End-of-life decision

Many of us may scarcely be prepared for the moral decision-making dimensions of medical treatments. A month ago, my family was in such a situation. My 98-year-old mother, whose mind remained as sharp as nails till then, had gone into a coma from a prolonged cancer that amazingly did not metastasize during the 10 years it had invaded her body. Finally, it had progressed to terminal stage and we were faced with the specter of her death.

In the beginning, the question of going through a needlessly prolonged and painful dying process escaped our consciousness. Our mother was the center of our family’s attention and we would have been happy to see her become a centenarian soon. Although we knew that every human life is an unrepeatable gift, the beauty of that truth never confronted us initially as we had to grapple with the myriad needs of hospitalization.

The outlook changed when the doctor informed us that her comatose condition had begun. When coma begins, death becomes imminent. But for how long, no one could provide the answer. It is when that question confronts you that one begins to look to the deposit of one’s spiritual faith. That faith had always taught us that human life had inherent dignity, sacredness and value. Because life is a gift, it is never rejected.

A choice had to be made. That choice never included euthanasia, that deliberate and willful act, the intention of which is to cause death. More so, the patient was our mother. Her life was clearly diminished because of cancer. Given that kinship, it was clear to us that she be instead given preferential treatment.

There was never any doubt from the family’s faith that euthanasia is a grave moral evil. A method of euthanasia is known as assisted suicide, aka active euthanasia. The patient wishes to terminate one’s life with the help of a medical doctor who administers a drug that causes death. It is legal in several US states but why should that not surprise us? Many of the craziest things in this world begin in the United States.

Faced with the near possibility of our mother’s death, we were given the options. There are common circumstances surrounding a patient when one is in need of what is known as “ordinary medical means.” Some ordinary means of medical treatment are the use of intravenous fluids (nourishment) and the administration of antibiotics (to fight infection). Withholding these is considered passive euthanasia and constitutes a grave moral error.

In contrast, some forms of treatment are considered “extraordinary medical means” when their benefits are disproportionate to the results anticipated for a particular patient, as for example intubation, advanced airway interventions, defibrillation. These are considered morally optional. But if not chosen by the family, they do not constitute as euthanasia. What is allowed instead is for natural death to occur.

We were told that our mother’s survival rate was low. The pain of the treatment would have been too great a burden for her. If she survived, she would be a vegetable. But who decides how great a burden a treatment is? By burden, we consider the risks involved, the side effects, the pain, its availability, even the costs, and the likelihood of that treatment in enhancing the life of the patient.

Prudence became a necessary virtue at this point in choosing the right and good path. Here arose the importance of consulting spiritual guides, in this case, a priest who was also an ethicist. Our mother was in coma. Death was imminent. Her condition was irreversible. Ordinary care was not interrupted. But extraordinary means were not an option.

In which case, DNR (an abbreviation I was then personally ignorant of) was resorted to—it meant Do Not Resuscitate—but AND (Allow Natural Death). True enough, as the end drew near, as her gasps for breath became few and far between, she simply stopped breathing. Oxygen reading was zero. So was her blood pressure. The only thing that continued was her heart that still persisted in pumping. She had a great heart, the attending nurse said at that point. We had also known that in a figurative way. But the electrocardiogram reading was flat. My mother was gone forever.

Our family had the benefit of church principles on bioethics for end-of-life decisions. But for those who die without that benefit, how unfortunate death is then for them. A few weeks later, five young college students, all in the prime of their lives, had their precious lives snuffed out by the blast of a bomb planted in the bus they had ridden. Their lives ended without them and their families being consulted. Not one of them, I am sure, was prepared to die. If a most severely debilitated and helpless patient like my mother retained the full dignity of the human person, how much more for these young lives who were preparing for their future?

We were enabled to live out the gift of faith, in this case our family’s Catholic faith, and the full recognition it accords to the dignity of the human person, as truly a gift and a guide to the free will given to us. The hospital staff sat with us and explained to us a checklist known as the Order for Life-Sustaining Treatment.

Human life issues will continue to confront our country fond of copying liberal Western trends on life issues. No single country in the world, no matter how liberal it is, will ever be able to change one very simple natural truth: Human life is precious. Sharing with you the joy of the birth of He who gave us Life, that message of Christmas made more real and palpable by my mother’s death. Thank you, Mama.