The Promise of Palliative Care

Dear brothers and sisters in The Lord,

I have had the privilege of spending the last two nights with my father as he is preparing for his journey into eternal life. This has been a chance for me to return thanks and give back to them, as I have been thinking of the many nights he and mom stayed up with all of us when we were sick!

I have seen first-hand the love and care of all of the sisters, nurses and staff here at St. John’s Hospital hospice here in Springfield who care for him and administer his medications so he is not in pain nor alone in his journey. Their choice of living this life of compassionate care is a blessing to us all.

While we appreciate the wonderful advances of modern medicine – which have given us many cures for diseases and extended our lifespan considerably – many people today also worry that our last days might be filled with undue pain, discomfort, or other indignities. One hundred years ago, most people died in their own homes; today, most people die in hospitals. We worry that the diseases that afflict us, or even excessive medical care at the end-of-life, may be too burdensome to bear. Few of us want to spend our last moments in an intensive care unit, with IV lines and breathing tubes and all the other apparatus of high-tech medicine.

But this vision of what medicine has to offer the dying is limited; it does not give us the full picture of what is available. Fortunately, medicine today offers better alternatives for end-of-life care – alternatives that do not involve excessively burdensome interventions that have little chance of benefit. In fact, there is now a medical specialty all its own devoted to the care and comfort of patients when cure has become impossible: it’s called palliative care. Good palliative care can offer tremendous solace and consolation to patients and families in the face of an inevitable death.

Good palliative care addresses the needs of the whole person – not just the biological aspects of disease or disability, but the psychological, social, and spiritual needs of people in their final days. The work of palliative care in medicine is complemented by the hospice movement in nursing, which has made great advances in recent years in allowing patients to die in the comfort of their homes surrounded by loved ones, rather than in a hospital bed. With these approaches, the goals shift from curing the disease (which at some point becomes impossible) to caring for the person (which always remains possible). Good pain management, treatment of depression and anxiety, emotional and social support, and spiritual care are among the building blocks of good palliative care. We understandably fear the effects of terminal diseases – pain, loss of functioning, isolation, or becoming a burden on others. But with good palliative care, we need not fear that we will spend our last moments in intolerable pain, or alone, or subject to humiliating indignities.

While he was on this earth, our Lord Jesus Christ’s ministry was a ministry of healing. In imitation of Christ we are called to provide healing, comfort, and care to the sick, and especially with those whose illnesses prove to be terminal. At the end of life, medicine has made not only technological advances, but also advances in compassionate care, which we should embrace as Catholics. Our Catholic faith and morals do not require that we continue to pursue useless or excessively burdensome treatments that have little chance of benefit. St. John Paul II witnessed to this in his final days: he heroically bore the burdens of chronic Parkinson’s disease for years, but in his last days he decided to forego further intensive medical treatments in a hospital, and instead lived out his final days in his apartment surrounded by caregivers and friends. He accepted death when God wanted it, without hastening it and without fighting uselessly against it.

Medicine is built upon a long and venerable ethical tradition, stretching back to the Hippocratic Oath, which can be summarized: when possible to cure, always to care, never to kill. Their choice of living this life of compassionate care is a blessing to us all, and truly enables us –with those whom we love and care for (compassion) — to choose the gift of life at the end of life!

As Pope Francis has said “There is no human life more sacred than another, just as there is no human life qualitatively more significant than another. The credibility of a health care system is not measured solely by efficiency, but above all by the attention and love given to the person, whose life is always sacred and inviolable.”

In Christ,

+ Bishop Vann