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Advance Directives

When talking about planning for medical decisions near the end-of-life, we usually hear about two kinds of legal documents: a “health care proxy” and a “living will.” Both of these documents allow a person to give “advance directives” about what kind of medical care and treatment they want as death approaches, if they can’t make decisions for themselves. For a number of reasons, we strongly recommend that people avoid “living wills” and instead execute a “health care proxy”.

Health Care Proxy

Under New York State law you can appoint a particular individual as your health care
“agent” or “proxy”. This person will have the authority to make all medical decisions that
are in your best interests, but only if you are no longer able to do so yourself. You can give
the agent/proxy specific instructions about the kinds of care and treatment you want, and you can also limit their authority.

Choose your agent/proxy carefully. Pick someone who has good moral character who
knows you well and knows your religious beliefs. Look for someone who understands
medical information, and can handle stress. It is especially vital to choose someone who
will make decisions according to Catholic moral teachings. Here is some language that
you may wish to include in your health care proxy, to give clear instructions that you want
to be treated according to Catholic principles.

“I desire to receive all care that is morally required by the teachings of the Church, and that nothing be done that is contrary to the teachings of the Church. I do not desire anything that will directly take my life, and that that no “extraordinary measures” be taken to unreasonably prolong my life. The term “extraordinary measures” should be understood according to the teaching of the Church. I desire that all ordinary care, including painkillers and assisted food and hydration, should be provided to me as required by the teachings of the Church.

Don’t let the law choose an agent for you.

If you become incapacitated and you have not appointed a health care agent, the law will appoint one (called a “surrogate”) for you. The choice will be made from a prioritized list of persons who are related to you –your spouse, adult children, siblings, etc. You have no control over who is chosen. You cannot guarantee that this person will make medical decisions for you in keeping with your preferences, moral values and religious beliefs. If your wishes are not known, the surrogate can use his own judgment about your treatment and best interests – which may not be the same as yours. To avoid this, we urge you to execute a health care proxy.

Where can I get a Catholic health care proxy?

1) You can download a Catholic health care proxy form here

2) You can also access one in the booklet “Now and at the Hour of our Death,” which you can find here.

Why should you avoid a living will?

A “living will” is a written legal document that specifies what kinds of care and treatment
you want or don’t want. We strongly urge you to avoid the living will.

If you become incapacitated, the doctors and your family are legally required to obey the
living will. There is no flexibility and the living will may not reflect your desires or best
interests in unforeseen circumstances. Nobody can foresee all possible situations and make sound moral decisions in advance.

The living will also prevents your agent from evaluating your specific condition and
deciding whether a treatment is ordinary (more benefit than burden) or extraordinary
(more burden than benefit). This may result in denying care or treatment that is morally
required under Catholic teaching.

Unless you are very careful about the terms of a living will, it can easily lead to
euthanasia. For example, some living will forms suggest that people decline ordinary care and treatment such as assisted food and hydration, the insertion of a feeding tube, assisted respiration, and even feeding by hand. As a result, you may die from starvation or
dehydration rather than from your underlying condition. That’s euthanasia, not a normal
natural death – and it is always morally wrong.

The MOLST (Medical Orders for Life Sustaining Treatment) is very commonly encouraged
by medical staff at nursing homes and hospitals. These share the same problems as living
wills – they’re inflexible, can’t foresee all circumstances, and are likely to result in the denial of morally required care. We urge you to exercise extreme caution about the MOLST – you are never required to consent to one.

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