How Faithful Catholics May Use the Law at the End of Life

Doctor-Patient-Hands-620x320The last time I checked, the mortality rate in this country was still 100%. To die usually involves unavoidable suffering. I don’t think these things will be changing any time soon.

This is not a cause for anxiety or dread. Christ our Savior has made death and suffering into pathways to eternal life. “Precious in the sight of the Lord is the death of his faithful ones.” (Ps. 116:15). “Eye has not seen, nor ear heard, nor have entered into the heart of man the things which God has prepared for those who love Him.”  (1 Cor. 2:9).

The Lord loves us. We are His body, the Church. His sufferings are ours, and ours are His. He has made it possible to endure unavoidable suffering by offering it to Him to help Him redeem mankind.

When we share His sufferings we “complet[e] what is lacking in Christ’s afflictions for the sake of his body, that is, the church.”  (Col. 1:24). Like the pain and fatigue of an athlete running a marathon, suffering is not the goal, but the byproduct, of what the Lord does to redeem us.

“Then he said to them, ‘Oh, how foolish you are, and how slow of heart to believe all that the prophets have declared! Was it not necessary that the Messiah should suffer these things and then enter into his glory?’” (Luke 24:25-26).

We are blessed to endure sufferings with Him in order to enter into the glory of the Resurrection with him.  “For he has graciously granted you the privilege not only of believing in Christ, but of suffering for him as well.”  Philip. 1:29.

Don’t get me wrong. I am not saying we should avoid pain-killers or other palliative care. Physical pain may be minimized; emotional and other pain may be soothed. But suffering of some kind, including emotional, is likely to be part of our dying or the dying of our loved ones. It is to be used, not feared.

Eternal joy with God awaits us on the other side of death if we are faithful. “Father, I desire that those also . . . may be with me where I am, to see my glory, which you have given me because you loved me.” (John 17:24).  “I consider that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us.” (Rom. 8:18).

Living out our own love for God can include using legal tools that allow us and our loved ones to die His way, which is not necessarily our way. This outline will describe how Christians may use American law on end-of-life issues to strengthen our ability to die a Christian death.

Legal Principle of “Autonomy” in End-of-Life Law

In issues that relate to life and medical care, American common law begins with the premise that our bodies are our own, and we are in charge of them. This is the principle of “autonomy.”

This not the same as the Christian view, of course. The Holy Spirit has told us in the Scriptures that our bodies are not our own, but are the Lord’s, and we are not happy unless we live in His way. (Romans 12:1; 1 Cor. 6:19-20).

Under the principle of autonomy, a patient may decide whether or not to obtain medical treatments. But what should be done when a patient is too sick or injured to make those decisions? Can the patient bind a health care institution in advance as to how he or she wants to be treated? Can someone else be deputized to make those decisions? What criteria should be used to determine whether a long-term unconscious person should be kept alive or not?

I practice law in Missouri. The States vary, and so do their laws, but I understand that most States, if not all, give primacy to the principle of autonomy over other principles, such as pure economic cost, in end-of-life cases.

Autonomy cuts both ways. It can allow a person to foreswear his religious principles and surrender to an attitude that may be summarized as, essentially, “If I can’t enjoy life any more and I’m helpless, then just get rid of me.” Or autonomy can allow Christians to exercise their right to obtain treatment procedures that makes their lives an offering to God, to do His will until death comes in God’s own good time.

In the law, it is the function of documents known variously as “advance directives” or “living wills” (a terribly misleading phrase, but common) to provide clear and convincing evidence of the patient’s own wishes about medical procedures later in life. In addition, it is the function of documents knows as “durable powers of attorney” or “health care powers of attorney” to clothe a third person with authority to make treatment decisions for an individual who can no longer do so for himself or herself.

To the extent that judges will enforce them, these documents can provide protections for Christian patients and families who want to die according to Gospel values.

The most important thing that Christians can do in order to assure that their dying honors life, even when life is not as pleasant as we would naturally prefer, is to appoint a good person with a strong personality as their agent under a durable (or health care) power of attorney to exercise and protect their right to live until death comes from disease or infirmity, and not from being starved to death or executed in other ways.

The second most important thing to do is to provide the agent with a good, solid advance directive that provides the principles that the health care agent should follow in making health care decisions on the Christian patient’s behalf.

Before anyone tackles these documents, he or she should do some homework. For a Catholic, the most important homework is to study the moral principles that the Church has honed from the Scriptures and the experience of hundreds of years of scientific medical treatments.

The best single introduction known to me appears to be “A Catholic Guide to End-of-Life Decisions,” a summary of less than 10 pages on the web site of the National Catholic Bioethics Center. One can also profitably review portions of the U. S. Catholic Conference of Bishops’ Ethical and Religious Directives for Catholic Health Care Services (Fifth Edition, 2009), particularly pp. 6-7, 29-30, and Directives nos. 55-64, pp. 30-32.

I have examined several types of advance directives and powers of attorney, and some are much better for Christians than others.  That is a post for another day.


Do we love the Lord? Do we love Him enough to let Him determine what is best for us? If we do, we will end up happy with Him forever. Let Him determine when we die. Let us use the time he gives us wisely, and if all we can do is pray for ourselves and others, let us do that with gladness and joy, the way He went to crucifixion for us.

“The Lord is not slow about his promise, as some think of slowness, but is patient with you, not wanting any to perish, but all to come to repentance.” (2 Pet. 3:9).

Never forget the way our final victory over death and suffering is described in Scripture.

“God himself will be with them; he will wipe every tear from their eyes.  Death will be no more; mourning and crying and pain will be no more, for the first things have passed away.’ And the one who was seated on the throne said, ‘See, I am making all things new.’” (Rev. 21:3-5).

Jim Cole received his law degree from Harvard Law School and practices law in St. Louis, Missouri.  He serves as volunteer general counsel for Missouri Right to Life.