Newark Archbishop Issues New Pastoral Letter
The Most Reverend John J. Myers,
Archbishop of Newark, today published a new pastoral letter, "Whether
in Life or in Death, We are the Lord's." This pastoral, addressed
to the 1.3 million Catholics of the Archdiocese and all who can
benefit from this teaching, examines from a theological and moral
perspective an issue that has been in the public eye for many months
- our obligation to provide care and comfort to our brothers and
sisters whose lives "are nearing the end of their time ordained
for this world."
The text of this pastoral follows.
"Whether
in Life or in Death, We are the Lord's"
Romans 14: 7
I. Introduction
Many of us have experienced the sadness and
suffering of standing close by as the life of a loved one fades
and comes near the end of the time ordained for this world. My father,
my sisters and brothers and I knew this ordeal when we had to make
a variety of decisions as my mother's life faded and she underwent
a series of medical emergencies. The occasions and the discussions
were difficult, even wrenching. Fortunately, the family is close
and our relationships have remained good. Finally, in God's time,
He took her to himself. We have been deeply comforted by the faith
which we shared with her, and which she nurtured in us.
In this spirit, I wish to share some reflections
with those in the Archdiocese of Newark who may now or sometime
in the future seek comfort in Jesus Christ's victory over sin and
over death.
The words from St. Paul's letter to the Romans,
in the title, direct us toward the very heart of Christianity. Jesus
is sent by the Father to reveal the Mystery of God as a community
of persons in a relationship of loving communion. As the revelation
of the Father, Jesus, through His humanity, shines light on what
it means to be a person created in the image and likeness of God,
what it means to be truly human. By His death and resurrection,
Jesus redeemed us and made us His own, giving us the means necessary
to experience here and now what we will live fully when we have
passed from death into eternal life. The Gospel celebrates the truth
that "Whether in life or in death, we are the Lord's."
For the Christian people, Jesus remains "the
glory of man fully alive." Christ alone completely reveals
what it means to express the love from which and for which we were
created. Through the Church, God continues to reach out to us in
the person of His Son. Through the power of the Holy Spirit, God
enables us to understand just what it means to live as men and women
created in the divine image. The invitation of Christ is a call
for all men and women to encounter the Divine Presence. This encounter
affords us the opportunity to bring the most troubling and heart-wrenching
questions of human existence to the One who provides us the way
to understand and to address the most difficult circumstances of
life.
The revelation of God proclaimed by Jesus
was expressed most perfectly and definitively through His own willingness
to suffer and to die. Jesus is, therefore, precisely the one to
whom we should turn when we find ourselves confronted by the reality
of death in our own lives or in the lives of those we love. He didn't
simply talk about suffering and death; He endured them and He prevailed
over them. Jesus teaches us not only what it means that "in
life and in death, we are the Lord's." He also enables us to
live the truth of the words St. Paul has spoken.
II. What We Must Ask Ourselves
Earlier this year, our nation, indeed the
world, watched with stunned fascination the unfolding of death in
the life of one American family. The death of Terri Schiavo saw
unparalleled media scrutiny. Although we may not know all the facts,
we do know that many questions remain, including, for some, confusion
about Church teaching in these matters. At the center of our confusion
lies a set of important questions:
• What is the nature and meaning of
personhood?
• What is our moral responsibility to provide food and water
to those who are unable to care for themselves?
• What is the role of competent medical authority in assessing
the condition of those who seem incapable of human response?
• What are the obligations of a democratic society to safeguard
the lives of those most vulnerable and in need of care?
In order for all of us in the Church to be
able to make informed and morally licit decisions when our own health
is seriously diminished or death is imminent, we need to review
the Church's teachings on these important questions.
Every day in our country, feeding tubes are
removed or refused without garnering even local media attention.
What set the case of Terri Schiavo apart, what indeed made this
situation so unusually tragic, was the struggle between two groups.
One group considered Terri as a person who existed with them in
loving relationship; the other group considered that her personhood
had ended long ago. One group felt that the loving thing to do was
to continue caring for Terri; the other group seemed convinced that
it was an act of love to move her from life with God here to life
with God in heaven.
In the midst of the overwhelming media coverage
of Terri Schiavo's dying and of her death, many of us perhaps stopped
seeing her as a person but rather as an idea or as a cause, or in
a worst-case scenario, as a political tool. In the midst of this
confusion, we cannot allow ourselves to forget that beneath all
the arguments was a living human being.
We all need to keep in mind that Terri Schiavo
was and is a person, a sister in our faith. Though much that transpired
in the process of her death was disordered, she is with the Lord
and she has become, in a sense, a symbol of the confusion in America
over the tension between individual autonomy and communal responsibility.
Certainly, this experience underscores the need of making one's
wishes known in writing and in a form which is recognized in particular
jurisdictions.
III. Death is Our Reunion with Christ
We need to remind ourselves that death is
not an evil that should be feared. In the words of the ancient preface
of the funeral liturgy, "Lord, for your faithful people, life
is changed, not ended; and when the body of our earthly dwelling
lies in death, we gain an everlasting place in heaven." Death
is not only an end to "earthly" existence; it also is
the passageway to eternal life. Unnecessarily prolonging death,
clinging at all costs to this life, can be an attempt to reject
what our faith boldly proclaims, "Death has no more power over
Christ!"
It is a virtuous practice to pray for a happy
death, and many Christians have implored St. Joseph to obtain for
them what each priest and religious prays for every night, "a
peaceful death." While we should not hasten our death, we must
not fear it either. St. Benedict reminds us to pray for death each
day, as if it were to come tomorrow; for we know neither the time
nor the hour of its approach. Our hope is not to live our mortal
lives without end, but to live for all eternity with God.
The mystery that shrouds death causes fear
for many. Faith nonetheless strengthens what is lacking in our human
frailty and gives us the courage to embrace what we cannot change.
Faith also recognizes the necessity to be fearless in the face of
death. "Where I am going you know the way," Jesus tells
His apostles. We must live with confidence that Christ is preparing
a place for us and will indeed return to unite us with Himself.
While we live as God's children now, we long
for the moment when we shall become like Him and see Him face to
face. The way we respond to the suffering and death of those whom
we love, the way in which we embrace our own mortality, speaks volumes
about the way in which we have accepted that Jesus Christ is Lord
of the living and the dead. The inability to accept that suffering
is redemptive, or the inclination to immediately end the pain of
those who are suffering, reveals that we have not yet accepted the
Way for us to live the fullness of our humanity. Likewise, the refusal
to accept that death comes to all, shown by attempts to maintain
biological vitality at all costs, also reveals a failure to place
our hopes in Christ. Christians always must embrace life here and
now with their hearts and minds set on a world that will never end,
a world in which every tear will be wiped away.
IV. Forming End-of-Life Decisions
Our attitude toward death must be an extension
of our attitude toward life. Living now for God will determine how
we will face the moment when we pass from this world to the next.
In order to help the faithful put in place appropriate and clear
legal and medical directives, the Church has articulated a set of
principles derived from the most fundamental teachings on the dignity
of the human person and the inherent dignity of each human life.
Just as every individual human life is unique and unrepeatable,
from conception until natural death, so too the physical suffering
and medical condition of each person is unique and cannot be generalized.
The following ethical principles of the Church respect this aspect
of our individuality as children of God. They are meant to serve
as a helpful guide to end-of-life decisions, allowing us to embrace
suffering and death in freedom, and with peace of mind.
Our Obligation for the Proportionate
Means of Preserving Life
Life is sacred, for it is a gift from God.
As recipients of this precious gift, we are always morally obligated
to use ordinary means for maintaining and insuring physical health.
"Proportionate means" describes those medical remedies
and procedures that in the judgment of the patient and competent
medical authority, in light of the Christian understanding of the
dignity of human persons, offer a reasonable hope of benefit. Many
of us employ this principle without much thought as we consider
to what extent we wish to experience the side-effects of over the
counter remedies for such common ailments as the flu, a cold, a
sore throat, a headache, or muscle pain. At times we forgo a remedy
in favor of letting the illness "take its course" because
we do not wish to be hindered by the side-effects of the remedy
being considered.
This common-sense approach to illness, one with which we are all
familiar, is to be applied to those illnesses that are more severe
and life threatening. Our reasonable hope in the benefit of a proposed
treatment should not reflect an attitude of preserving life "at
all costs."
The Presumption in Favor of Providing
Nutrition and Hydration
As members of the human family, every man
or woman, regardless of age or socio-economic condition, requires
a set of fundamental human goods, among which are those required
for maintaining life: food, air, and water. Without these primary
goods, other basic human needs become inconsequential.
To insure that the human dignity of every
person is respected, there must always be a presumption in favor
of food and hydration, even for those patients who require assistance
for the delivery of those goods. When specific medical conditions
indicate that a medical treatment may place excessive burdens on
the patient without a sufficient benefit, the decision not to undertake
such a treatment can be morally licit. When such a decision is made,
continued care must be extended, including offering food and water
to the extent to which the patient is able to receive them.
The presumption for food and hydration must
also be carefully weighed, however, in consideration of both perceived
benefit and excessive burden. This is especially true when a feeding
tube has already been inserted. Depending upon the assessment in
light of proper ethical principles and in consultation with proper
medical professionals regarding the condition of the patient and
the capability of human response, it may be morally licit not to
undertake artificial nutrition and hydration, providing that the
intention is not to bring about the death of the patient and that
basic care is continued. For instance, if the food and hydration
in fact harms the patient, then capping or removing the feeding
tube would be a prudential judgment to relieve unnecessary pain
and suffering. The patient himself or herself or the designated
surrogate are the proper persons to make any required decisions.
Forgoing Extraordinary or Disproportionate
Means of Preserving Life
Often when it is time to make a decision
to forgo extraordinary means of preserving life, families and loved
ones are overwhelmed by the situation at hand. They may be pressed
for decisions on whether or not to harvest organs, whether or not
to remove life support or assisted respiration, or whether or not
to accept a diagnosis of "brain death." In such moments,
when there is little time to work through the facts and the emotions
of the situation, it is important to realize that the Church's teaching
is not "life at all costs." A discussion of reasonable
hope and excessive burden is not a denial of love and care for the
person who is suffering.
Whether or not a proposed medical procedure
is "extraordinary" or "disproportionate" can
only be determined with reference to a specific medical condition
of one given individual. Not all cancer patients, not all non-responsive
individuals, not all persons facing imminent death can be assessed
under a predetermined protocol. An informed judgment can only be
made by the patient or legal surrogate in close concert with medical
professionals in the light of Church teaching.
The intensity of emotion can inhibit our
ability to assess either the hope of benefit of the proposed treatment
or any potential burden that treatment might inflict on the patient
and on those responsible for providing the care - the family, doctors,
nurses, and aides who are tied in love and charity to the patient.
It is essential to establish a loving human relationship between
the medical caregivers and the patient in order to insure that the
dignity of that person is appropriately respected. Always, provisions
should be made that the person receive the sacraments of the Church,
including the Apostolic Blessing reserved for those near death.
The family and friends should have the benefit of the ministry of
the Church, and representatives of the Church should encourage them
with prayer and by sharing our faith in Jesus and the salvation
He offers.
The Importance of Making a Free and
Informed Judgment
In order to assure a patient or a chosen
legal surrogate that the decisions made regarding the end of life
are licit and expressive of faith in Jesus Christ, the Church encourages
all the faithful to seek guidance from medical professionals and
from pastoral caregivers.
An informed decision should include competent
medical authority. We must welcome and embrace all that has been
learned by those who practice the medical arts as a vocation of
human relationship. The development of this relationship will help
remind all parties involved that the decisions to be made are always
moral, as well as scientific.
No one should feel alone or incapable of
deciding what best respects the individual dignity of the person
suffering. When fully informed by the teaching of the Church, each
Christian's prudential judgment regarding end-of-life issues is
an exercise of that same freedom we experience in our sacramental
union with Christ. It is the same freedom we feel having celebrated
the sacrament of Penance, the same freedom we feel receiving the
Eucharist, and the same freedom we feel in the loving company of
those whom Christ has gathered around him in friendship.
On the Nature and Meaning of Human
Personhood
Those whose lives are dedicated to the medical
arts can also help us understand the Church's teaching on the nature
and meaning of being a person. The advances in our knowledge of
the workings of the mind and body as a compact unity affirm that
which the Church has always held: being a person is a gift of having
been created in the image and likeness of God. While all created
reality serves God's purpose, only human beings are able through
their physiology and spirituality to participate with God in the
work of creation. Likewise, the medical arts are a supreme example
of our ability to work with nature as we journey toward our completeness
in physical health and through a "long stretch of days."
Medicine, when rightly practiced, seeks to insure that all men and
women can experience their humanity with vitality and fullness.
While all living creatures reveal the mystery
of God in a way unique to each, only human beings reveal the mystery
of God in a way not determined or limited by physiology alone. Only
human beings can act in such a way that their life in the body conforms
to their hearts, their minds, and their wills. This is why a human
being is rightly called a person, for human beings are more than
the aggregate of physiological integrity. They have a spiritual
life as well, and are capable of thought and decision, even though
in the embryo or fetus these abilities are present potentially.
When assessing the mental state or physical
condition of a developed human being, competent medical authorities
seek to determine the extent to which everything physically required
for an individual to express him - herself, beyond merely bodily
response, is functioning appropriately. Our medical professionals
try to ascertain whether or not, in some appreciable measure, the
individual is capable of communicating, "I am present."
While this diagnostic communication is taking place, we should all
encourage our doctors to be open and honest with us as patients,
family, and friends. Participating in a genuine relationship with
our doctors requires that we trust their professional judgment,
especially when the situation is deemed life-threatening.
When facing end-of-life situations, we should
never forget that personhood and human life are inextricably bound
together. The Catholic Church teaches that the dignity of personhood
is an innate dimension of being human. Personhood and human life
can never be separated, for they are a unity willed by God. The
Church looks to the advances made in the medical arts to understand
better those situations in which the unity willed by God is no longer
viable.
Each human person, therefore, is always more
than the sum total of biological integrity. While it is true that
human beings can be physically and mentally disabled by imperfections
of the mind or body, it is never true that the physical or mental
diminishment of a human being means that an individual is no longer
a person. Personhood must never be thought of solely as a judgment
imposed by others. Being a person is the ultimate gift of having
been created by God in such a way that one can choose to share God's
life. To make such choices, we must first have a degree of mental
and physical health that enables us to do so.
On the Question of Euthanasia
Many, many Catholics have shared the experience
of tending to their loved ones in their last days and know the complexity
of the emotions and questions which can arise. Their love for the
Creator and His will offers sure guidance and comfort in protecting
life appropriately, even when the situation is beyond our understanding.
We must be careful as a nation that the laws
we enact to promote and protect our prudential judgments over end-of-life
issues do not intentionally or unintentionally allow for the direct
termination of a human life. What a person experiences in embracing
suffering and death informs and instructs others about the responsibility
we have to one another in love. Human life will only be cherished
and sacred to the extent that the commitment we make to respect,
care for, and love one another is unwavering.
V. The Sacrament of Presence
For the Catholic faithful, the gift of each
life is essentially a "sacrament" of presence. This teaching
emanates from the fact of God becoming man in the person of Jesus.
The abiding sign of the Church's belief in the dignity of the human
person is the belief in the real presence of Christ in the Blessed
Sacrament. By Jesus' words and the power of the Holy Spirit, the
Eucharist is the means by which Jesus' real presence remains with
us until the end of time. Through the power of the Holy Spirit,
the goods of creation are used to permeate the whole of human history
with the Presence of divinity. What appears as simple bread and
wine communicates a Presence that transcends our human senses.
In the same way, human life is able to communicate a Presence that
transcends what we sensibly perceive. Through the power of the Holy
Spirit, individual human lives are incorporated into the life of
Christ in such a way that they become the means by which his Presence
is encountered and experienced in the world. Just as we cannot reduce
the elements of the Eucharist only to that which we are capable
of sensing, we must likewise never reduce a human life to what is
merely biological.
Every human life bears the dignity of the Creator. No human life
is ever considered to be the mere sum of biological and physiological
processes. These natural processes ordered toward and directed by
the brain, allow a person the sense of being present. Because of
advances in medical technology, the precise time of death can be
difficult to ascertain. Both ethical and medical criteria should
be applied, often in dialogue with those with special training.
Again, the patient or proper surrogate should make any decisions,
fully informed of the teaching of the Church.
For the Christian people, baptism empowers
the original dignity of personhood to become an active and innovative
sign of God's love as a present reality. That is why the Church
speaks of the "quality" of a human life as something greater
than one's emotions or reflexive responses. The quality of each
human life lies in the fact of its presence as a living, existing
reality that remains an incarnate sign of the God who created all
things.
Therefore, special and loving care must be
extended to each human being, especially those no longer experiencing
life as the compact unity that God intended. For them and for those
who have died, we have a singular responsibility to insure that
our treatment of them is worthy of the dignity they possess as having
been created in God's image and likeness. Whether in life or in
death, every one of us matters.
Veneration for and care for the body does not end with death. Since
the body is integral to the human person, Christian believers have,
from the earliest days, accorded the body special respect. It is
preferable that the body be buried with due solemnity and with prayers
for the deceased. Together, after all, we look forward to its resurrection
and to our more complete sharing in the Life of Christ.
VI. Conclusion: Keeping Vigil with
the Dying
To stand with others and keep vigil while
they suffer and die is the greatest gift of love a human being can
experience. It also provides the greatest opportunity to learn.
Those who suffer and those preparing to die have much to teach the
healthy and the living about the mystery of our humanity and the
dignity that is ours through our relationship with God. Every human
life is valuable. Those who keep vigil with the dying are familiar
with the overwhelming beauty of this truth.
We witnessed this recently through the unfolding
death of John Paul II. While the world watched the controversy surrounding
the last days of Terri Schiavo, this great man offered his life
as a testimony to what the Church believes and holds sacred. His
choices about how he would die embodied the way he chose to live:
of and for the God who had called him to the priesthood and eventually
to stand as Peter. In life and in death, John Paul II made it clear
that he lived for God. Through his own slow demise, he became an
icon of human dignity and a sacrament of the inherent worth of each
individual person.
Christ demonstrated this for us on the Cross. He allowed the experience
of His physical condition to become an opportunity for others to
learn what only those who are dying are capable of teaching. Like
the crowd of people who stood and kept vigil, we are challenged
to find our place near "the Cross" of other people's suffering
and death.
The grace of keeping vigil touched the lives
of the men who were present only out of duty and obligation. It
was the job of the soldiers to stand and keep vigil. What Jesus
revealed through His suffering and death changed the lives of many
of those men; they experienced something beyond what they were used
to or what they expected. It was because of the way that Jesus embraced
the dignity of His personhood through the reality of His tortured
and diminishing humanity that one of the men was forced to say,
"Truly this was the Son of God." At the moment of the
Cross, humanity and divinity were perfectly one in a glorious way.
Others were moved to be present for varying
reasons, some out of genuine human compassion. They were affected
in ways they could not have anticipated. Their willingness to keep
vigil opened their eyes to the revelation of Divinity that was only
possible through the diminished physical body and limited human
responsiveness of Jesus. That afternoon they walked away with a
deeper insight into the dignity of their own fragile and vulnerable
humanity because they recognized in the suffering and death of Jesus
the real presence of God.
Those who had felt such a presence throughout
Jesus' public ministry were also there that day. Foremost among
them was John, the beloved friend who had left everything to come
and see the one who just might be the messiah. No one can imagine
what John felt as he kept vigil with Jesus dying on the Cross. We
can say with utmost certainty that the moment of the Cross defined
everything John thought about Jesus and every experience they shared.
For Pope John Paul II, one of the greatest gifts he received from
Christ was that many kept vigil with him while he died.
Next to John at the foot of the Cross was
Mary, the Mother of Jesus. She experienced the grace of keeping
vigil with the dying in a way unlike any other. What she learned
through the suffering and death of her only Son was a gift entrusted
to the Church at its inception. It remains a gift preserved by the
Church to this day. Mary's insights about suffering and death, her
solidarity with those whose lives are physically and mentally diminishing,
are a great consolation to all of us who will one day pass from
this life to the next. What Mary is able to teach us can help us
in the decisions we make about how we will approach the end of our
lives. Let us ask her to assist us now and at the moment of our
deaths in order that we may see with greater clarity how to live
both our life and our death as she did: for the Lord.
Given at my Chancery this 8th
day of September, 2005, The Nativity of the Blessed Virgin
Most Reverend John
J. Myers
Archbishop of Newark
