WORCESTER MEDICAL ETHICS

A Roman Catholic Perspective

Monsignor Peter R. Beaulieu, M.A., S.T.L.

A project to assist medical professionals, patients and families in understanding Roman Catholic teaching on the quality of life and other moral issues. This is a work in progress.  Please check periodically for updates.


A CATHOLIC VISION OF QUALITY OF LIFE

The debate on what is labeled quality of life is as old as the advent of philosophy, since it was Aristotle who pondered that issue and determined that eudaimonia (i.e. human flourishing or happiness) constituted the good life. This notion is frequently used in a variety of settings, especially when talking about medical treatment. A corollary to that technical term is the good life—meaningful work, ideal living conditions, a supportive network of human relationships, decent housing, and good health. Due to an apparent similarity, it is crucial to draw an important distinction between quality of life and what the Church calls the inherent dignity of life. In their pastoral letter, Faithful Citizenship, the Catholic Bishops of the United States said, "Every human person is created in the image and likeness of God. The conviction that human life is sacred and that each person has inherent dignity that must be respected in society lies at the heart of Catholic social teaching. Calls to advance human rights are illusions if the right to life itself is subject to attack. We believe that every human life is sacred from conception to natural death; that people are more important than things; and that the measure of every institution is whether or not it enhances the life and dignity of the human person." Since life inherently commands our respect, every member of society has a shared responsibility to create those conditions, which are conducive to a high quality of life for all citizens. Any deterioration in a given individual’s quality of life neither diminishes nor negates their fundamental human dignity. As the quality of someone’s life lessens, the obligation to defend that inherent dignity increases.

As Catholics, created in the image of God, people are not only exalted among all God’s creatures but those God-like qualities make us responsible for what we create, the resources we use—these and all the other elements which constitute the good life—are not solely for personal use, but for the benefit of all and a sign of the graciousness of God. Our lives will be judged by God on the basis of our virtue, not our possessions. For believers, the reality of human suffering is a true paradox. In this world, suffering is almost unavoidable and it is not simply negative.

In the apostolic letter Salvifici doloris, Pope John Paul II wrote about what he labeled the Gospel of Suffering, "This [next] chapter [in the Gospel of Suffering] is written by all those who suffer together with Christ, uniting their human sufferings to his salvific suffering. In these people there is fulfilled what the first witnesses of the Passion and Resurrection said and wrote about sharing in the sufferings of Christ. Therefore in those people there is fulfilled the Gospel of suffering, and, at the same time, each of them continues in a certain sense to write it: they write it and proclaim it to the world, they announce it to the world in which they live and to the people of their time. Down through the centuries and generations it has been seen that in suffering there is concealed a particular power that draws a person interiorly close to Christ, a special grace" (SD, n. 26).

In hospital settings, quality of life becomes part of the complex deliberations that go into determining how appropriate a medical treatment or procedure is in a specific situation. So, if the patient could reasonably expect a good quality of life, even what the Church labels an extraordinary treatment, the prospect of a reasonably good life after such treatment, could be a reason to accept treatment that can be legitimately declined. Thus, quality of life in healthcare terms is not the equivalent of a comfortable life, as much as it is the expectation of a meaningful existence after treatment. The determinants of a good life include human relationships, the ability to communicate, a relatively pain-free future, the ability to enjoy life’s pleasures and, in many instances, the desire to be useful for other people.

Frequently, people who are dying express a fear—not to be an excessive burden. For Catholics, caring for the sick and dying is a supreme example of faith. Far too many people, either out of fear or expedience, dismiss any thought of quality of living among those who are dying. There are untold blessings that come from such a tragic situation—the great benefits that arise from the ability of those who are terminal to both receive and to impart acts of human kindness, gestures of sacrificial love. Today, the good life is almost exclusively associated with luxuries and firm control over life itself. For those who believe, human dignity is the foundation upon which any quality of life must be built, human suffering, while not sought, can become meaningful—and the lives of the suffering remain a gift and sign to others, the sick, suffering and/or dying offer untold opportunities both for those who are sick and for all who are healthy to bestow mutual acts of kindness that constitute true blessings. These actions are not only earthly signs, but they fulfill the command that Christ gave to His Church that she always have a preferential love for the sick.

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