than would have been the case years ago. The death of a child is always a tragedy, although many died in childhood a century ago. Adolescence is prolonged and decisions that define a life, like marriage, are often put off into the late 20s or the 30s. The 40th birthday no longer marks a person as clearly set in middle age. Old age begins, perhaps, in the 70s, certainly not at 60; and octogenarians are not looked upon as exceptional.
Elderly people have always been part of human history, even if not in the same proportion as today. Over 3,000 years ago, the Psalmist prayed: “The years of our life are 70, or 80 if we are strong; …yet they are soon gone, and we fly away” (Ps 90:10).
As one grows older, the recall of the past is put into a larger perspective. I remember vividly now events and conversations I did not think especially important when they occurred; and things I thought of great moment not so many years ago are now all but forgotten. Right now it seems pretty important that the Blackhawks brought the Stanley Cup back to Chicago after so many decades, but I’m not sure how the very real joy and enthusiasm of today will stack up over the long haul of a lifetime’s memories. At the same time as the past is reconsidered and sometimes reevaluated, the horizon of the future is more restricted, and one turns to considering the end of this life. Sometimes people say they do not fear death, but they are afraid of dying. I’m not entirely sure what that means, since both are unknown.
In the face of the unknown, a natural instinct is to try to control. Advance health-care directives are one means to direct medical care and treatment, even after one loses consciousness; another means is to appoint a surrogate to make life and death decisions when one is unable to do so personally. Some who anticipate their becoming prisoners of their bodies do not also want to be prisoners of machines.
No one is autonomous; we are all members of the human family. For everyone, life is a gift and we are all its stewards. From these two principles flows the moral imperative that no one can intentionally commit or omit actions that, by their nature or their consequences, would directly cause his or her death or the death of another human being.
While both direct abortion and voluntary euthanasia are therefore always immoral, the calculation of what is appropriate treatment at the approach of natural death cannot be completely anticipated in a written set of directives. Since food and water are necessities of life and generally should be provided primarily in an oral way, they are morally required. No one may be deliberately starved to death. This common sense prescription was set against the contemporary dictate of “autonomy” and caused some public discussion a year or so ago. Much of the discussion was alarmist and perhaps deliberately stirred up to discredit Catholic health care.
Some morally acceptable reasons not to use artificial means to feed people might be physical resistance, dread, great discomfort, closeness to death, irreversible edema or choking. One has to be especially careful to protect the rights of the handicapped, the medically incompetent and other helpless patients; and one may never intend to directly bring about death because a patient has Alzheimer’s disease, congestive heart failure, end-stage cancer and other chronic conditions. Obviously, the advantage of appointing a personal health-care proxy is that each case can be handled individually and as the patient’s changing condition indicates.
Perhaps we have trouble facing death because we have trouble giving ourselves in love. In both dying and loving, personal autonomy is surrendered; and both presuppose trust. As one grows older, the body becomes less trustworthy. Organs and muscles that could be taken for granted fail or decay. How much more important is it, then, that friendships grow stronger. When we cannot count on our bodies, we must count on those who love us, especially on God.
God is love, and he desires nothing more than that we share his life now and forever. That conviction from our faith sustains us all our lives and gives us strength in old age. God bless you.
Sincerely yours in Christ,
Francis Cardinal George, OMI
Archbishop of Chicago
