We plan for most events in our life, so why not plan for your end days as well. CNS photo/Nancy Phelan Wiechec

End-of-life care requires good planning

  • October 31, 2018

If vacations, weddings, babies and football games are important enough to require planning, why don’t we plan for sickness, frailty and dying?

“It’s only a modest majority of Canadians who have their Wills and Powers of Attorney sorted out. There are great numbers of people who don’t,” said lawyer Phil Horgan.

In an era when death is now legally presented to us as part of a buffet of end-of-life choices, careful planning for that final journey in life has become even more important.

“The most important part of such a process is writing a proxy, or a substitute decision-maker, or a power-of-attorney for health care matters document that specifies who will make decisions for you when you are incapable,” said clinical ethicist Fr. Mark Miller, who is also superior general of the Redemptorist Fathers in English Canada.

This isn’t a matter of trying to guess all the possible medical catastrophes and complications that might befall you on the way to the grave, then ordering up the correct treatment from a medical menu.

“Trying to guess one’s condition at the end of life is beyond most people,” said Miller. “But if they talk with their proxy or proxies, then the latter will have a good idea of what decisions would be made by the patient — and that’s the key.”

In addition to a Will, Horgan tells his clients they need two documents drawn up to cover them from debilitation to death: a Power of Attorney for medical care and a Power of Attorney for property. The lawyer’s fee starts at $100 per document if they are simple and straightforward.

“The key is you want to appoint someone you trust in both cases,” Horgan said.

Trusting that family will step in and just take care of things is a crapshoot. It’s hard to predict where your family will be and what other demands they will face when you can no longer speak for yourself.

“In situations where you don’t exercise your powers through either a Will or Powers of Attorney of your own, you’re also going to be subject to what the government may dictate,” Horgan said. “That’s going to be something which many people are going to have concerns about.”

On the surface, the process of setting up the proper documents with a lawyer and making wishes known to siblings and children seems relatively simple. Still, there is obvious resistance.

“The vast majority of people do not want to talk about what they don’t want to think about — debilitation at the end of life,” said Miller.

But now that euthanasia is legal, Catholics have even greater reasons to get over their reluctance.

“Perhaps many of us will have to write out directives that under no circumstances are we to be put to death,” Miller said.

Few of us make our best decisions when we are weak, afraid and vulnerable near the end of life. If we find ourselves in a medical and cultural setting that thinks of dying as a solution to all such difficulties, our minds might be made up for us by the most convenient and concrete option at that moment.

“(Patients) are being brainwashed by the euthanasia societies to think of dying as a horrible, painful procedure that one doesn’t have to go through,” Miller said. “To me, the place of dying is a holy place, where God is particularly close to the vulnerable and the weak.”

Since 1997, Horgan has offered standard Catholic formulations for a Power of Attorney for medical care. Twenty years ago it was a matter of ensuring nutrition and hydration as standard and ordinary care, in conformity with Catholic teaching. Now he has added clauses that clarify euthanasia, Medical Assistance in Dying or assisted suicide will neither be offered nor discussed. 

Most of Horgan’s clients will also specify they do not wish for extreme interventions that would extend life when death is the normal and natural course of events.

“It’s been quite popular with my Catholic clients,” Horgan said.

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