Dying, As A Franciscan: Approaching Our Transistus to Eternal Life, Accompanying Others on the Way to Theirs

When the Hour of his Passing was Approaching –Ethical Issues in Care at the End of Life

wHen tHe HOur OF His passing was apprOaCHing – etHiCal issues in Care at tHe enD OF liFe Daniel sulmasy, O.F.m., m.D., pH.D. We are going to be taking a look at a different technicality. When we talk about death we are going to take a few steps back before death. And I must offer this disclaimer: these are my views and do not represent the opinions of the Presidential Commission for the Study of Bioethical Issues. I’m going to talk about ethical issues when you’re caring for people at the end of life within the Catholic tradition. For many of you this is going to be a review, but I want to make sure everybody’s up to speed. We start with some bedrock principles in the sense that everyone is created in the image and the likeness of God and that includes people who are dying. This dignity is an exalted value – a little less than the angels – and is truly inalienable – cannot be taken away by anybody or given away by anyone. What is most radically equal about us is the fact that we are human and we have a duty to be good stewards of the body. One of the prayers this morning mentioned that no matter how genetic engineering may improve your life, life is always a gift. We cannot choose our own biological parents since it’s metaphysically impossible. Life is always given to us and we ought, when our pastors talk to us about stewardship, realize that it’s not all about money but also about being good stewards of our bodies. This is the ethical principle behind prevention and doing what our mothers told us – to eat spinach and exercise out of respect for the gift of our bodies – because we have roles to play in the world and duties toward other people and we have obligations that derive DaNiel sulMasy 62 from that. But it’s a limited duty because while we have this great gift with this wonderful value that we call dignity, we are also finite. We are finite morally, that’s the nature of sin; we are finite mentally – we make mistakes and exercise poor judgment; and we are finite physically. And that’s who we are as human beings. We have this great exalted value – a little less than the angels – but yet are finite, finite creatures. Suffering is an experience that makes explicit the inherent tension between this intrinsic dignity and our finitude. Every drop of blood, every wave of nausea, every creek in the bones reminds us of our finitude . Pain and suffering are not the same things. I am the ultimate non-runner but I understand that people like to run marathons. That hurts a lot, but runners seem to enjoy it, so pain is not suffering for them. Yet we also know that there is a lot of suffering that is not physical , such as interpersonal hurt or depression. There is no physical pain there, but still it’s deep, deep suffering. Then there’s the pain of arthritis . Arthritis in some ways doesn’t become suffering until it limits our ability to do what we used to do. It’s this tension between being a little less than the angels and yet recognizing that we are finite. It’s the tension between those two that’s made explicit in an experience that’s the occasion of suffering. Illness is a fact of life but it’s also a mystery. People ask the questions all the time, “Why must I suffer, or why must this happen to me or to my child?” It is no accident that many of the great saints have had their experiences of conversion in their own experience of suffering and that of others. Saul of Tarsus was knocked off his horse and blinded yet somehow in this experience hears the voice of God. In our own tradition Francis of Assisi began his conversion experience with his illness as a prisoner of war and extended that experience when he reached out to another who is sick, finally culminating in his embrace of Sister Death. The goals of medicine really are to minister to this mystery of the human between our dignity and our finitude. That’s Right Square where we are. Any of us who are caregivers are putting our hands into the midst of that tension and that mystery. The goals of medicine...