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Photo: Joseph Romagnano
Against God's Law
By Dan Valenti (Jun 1, 2012)
"Doctor, please let me know when treatment will no longer be of benefit."
Doctors, nurses and other healthcare workers caring for the terminally ill often hear this plaintive request. The entreaty is a call for help as a person struggles with end-of-life considerations, including the decision to end one's life.
Suicide on Mass. Ballot
The matter is especially relevant today in Massachusetts. In November, voters will vote on a binding referendum on physician-aided suicide (PAS). On moral and ethical grounds, the Catholic Church is opposed to the practice of PAS, which is currently legal in Oregon (since 1994) and Washington state (2005).
"Suicide is a painful topic," says Dr. John Howland, MD, a general practice physician in Worcester County, Mass. "Doctors not only have no right to assist in a patient's death, they have an obligation to the opposite, to ease suffering and preserve life."
PAS likes to hide behind euphemisms, Dr. Howland says. In Massachusetts, for example, the ballot initiative is called the "Death with Dignity Act." But it's "painfully obvious: Suicide is a sin."
Suicide is Contagious
People at the end of life may entertain suicide as a solution for many reasons, says Dr. John Howland, MD, one of the speakers at the annual Healthcare Professionals for Divine Mercy conference in May at the College of the Holy Cross, in Worcester.
These reasons may include loss of dignity, inability to engage in activities, and pain. Also, suicide can be contagious, Dr. Howland says. When a celebrity commits suicide, a spike in suicides often follows. For example, this was seen after the deaths of actress Marilyn Monroe and singer Kurt Cobain. One thinks here of the recent suicide of former NFL star Junior Seau, whose suicide at 43 came as a shock.
"For reasons we don't fully understand, suicide seems to have a certain contagion about it," Dr. Howland says. "We know of suicide clusters in young people. Certainly, when you have a high-profile suicide, with lots of media attention, the thought gets planted in people's minds. For someone in great pain facing end-of-life issues, that might be enough for them to consider taking their own life. Certainly, when a state has [legalized PAS], it makes the act more inviting."
Doctor Howland, a practicing Catholic who agrees with the Church's position against PAS, has been speaking and advising patients, trying to educate them about the issue. He urges voters not to give doctors the power to assist in bringing a patient to death. He incorporates the message of Divine Mercy into his presentations, being careful to do so in a respectful and loving way, especially when addressing secular groups. He says reasonable people respond favorably to the message of love and mercy, and more often than not agree that life is precious and should be saved.
Why Do People Kill Themselves?
Why do people kills themselves? Generalizations, of course, are risky, but Dr. Howland's research identifies three overriding factors, one or more of which are almost always present: lethality (a person shows a capacity for and tendency toward lethal self-injury for any reason, but especially great pain), loneliness (having little or no sense of belonging to anyone or anything), and burden (a deep sense of incompetence, ineffectiveness, worthlessness, and being a burden on others).
Philosophers, theologians, and thinkers have long debated the philosophical question of suicide. Does a person have a right to kill himself or herself? Doctor Howland says that while free will gives a person autonomy, and therefore choice and freedom, "Freedom must be grounded in truth, and it must reflect the natural moral order. On that grounds, it is wrong."
In the Diary of St. Faustina, we find in passage 192 this entry:
Once, I took upon myself a terrible temptation [that] one of our students in the house at Warsaw was going through. It was the temptation of suicide. For seven days I suffered, and after the seven days, Jesus granted her the grace [that] was being asked, and then my suffering also ceased. It was a great suffering. I often take upon myself the torments of our students. Jesus permits me to do this, and so do my confessors.
Suicide is Not Painless
Saint Faustina's reference to her great suffering in connection with suicide illustrates the pain and problem associated with the taking of one's life. According to Dr. Howland, a physician's job is to save, protect, and nurture lives, not take them. Only God can do that. Suicide, he tells us, is contrary to society by harming the family; contrary to natural law; contrary to a physician's Hippocratic oath; contrary to stewardship (see Catechism of the Catholic Church, 2280); and contrary to God, self, and neighbor.
"Suicide leaves in its wake the worst kind of bereavement and mourning" for family, friends, and loved ones, Dr. Howland says. For all these reasons, doctors should not be given the option of legally assisting in ending someone's life.
Suicide prevention, a whole other problem and area of concern, falls into two large categories: access to services (treatment, education, counseling, and the like) and involuntary commitment. About the latter, Dr. Howland says society has the right and the obligation to take away a person's freedom in order to save a life.
In short, a doctor's obligation is to help a person, not hurt them: "Preventing suicide is about life," Dr. Howland says. "Physician-assisted suicide is about death."
Spiritual Needs of the Patient Come First
"The spiritual needs of the patient remain foremost in my mind," says Marie Romagnano, RN, a critical care nurse and founder/director of Healthcare Professionals for Divine Mercy, an apostolate of the Marian Fathers of the Immaculate Conception. "Care for the dying is one of the corporeal works of mercy and requires a spiritual dimension. The same applies to someone who is suicidal."
Doctor Bryan Thatcher, MD, director of Eucharistic Apostles of The Divine Mercy, another Marian apostolate, mentions the importance of what he calls "the bargaining phase." That's when a terminally ill patient tries to "bargain" with God with a quid pro quo: "If you cure me, I'll reform my life." People must be allowed to go through it.
After that, Dr. Thatcher says, the patient must come to accept his or her prognosis. "That's when you have to let them talk, vent, and get things off their chest. Acceptance is often difficult, especially in dealing with life's regrets. For me, Divine Mercy provides the answer through the power of forgiveness. My intent at that point is to be present to patients and families physically, mentally, and spiritually," he says.
Forgiveness is Crucial
Doctor Howland, Nurse Marie, and Dr. Thatcher agree in encouraging a despondent patient who is near death and perhaps showing suicidal ideation to have a "closure talk" among members of the dying person's family. They say the family must release any negativity they have by forgiving both themselves and the dying person.
"Love is the most frequent message exchanged between the living and dying," says Dr. Thatcher, "because we all want to end better than we started. We should live each day as if we were terminal, because we are. Live in the moment."
What should a doctor or nurse say to the dying person's loved ones or to someone who has killed themselves?
'Send a Message of Love'
"Send a message of love," says Dr. Thatcher. "God is love. When we love, we are living in God. The dying process does not nurture pettiness and triviality. It teaches us that life is a wonderful thing."
Doctor Howland says the vulnerability caused by terminal illness can help open hearts to God. Catholicism has the intellectual and spiritual framework to help the dying and their families because of its doctrine on redemptive suffering. Suffering is a universal experience. As such, it provides a common vocabulary for people to deal with pain and sorrow in productive ways.
"God doesn't waste any experience. He's too good and loving for that," Dr. Thatcher says. "We only need to trust in His wise care."