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I have worn many labels (Not in any particular order): Catholic, Wife, Mom,Gramma, Doctor, Major, Soccer Mom, Military Wife, Professor, Fellow.

All of these filter my views of the world. I hope that like St. Monica, I can through prayer, words and example, lead my children and others to Faith.
"The important thing is that we do not let a single day go by in vain without putting it to good use for eternity"--Blessed Franz Jägerstätter

Wednesday, February 09, 2011

Catholic In the Name Is No Guarantee

My father, my siblings, and I are facing a difficult time right now. My mother became ill the day after Christmas as her chronic leukemia transformed into an acute leukemia. Within days she was intubated in the ICU of MD Anderson. She has remained hospitalized though no longer requires intubation. Initially, it was felt that if we could just support her through the chemotherapy, she could recover. There were complications with one organ system after another, but each was dealt with and the ultimate goal remained recovery. However, in the last week all systems crashed. There is kidney failure, heart failure, respiratory distress, and probably a stroke. In addition, her response to chemotherapy has been less than ideal. We understand that recovery is no longer the goal. Comfort and preparation for death is. So it is time to seek out hospice in the Houston area.

Let me be clear that not all hospice organizations are the same. Some truly seek to care for the patient and provide a dignified and patient centered end to life. Others want to provide minimal care and collect their payments from Medicare. I am sorry to say that the hospice organization affiliated with the local Catholic health care institution falls in the latter category. The representative of this organization spoke to my father, my sister, and me before she had any knowledge of my mother's condition. Her focus was on providing morphine for "pain". My mother has no pain. When I asked her about nutrition and hydration she immediately told me to remember that we are talking about hospice care. They do not do hydration or any form of artificial nutrition. John Paul II, the US Conference of Catholic Bishops Ethical and Religious Directives for health care, and the Congregation for the Doctrine of the Faith all clearly state that nutrition and hydration are ordinary care even if administered by artificial means. If a patient can benefit from such care, we are morally obligated to provide it. I find it appalling that a hospice organization that purports to be Catholic would shun this basic principle. I do not know if my mother needs artificial nutrition and hydration. However, I cannot in good conscience entrust her to the care of an organization that views this basic level of care as extraordinary and unnecessary. Similarly, when I asked about the use of oxygen for her respiratory distress, I was told that while they do administer oxygen, their immediate response to a patient struggling to breathe is to administer morphine. They would not check an oxygen saturation (a non-invasive test done at the bedside by clipping a sensor to my mother's finger) to see if my mother was getting adequate oxygen. It is true that morphine can help some respiratory distress, but the hospice representative presented it as an agent of sedation to stop the discomfort of shortness of breath. She had so many different reasons to offer morphine, it seemed she just couldn't wait to euthanize my mother.

My father will be speaking with a representative from a different hospice agency this evening. I have already spoken to a representative from this agency and found it to be much more in line with Catholic bioethical principles. It is a sad commentary on the state of Catholic health care when a secular for-profit hospice agency sounds more Catholic than the local Catholic agency.


Andrei said...

Almost exactly year ago my mother died, the circumstances sound similar to the ones you describe for your mother.

We took her home and had nurses come in, is this possible for you? It was what she wanted and she died surrounded by her Children and Grandchildren in her own bed.

My Father died in a hospice and it was right for him but mothers death at home was I think better for all.

May I share with you a Russian Orthodox prayer appropriate to this time
O Almighty God and Father of our Lord Jesus Christ, we
pray to You for Your servant N. whose sickness is bringing
him/her to the end of his/her earthly life. You are the God
whose only-begotten Son taught us that not even the
smallest sparrow can fall without Your knowledge, and that
You hold all creation in Your merciful arms. Look upon Your
servant N. and allow this illness to be for the death only of
those things which are the result of evil and sin. Let his/her
thoughts be quieted with the peace and confidence of his/
her final deliverance into the fullness of Your love. Keep his/
her soul and body pure, and sanctify them during the time
he/she remains among us, that on the last day he/she may
be raised up with all Your saints to live with You in neverending glory. For to You belong praise and worship, to the
Father, Son, and Holy Spirit, now and ever, and unto ages of
ages. Amen

Denise said...

Thank you so much for that beautiful prayer. I am not sure if you are in the United States, but here hospice refers to both end of life care in a hospital setting and the end of life care at home. The first agency we were talking to was for outpatient care at home with nurses who come in. It was really disturbing to see what little care they wanted to provide. I just got off the phone with the second hospice agency and it was a breath of fresh air. The first thing the representative said was, "We do not play God. We are not here to speed up death or to prolong death. We are here to help her walk this final journey as comfortably as possible." That is exactly what we want for my mother. Thank you again for your prayers.