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Confronting death before it comes

Questions about the end of life have faced human beings for as long as we have walked the earth. When will it come? Is there life after death?

Thanks to modern medicine, we now live longer and, thankfully, can prevent many premature deaths. But with these advances come many more questions: What is a "natural death?" How long would I want to prolong my life if I were facing a serious illness? What does it mean to "die with dignity?" Will I be ready for death?

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Whether we face these questions from a spiritual or practical perspective, we know one thing with certainty: Death will come to each of us and to our loved ones, and we would do well to think about some of these difficult questions before we are facing a crisis.

These questions have been recently highlighted by the very distressing story of Brittany Maynard, the 29-year-old woman with terminal brain cancer who plans to kill herself Nov. 1st in Oregon, where physician-assisted suicide is legal. We all offer our empathy and prayers to this young woman and her loved ones, even while many find her decision to commit suicide a terribly sad choice.

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It is to be hoped that it will also raise awareness of the important role that family, medical professionals and clergy can play in alleviating the fear and suffering that do not need to accompany the moment of our death. By taking the time to work with our caregivers so that they understand our wishes for pain relief, palliative care and spiritual support, we can offer a much more hopeful alternative to patients facing a terminal illness.

I sympathize with those who are the appointed health care agent of a loved one with responsibility for making emotionally and ethically challenging decisions for them as their health declines. I am thankful that when the time may come for me to make decisions on behalf of my parents, who are both in their 90s, I will have the comfort of being guided by our shared faith and by their trust in me to apply their wishes and the principles of our faith to whatever medical circumstances might present themselves during their care.

Evaluating the merits of medical interventions in a patient's treatment involves as much prayer as it does science, and every circumstance must be judged according to its individual nuances. All patients deserve access to effective pain management to ensure they do not suffer needlessly, and to appropriate palliative and hospice care. No one should feel the obligation to accept treatments that are excessively burdensome or that offer no medical benefit. But nonetheless, our most basic moral and ethical principles remind us that we can never cross the line that would allow us to willingly administer or provide the means to cause the death of another, no matter how "merciful" such an act may seem.

It is even more important that all of us provide for our spiritual care, having one's relationship with the Lord and with our faith community in good shape as that time approaches. With the support of our family and fellow believers, this time can be one of peace and grace for ourselves and loved ones if we have properly prepared for it.

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Recently, the Catholic bishops in Maryland issued several publications addressing these issues, including Comfort and Consolation, a foundational document outlining ethical principles to consider when making end-of-life decisions. We have also published a Q&A brochure summarizing Comfort and Consolation, and a practical brochure offering guidance in how to appoint a health care agent and complete an advance directive for medical decision making. It is our hope that these documents will be useful not only to Catholics but to all who wish to give serious and faithful thought to preparing for the end of our lives and of those we love.

We do not know the day or the hour, but by confronting these questions — before a crisis arises — we can do a great service for ourselves and our loved ones by sharing our wishes with faith, honesty and hope in the life to come.

William E. Lori is archbishop of Baltimore. He can be reached at communications@archbalt.org.

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