Making Sense of Bioethics: Did I make the right choices as dad was dying?

Sometimes people will contact the National Catholic Bioethics Center (NCBC) wondering if the decisions they made on behalf of a dying family member were the right ones. The NCBC provides a free Ethics Consultation Service where individuals can ask questions and seek guidance about ethics and medical decisions. 

Some who call are interested in reviewing the details of how a loved one died, along with the advice they were given by doctors, nurses, hospice workers, family members and friends. While their loved one may have died months or even years earlier, they may still be unsure or unsettled about the treatment decisions they made.

End-of-life situations are not easy to sort out. Important practical details and medical facts may no longer be available or may have been forgotten with the passage of time. Sometimes family members may have disagreed with each other or were feuding about how best to proceed or may not have wanted to seek out expert advice or guidance, so the decisions they made might have been hasty or under duress.

A friend once spoke to me about a young man who had shared with her some details about his father’s death. He told her that as he looked back on it, he had doubts that he had made the right decisions as his dad became more debilitated. He felt he had failed his dad because of the limited kinds of care he ended up authorizing on his behalf. My friend sought to reassure him that he really shouldn’t be troubled about it, because she couldn’t imagine that he would have done anything but his best under the circumstances, and so his dad likely had received very good care.

When she recounted the story to me, I asked, “But how would you actually know that his dad received good care and that the son really did make the right choices? Objectively speaking, the son may be right that some of the decisions were poorly made or selfish or otherwise flawed.” I asked her whether her first instinct may have been to try to soothe his feelings and emotions, rather than considering the specific medical and ethical concerns he was raising.  

I continued and offered: Maybe he really does need to discuss the facts of the case as best he remembers them. Perhaps he might benefit from bringing some of his concerns to the Sacrament of Confession. Assuming his concerns have some basis, even while acknowledging the uncertainties in his own decision making, such a step would help him find needed healing. By turning to the infinite mercy of God, and “clearing the decks” with the Lord in this manner, he would be strengthened to move forward in a new way without continually having to look over his shoulder and wonder endlessly about whether he did right by his dad. Finding a sense of peace and resolution in this way is important, and his father, now long deceased, would, we could presume, want to see that kind of healing for his son as well.

My friend was intrigued by my comments and acknowledged that her first inclination had been to try to palliate and calm the situation by mostly talking around the issues and concerns he had raised. On further reflection, she could see the value of dealing more directly with those concerns so he could find a real measure of closure.

Dying well, of course, is a profound grace, not only for the person who passes on, but for all who are left behind. To die well does not imply that we have to use every medical treatment that may be available. We are required only to use those medical treatments or procedures that are deemed reasonable or “ordinary.” In other words, we should avail ourselves of those treatments that offer us more benefits than burdens.

It can be challenging to find useful and reliable sources of information to assist us as we try to make informed decisions about complex health care situations that may arise as death approaches. 

I typically recommend these resources from the NCBC: First, some of my writings on “End of Life Decision-Making,” available at Tiny.one/EOL-decisions. Second, a newly-released video, entitled “The Gift of Dying Well,” available at Vimeo.com/bioethicsvideos, and finally, the NCBC’s “Catholic Guide to End-of-Life Decisions,” available at Tiny.one/NCBC-Guide.

Our efforts to lovingly support our family members through the dying process and to make careful and morally correct decisions on their behalf as they decline in health are very important. Those committed efforts are signs of our desire to be faithful to the beautiful bonds of love connecting us to our dear ones and to the Lord of life. Therefore, we should never be afraid to seek counsel and to avail ourselves of the Church’s wisdom in these areas.

Rev. Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, Mass., and serves as the director of education at The National Catholic Bioethics Center in Philadelphia. See ncbcenter.org and fathertad.com.