Fundamental Principles About Life and Death
In the Catholic tradition, human life is regarded as sacred from the moment of conception until natural death because it is created and given to us by God. For this reason, we have a duty to protect and preserve our lives. But this duty is not absolutely binding under all circumstances because our ultimate end lies in eternal life with God.
In his encyclical letter Evangelium Vitae, Pope John Paul II explained it this way: “Man is called to a fullness of life which far exceeds the dimensions of his earthly existence.... The loftiness of this supernatural vocation reveals the greatness and the inestimable value of human life even in its temporal phase....” However, Pope John Paul wrote, “it is precisely this supernatural calling which highlights the relative character of each individual’s earthly life. ...[L]ife on earth is not an ‘ultimate’...reality.” (#2)
In their guidelines for Catholic medical personnel, the U.S. bishops wrote: “We are not the owners of our lives, and hence do not have absolute power over human life. We have a duty to preserve our life and to use it for the glory of God, but the duty to preserve life is not absolute.”
Moreover, the bishops explained, reflection on the innate dignity of human life in all its dimensions is indispensible in making moral decisions about health care. Such decisions must be made “in light of the Christian meaning of life, suffering and death” (c.f. Ethical and Religious Directives for Catholic Health Care Services, #54).
For Catholics then, decisions about medical treatment always seek to balance a responsibility to receive life as a gift and to preserve it as best we can with a willingness to relinquish this life gracefully, with faith and hope, when the time comes.
- Download a summary of what Catholics believe about life and death. Click Here
- Print a checklist of what you believe about life and death. Click Here
Assessing the Benefits and Burdens of Health Care Procedures
While suicide and euthanasia are never morally acceptable options for Catholics, the U.S. bishops have written that Catholics may reject life-prolonging procedures “that are insufficiently beneficial or excessively burdensome.” (Ethical and Religious Directives #54)
According to the bishops' Directives, “A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are those that, in the judgment of the patient, offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community.” (#56)
However, the bishops wrote, “A person may forgo extraordinary or disproportionate means of preserving life.
Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden or impose excessive expense on the family or the community.” (#57)
Catechism of the Catholic Church
makes the same distinction between proportionate and disproportionate medical treatment based on the potential benefits and burdens anticipated by the patient. According to the
it is legitimate to refuse or discontinue medical procedures “that are burdensome, dangerous, extra-ordinary or disproportionate to the expected outcome.” It calls such choices “the refusal of ‘over zealous’ treatment,” in which case “one does not will to cause death” but accepts “one’s inability to impede it.” (#2278)
- Download a list of questions you can use to assess benefits and burdens of recommended health care procedures. Click Here
- Print a checklist of what you believe about life and death. Click Here
Guidelines for Making Critical Choices About Medical Treatment
The following guidelines were prepared by the Archdiocese of Dubuque Consultant for Health Care Ethics.
• Using or Forgoing Life-Sustaining Treatments.
According to the Ethical and Religious Directives for Catholic Health Care Services issued by the U.S. Catholic bishops, “a person has a moral obligation to use ordinary or proportionate means of preserving his or her life.” The bishops define proportionate means as “those that, in the judgment of the patient, offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community” (#56).
However, the bishops’ Directives say, “a person may forgo extraordinary or disproportionate means of preserving life.” The bishops define disproportionate means as “those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden or impose excessive expense on the family or the community” (#57).
• Medically Assisted Nutrition and Hydration.
In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration, when they cannot take food orally.
However, medically assisted nutrition and hydration need not be provided when this treatment cannot reasonably be expected to prolong the patient’s life or when they would be excessively burdensome for the patient or cause the patient significant physical discomfort. For this reason, medically assisted nutrition and hydration may not be obligatory for patients drawing close to inevitable death.
• Pain Management and Palliative Care.
Patients should be kept as pain-free as possible so that they may die comfortably and with dignity. However, since a person has the right to prepare for his or her death while fully conscious, patients should not be deprived of consciousness without a compelling reason.
Suffering patients should not be deprived of needed pain medications out of a misplaced or exaggerated fear that the medications might have the side effect of shortening life. The risk of this happening is extremely low when the medication is adjusted to a patient’s pain level. In fact, severe pain may shorten a dying person’s life.
• Euthanasia and Assisted Suicide.
Euthanasia or assisted suicide are never permissable. Patients who make such requests should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.
• Advance Medical Directives.
Each person may create a Living Will and assign in advance the Durable Power of Attorney for Health Care to a surrogate who can make health care decisions in the event that the person loses the capacity to make health care decisions for themselves. Decisions made by the surrogate should be faithful to the person’s intentions and values and to Catholic moral principles. If a person’s intentions are not known, decisions made by the surrogate should be in the person’s best interest.
In the event that a person does not have advance directives, those who are in a position to know the patient’s wishes (usually family members and loved ones) should participate in the
treatment decisions for the person.
- Download a checklist of treatment choices approved by the Archdiocese of Dubuque's Medical-Moral Commission. CLICK HERE
- U.S. Conference of Catholic Bishops
- Archdiocese of Dubuque
- New York State Catholic Conference
- National Catholic Bioethics Center
- Ethical & Religious Directives for Catholic Health Care Services/5th Edition, U.S. Conference of Catholic Bishops
- A Guide to Making Good Decisions at the End of Life. Washington State Catholic Conference.
- To Live Each Day With Dignity. U.S. Conference of Catholic Bishops.
- Now and At the Hour of Our Death (video). New York State Catholic Conference.
Last Update: 09.22.15
- "Deathbed Confusion - Struggling With Decisions at the End of Life," Heather Grennan Gary (U.S. Catholic)
- "Death - It's Part of Life," Myules Sheehan, SJ (U.S. Catholic)
- "Death with Dignity and End of Life Ethics," Daniel Sulmasy, OFM (U.S. Catholic)
- "Facing Terminal Illnesses Realistically," Rev. Tadeusz Paqcholcz (National Catholic Bioethics Center)
- "FAQ About the Persistent Vegetative State," (National Catholic Bioethics Center)
- "Final Steps," Michelle Martin (Our Sunday Visitor)
- "Seven Steps to Making Good End-of-Life Decisions," Heather Grennan Gary (U.S. Catholic)
- "Should I Have a Living Will?" Rev. Tadeusz Paqchoicz (National Catholic Bioethics Center)
- "What Constitutes 'Extraordinary' Care?" Mary DeTurris Proust. (Our Sunday Visitor)