Q. I am an 83-year-old woman currently considering how to word my health care proxy. I’m wondering about the ethics of requesting that I not be resuscitated if I stop breathing or my heart stops. Might I consider this to be “God calling me home” or would that be premature since I am not very elderly or very ill? (I’ve heard that resuscitation can cause ribs to break, which in turn can injure lungs and heart; I’ve also been told that one does not necessarily recapture the original state of health after being revived.) (Green Bay, Wis.)
A. A DNR (“Do Not Resuscitate”) order instructs medical personnel not to attempt cardiopulmonary resuscitation (CPR) when a patient’s heartbeat or breathing stops. CPR may involve a combination of techniques, including chest compression, electrical shock and the insertion of an airway tube, which, as you indicate, have risks, particularly when the patient’s health is already in serious decline.
A DNR order may or may not be morally appropriate, depending on the circumstances of a particular case. The decision requires a balancing of burdens and benefits. For a patient who is frail and elderly, one who is terminally ill or one who has suffered extensive brain damage, it may appropriately be judged that CPR would be excessively burdensome compared to the transitory benefit it might offer. But for an otherwise healthy person who has suffered cardiac arrest, CPR is the proper call since it would likely restore the patient to a fairly normal life. In the traditional terminology of Catholic medical ethics, whether CPR constitutes ordinary or extraordinary care can only be judged as it pertains to an individual set of circumstances.
In your situation, since no serious medical emergency has yet arisen and you have no way of forecasting the exact details of such an emergency, I believe it would be premature and unwise for you to sign a DNR. It’s probably best for you simply to indicate to your health care proxy that you would be comfortable with a DNR in a circumstance where Catholic moral teaching would allow it.
Q. I enjoy reading your column, and your answers are informative and insightful. A while ago, though, one of your columns really irked me — not your answer, which was fine, but the question itself. A woman wrote to complain about the length of her parish’s Sunday Mass. She moaned that it took more than an hour, and I say, “So what?” She minded the fact that the lector had to walk from pew to the lectern (which probably took all of 30 seconds). She mentioned that she and her husband are of Social Security age and have no patience for delay. (My husband and I are that same age, and we love going to Mass.)
Think about this: Jesus spent three hours on the cross in a terrible agony. Before that, he was whipped by Roman soldiers, had thorns pushed into his head and was made to carry a cross. And we can’t spend an hour a week honoring him? That woman definitely needs prayers, and I will include her in mine. (Metuchen, N.J.)
A. Direct language from a true New Jerseyan. You’re right, an hour given back to God seems rather modest. The General Instruction of the Roman Missal makes a strong plea for reverence in the eucharistic celebration, including periods of silent reflection.
The need to empty the parking lot before the crowd arrives for the next Mass is a valid concern, but it shouldn’t be allowed to trump everything else. As with many things, though, balance is the key.
In No. 40 of the general instruction, we’re told that there should be “due consideration for the culture of the people and abilities of each liturgical assembly,” and a parish church is not a monastery.
Questions may be sent to Father Kenneth Doyle at firstname.lastname@example.org and 40 Hopewell St., Albany, NY 12208.
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