Living_will_Terri_Schiavo
A collection of thoughts about our last days...
Download a Health Care Proxy form: New York State
A commentary on the case by Barbara Crafton:
THE TERRY SHIAVO CASE....
March 21, 2005
By now, her
disconcertingly animated face is familiar to all of us -- Terry
Shiavo wears a permanent smile. But both her hands are clenched
against her shoulders in tight little fists she can't relax.
Sometimes she seems to respond to people; usually she does not.
Sometimes her eyes seem able to follow motion; usually they do not.
So is this a persistent vegetative state? I am not qualified to
evaluate that, but I have done enough hospital work to know that
such conditions are not always what they seem on observation alone.
This is an extraordinary case, House Speaker Tom Delay said last
night -- but the terrible truth is that it is not at all
extraordinary. Not in the least. Every doctor has seen many of them,
every nurse, every pastor. There are thousands of Americans in just
Terry's condition in hospitals throughout the country right now.
And so both houses of Congress hurried back to Washington -- as did
the president -- to enact a law for this one tragic case. Terry's
Law, I suppose it will be called, in accordance with the recent
naming of laws after the person in whose memory they are tailored.
And, because it is law, it will in some way become part of
precedent: you argue law on the basis of law that has gone before.
But perhaps it is not its content, so specific to Terry
Shiavo, that will be its legacy in precedent: instead, it will be
the expectation it will engender. My daughter, my son,
my mother -- why can't I have an act of Congress to resolve my
pain? They ran back to the Capitol for Terry Shiavo -- what about my
sister? What about thirty, forty, a hundred people's sisters whose
lives hang in the terrible ellipses in which Terry's lingers? Shall
we have a federal law for each of them?
I am torn about Terry. I don't know what is best. But I do know that
a dangerous precedent is being set in ratcheting this tragedy up to
the congressional level. There is a reason why we have separation of
powers, a reason why we understand the states to be competent to
decide such matters themselves. Proponents of congressional
intervention argue from the tragedy of this case and the innocence
of its central figure. But there are thousands of tragedies every
day. Millions. Millions of innocents. Congress cannot manage them
all, and it must not be allowed to pick and choose those it will
entertain for its own political reasons.
Hospital chaplains and compassionate doctors and nurses help
families walk this terrible path every day. I wish they had been
allowed to finish their work in Florida.
Copyright © 2005 Barbara Crafton
LIVING WILL IS THE BEST REVENGE
Series: SAY WHAT?
Robert Friedman. St. Petersburg Times. St. Petersburg, Fla.: Mar 27,
2005.
pg. 8.P Robert Friedman is editor of Perspective. He can be reached
at
mailto:friedman@sptimes.com.
Like many of you, I have been compelled by recent events to prepare
a more
detailed advance directive dealing with end-of-life issues. Here's
what mine
says:
In the event I lapse into a persistent vegetative state, I want
medical
authorities to resort to extraordinary means to prolong my hellish
semi-existence. Fifteen years wouldn't be long enough for me.
I want my wife and my parents to compound their misery by engaging
in a
bitter and protracted feud that depletes their emotions and their
bank
accounts.
I want my wife to ruin the rest of her life by maintaining an
interminable
vigil at my bedside. I'd be really jealous if she waited less than a
decade
to start dating again or otherwise rebuilding a semblance of a
normal life.
I want my case to be turned into a circus by losers and crackpots
from
around the country who hope to bring meaning to their empty lives by
investing the same transient emotion in me that they once reserved
for Laci
Peterson, Chandra Levy and that little girl who fell into a well.
I want those crackpot strangers to spread vicious lies about my
wife.
I want to be placed in a hospice where protesters can gather for
weeks on
end, so they can bring further grief and disruption to the lives of
dozens
of dying patients and families whose stories are sadder than my own.
I want all those people who attach themselves to my case because of
their
deep devotion to the sanctity of life to make death threats against
any
judges, elected officials or health care professionals who disagree
with
them.
I want the medical geniuses and philosopher kings who populate the
Florida
Legislature to ignore me for more than a decade and then turn my
case into a
forum for weeks of politically calculated bloviation.
I want total strangers - oily politicians, maudlin news anchors,
ersatz
friars and all other hangers-on - to start calling me "Bobby," as if
they
had known me since childhood.
I'm not insisting on this as part of my directive, but it would be
nice if
Congress passed a "Bobby's Law" that applied only to me and ignored
the
medical needs of tens of millions of other Americans without
adequate health
coverage.
Even if the "Bobby's Law" idea doesn't work out, I want members of
Congress
- especially all those self-described conservatives who claim to
believe in
"less government and more freedom" - to trample on the decisions of
doctors,
judges and other experts who actually know something about my case.
And I
want members of Congress to launch into an extended debate that
gives them
another excuse to avoid pesky issues such as national security and
the
economy.
In particular, I want House Majority Leader Tom DeLay to use my case
as an
opportunity to divert the country's attention from the mounting
political
and legal troubles stemming from his slimy misbehavior.
And I want Senate Majority Leader Bill Frist to make a mockery of
his
medical training by misrepresenting the details of my case in ways
that
might give a boost to his 2008 presidential campaign.
I want Frist and the rest of the world to judge my medical condition
on the
basis of a snippet of dated and demeaning videotape that should have
remained private.
Because I think I would retain my sense of humor even in a
persistent
vegetative state, I'd want President Bush - the same guy who
publicly mocked
Karla Faye Tucker when signing off on her death warrant as governor
of Texas
- to claim he was intervening in my case because it is always best
"to err
on the side of life."
I want the state Department of Children and Families to step in at
the last
moment to take responsibility for my well-being, because nothing bad
could
ever happen to anyone under the Department's care.
And because Gov. Jeb Bush is the smartest and most righteous human
being on
the face of the Earth, a man who has never made a mistake or allowed
his
judgment to be sullied by personal or political concerns, I want any
and all
of the aforementioned directives to be disregarded if the governor
happens
to disagree with them. If he says he knows what's best for me, I
won't be in
any position to argue.
PASTORAL LETTER TO
ALL THE CHURCHES AND FAITHFUL IN THE DIOCESE OF SOUTHEAST FLORIDA
FROM THEIR DIOCESAN BISHOP, THE RIGHT REVEREND LEOPOLD FRADE:
Grace, mercy and peace to you from God the Father and from our
Resurrected Lord Jesus Christ. As we begin this Easter Season we
rejoice in the knowledge that our Lord Christ is risen from the
dead, trampling down death and giving life to those in the tomb.
As I write this Pastoral Letter, we are challenged by the reality
of death in the suffering of a family facing the death of their
spouse, daughter and sister. Terri Schiavo is our neighbor, a
fellow-Floridian, and our sister in Christ.
By now we have all heard how this young woman sustained severe brain
damage from lack of oxygen after collapsing at home in 1990 with
heart failure due to a chemical imbalance believed to have been
brought on by an eating disorder. We know that the many doctors who
have examined and treated her have determined that she is in a
persistent vegetative state with no hope for recovery. Tests have
repeatedly shown massive shrinkage of the cerebral cortex and no
electrical activity coming from the brain.
Because Terri Schiavo left no instructions about whether she would
want to have life- ustaining treatment continued in such a
situation, her family has been left with a painful decision to make.
In 1998, Terri’s husband petitioned the courts to allow the removal
of a feeding tube that serves as her means of hydration and
nutrition. Although the decisions of both state and federal courts
since that time have been overwhelmingly in favor of removing the
tube, Terri’s husband and parents are engaged in a bitter dispute
about her care, and both state and federal legislators have become
involved in the case.
Unfortunately, a decision like the one that the relatives of Terri
Schiavo are facing is being faced in many hospitals at this very
moment in our country and around the world. I am sure that many of
our faithful are suffering, have suffered or will face the pain of
making such sad decisions in the future. I encountered such a tragic
and painful moment myself, at the deathbed of my comatose mother,
when my sister and I were forced to decide whether to continue care
or to accept our mother’s condition as irreparable. I understand the
pain and suffering of the relatives of Terri Schiavo and how hard
such a decision must be for them, as it was for my sister and me.
Medical science continues to provide us with many miracles of
healing, but it has also given us these painful choices. As
Christians, we must be ready to face these difficult questions when
they arise in our lives and in the lives of those around us. We must
remain faithful to our Christian belief in the sanctity of each
human life as a cherished creation of God, but we must reject an
attitude that disregards the inevitability of physical death. Our
Easter faith assures us that the death of the body is not the end of
life.
There is a difference between allowing a terminally ill person to
die of natural causes, even by withholding or withdrawing of heroic
and extraordinary life-sustaining treatments, and the initiating of
actions that will cause someone’s death. I believe that allowing
death to take its course is morally appropriate when death is
inevitable and will obviously be the natural outcome. We must be
aware that our good intentions in blocking this process can rob the
patient of the dignity of a peaceful and natural death. We must not
be trapped by our own technology that can prolong dying without
really extending life.
I totally agree with our Church’s decision at General Convention in
1991 where a resolution was passed stating, “there is no moral
obligation to prolong the act of dying by extraordinary means and at
all costs if such dying person is ill and has no reasonable
expectation of recovery.”
However, the same resolution stated, “it is morally wrong and
unacceptable to take a human life in order to relieve the suffering
caused by incurable illness. This would include the intentional
shortening of another person’s life by the use of a lethal dose of
medication or poison, the use of lethal weapons, homicidal acts, and
other forms of active euthanasia.”
I must note that terms like passive and negative euthanasia are
sometimes used incorrectly to refer to the discontinuation of
extraordinary means of preserving life when there is no hope of
recovery. This process is not in proper medical and ethical sense
euthanasia. Instead it belongs to the responsible care that we,
medically and ethically, are due to patients that appear to have
entered an irrevocable process of dying.
I emphatically state that the family should be the proper context
for decision-making in this type of determination, and that the
government should not intrude in even a surrogate role. Our Church
in 1991 expressed its deep conviction that both state and national
government should guarantee the individual’s rights and provide for
the withholding or withdrawing of life-sustaining systems, where the
decision has been arrived at with proper safeguards against abuse.
Our courts are the proper vehicles to achieve these safeguards and
the intrusion by politicians is extremely inappropriate.
This is the time for wisdom and forbearance in our nation, as we
support with our prayers not only Terri Schiavo and her family but
also the many families who are dealing with painful decisions about
life and death. Let us also pray for a reconciliation of all men and
women who hold different opinions on these matters. And let us
always work to reconcile our own hearts, so that we may live in
concord and peace in this country, despite our differences,
“respecting the dignity of every human being”, as we have promised
in our Baptismal Covenant.
Finally, I call on all the clergy, vestries and other church
leaders to encourage all members of our flock to provide for advance
written directives concerning medical treatment and durable powers
of attorney, setting forth medical declarations that make known a
person’s wishes concerning the continuation or withholding or
removing of life sustaining systems. I also remind you that
information on these kinds of documents, as well as help with
preparation of our wills and other end of life considerations to
provide for our families and our church, are available from the
Southeast Florida Episcopal Foundation.
Now to God who is able to strengthen you in the service of the
resurrected Christ I say put things in order, listen to my appeal,
agree with one another, live in peace; and the God of love and peace
will be with you. Greet each other with the peace of the Lord. The
grace of the Lord Jesus Christ, the love of God, and the communion
of the Holy Spirit be with all of you.
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Health care proxy can spell out patient's desires if incapacitated
The Sunday Gazette, March 27, 2005
ALBANY -AS the national controversy over Terri Schiavo unfolded this past week, online traffic skyrocketed on a state Web site offering health care proxy information.
The state Health Department's site received 10,600 hits on Thurs- day alone, said Kim Volean, 'a spokeswoman for the state Health Department.
Typically, that portion of the Web site receives about 100 hits a day.
Interest in the Web site has been steadily rising since the fIrSt of the year, with 3,900 hits in the month of January, 4,200 hits in February and then a whopping 19,600 hits (including Thursday's 10,600) for the first three weeks of March.
The Schiavo case has become a battle over whether to remove a feeding tube from a woman who for 15 years has been in what doc- tors call a persistent vegetative state. It's a telling example of why it is important for everyone to have a health care proxy in place. according to a prepared statement from the Health Department.
A generation ago, a similar national controversy over Karen Ann Quinlan, a young woman left comatose by a drug overdose in the late 1970s, generated nation- wide interest in the concept of a living will In that case, her parents went to court seeking the right to disconnect her from a ventilator.
PRIMARY DOCUMENT
A health care proxy is a document in which a person designates someone to act on their behalf if they become incapacitated. The form, authorized by state legislation, can be downloaded at the Health Department's Web site.
Health care proxies are more specific than living wills, which in general terms spell out how a person wants to be cared for if they become unable to make their own decisions. Living wills are more subject to interpretation and legal challenge than health care prox~ ies, according to the state Health Department.
In New York state, the primary document to have in place is a health care proxy, said Alicia Ouellette, a professor at Albany Law School specializing in bioethics. People don't need a lawyer to complete the simple form, Ouellette said, but the process does require the signature of two witnesses. The problem with living wills is that it's hard to anticipate all the different health scenarios that may crop up, Ouellette said. She wouldn't dis- courage someone from writing a living will, which should be done under a lawyer's guidance, but said it should be viewed more as a back-up document to a health care proxy.
Still, both documents are good at providing some guidance about how a person wants to be cared for.
"With the Schiavo case, had she had something in writing, it would be a very different case," Ouellette said.
WORST LAWS
But Glenn McGee, director of the Center for Bioethics at Albany Medical Center, said New York state's laws are the worst in the country when it comes to safe-guarding people's interests when they are incapacitated.
That's particularly true if no health care proxy or durable power of attorney has been signed and put into place, he said. New York's law is particularly bad, he said, because there's no provision for establishing which family members have preference.
New York also requires that, absent something in writing, there must be some other clear and con- vincing evidence of a patient's wishes. "The level of evidence to show what you wanted is higher here than anywhere else," McGee said.
"The 'end of life' law has been hamstrung for more than a decade by special interests fighting to include tack-on amendments on issues like abortion and health care finance," he said. "As a result, 49 states have something we don't have, which is a way for family members' wishes to be recognized.
" There is, for example, no law that gives a spouse first preference in making decisions and no standard for deciding who should decide if there are several people -say three siblings, for example -all vying for decision-making authority. "If the Schiavo case had happened here, it would be so much worse than in Florida, " he said.
Without a health proxy, "you're in real trouble," McGee said. But given the dramatic events involving the Schiavo case, there's no guarantee that even that proxy won't be contested or somehow become of the topic of political maneuvering, he said.
DEATH ANXIETY
While there aren't solid statistics on how many people have some sort of living will or health care proxy, health experts esti- mate the number could be as low as 10 to 13 percent.
"Death anxiety is very prevalent in society," said JoanDascher, director of palliative home care at Community Hospice. "There's al- most a superstition that if you have the discussion, then some- thing will happen. "
But the Schiavo case, affecting a woman who was 26 when her brain was damaged, illustrates the need for people of all ages to have these discussions, and complete the needed paperwork; she said. "People should start thinking about this in their 20s," Dascher said.
Most people don't. "It's very hard for young people to have this discussion," Dascher said. "When you're in your late teens, 20s and your early 30s you think, 'I'm not vulnerable. This can't happen to me.'"
But it's not just 20-year-olds who resist the topic. People 6f all ages are reluctant, she said, noting that for many people, broaching the topic itself is perceived as a message that the end is near.
"It's one of the hardest discussions to have with people," Dascher said.
Hard, but important, she said. "It's the most pro-active and em- powering thing a person can do to provide yourself and your family," Dascher said,
Ouellette agreed, "It's really a gift you can give your family to set it up ahead of time, and documenting your' wishes," she said. "It takes away the guesswork, and makes the hard time a little bit easier for them,"
These issues are particularly important for people to address before they become sick or disabled, and especially before there's a crisis,
"When you're stressed or anxiety-ridden, decision-making is not clear. You're going to respond to the crisis at hand," Dascher said.
Instead, have these kinds of discussions when there's plenty of time to talk, and to talk specifically and frankly.
HEROIC MEASURES
Someone might, for example, say they wanted no heroic measures undertaken if they were in a coma. But with no clearcut definition of "heroic measure," there's ample room for uncertainty, Ouel- lette said. "Is giving food and water a heroic measure or not?" she said.
New York's health care proxy form directly deals with the issue of nutrition and hydration -the issue at the heart of the current Schiavo case. "In order for your agent to make health care decisions for you about artificial nutrition and hydration (nourishment and water provided by feeding- tube and intravenous line), your agent must reasonably know your wishes," the form said. "You can either tell your agent what your wishes are or include them in this section. "
Dascher said there's long been confusion over some of these terms. Living wills and health care proxies both fall under the umbrella term "advanced directive." 11iere is also durable power of attorney, written with a lawyer's advice. "Do not resuscitate orders" are often confused with living wills, DaScher said. But they shouldn't be; a DNR order deals specifically with the issue of cardiopulmonary resuscitation.
Filling out the health proxy form doesn't require legal or medical assistance, but Dascher said a person's doctor is critical in helping people understand what kind of care and technology is out there, and what it might mean.
"The one thing we've learned over the course of many, many years of the hospice movement is that when you don't chose [aggressive intervention], it doesn't mean you're forgoing care."
Palliative care provides a wide range of options that reduce pain and provide comfort.
"If you have a terminal illness, you can say 'I want pain relief. I want hospice care. I want. support not only for me but for my family members,' " Dascher said.
"There's a whole continuum of care out there other than aggressive medical care," she said.
Information about health care proxies in New York state, including a downloaded form, can be found at www.nyhealth.gov . - Reach Gazette reporter Judy Patrick at The daily Gazette.
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Download a Health Care Proxy form: New York State
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Some resources:
The
supplemental materials in Enriching Our Worship 2 - Ministry
with the Sick or Dying, and Burial of a Child -- some excellent
prayers for times of decision about discontinuing life support.
- - - - - - - - - -
... and another viewpoint...
Personal Reflections on Theresa Schiavo's Life
The Interfaith Alliance
March 21, 2005
Dear Members and Supporters of The Interfaith Alliance:
Over the past several hours many of you have been kind enough to share with us your thoughtful reflections and questions regarding the tragic situation involving Theresa Marie Schiavo. Several of you have inquired as to whether or not The Interfaith Alliance has taken a position on the end-of-life issues swirling around Mrs. Schiavo or on the involvement of the United States government in this case by way of votes in the United States Senate and in the United States House of Representatives on Sunday evening and early Monday morning respectively.
The Board of Directors of The Interfaith Alliance has not adopted a position on end-of-life issues or directed the staff of The Interfaith Alliance to give attention to these issues either in our policy work or our educational efforts. I cannot speak for them or for the organization on these issues. However, I am astonished, appalled, and grieved by the actions of the two houses of the United States Congress and the White House that have prompted me to write this personal letter.
The life-and-death issues brought into focus by Mrs. Schiavo’s sad condition involve medical questions and legal considerations far too complex for me to address without more information. I might add that, in my opinion, members of the United States Congress would have been well advised to adopt a posture of humility and compassion related to these issues as they impact Mrs. Schiavo and her family. Neither Members of Congress nor any of us have any business seeking to dictate procedures for members of a grieving family and numerous doctors, lawyers, and courts that already have considered the familial, medical, legal and personal issues involved in this situation and attempted to address them with fundamental moral, medical, and legal values.
As a pastor for many years, I repeatedly have stood with troubled families grappling with the issues that surround Mrs. Schiavo’s bedside. Those experiences have taught me the myths that often get perpetrated as facts in public debates regarding circumstances like those involving Mrs. Schiavo. No perspective regarding a resolution for such a difficult situation has all of the weight of compassion and wisdom behind it
Alongside my concern for the family of Mrs. Schiavo stands my concern for our nation. A family’s grief over the loss of a loved one is being compounded by pontifical posturing among politicians and religious leaders who know too little about the situation even to comment on it much less to attempt to control it. A tragic situation is being made more tragic by the insensitive intrusion into it by Washington politicians seeking yet another venue for speaking to their partisan constituencies and for strengthening their political “base.” For Congress and the White House to jump into this tragic situation at the last minute, after years of court proceedings, and to take a position on the value of life so inconsistent with, if not contradictory to, many of their other decisions, represent unconscionable meddling in the private decision of an American family—a family who needs our thoughts and prayers, not our spirit of blatant judgment and our not-too-subtle politicization.
Profound questions disturb me. Are there no limits on the intrusive reach of this government? Where will Washington go next? Do claims of both religious and political authority give a government the right to invade the spheres of personal autonomy and religious independence? How long will the American public wait for such questions to be answered.
Dear friends, all of us would do well to step back from the bedside of a woman caught somewhere between death and life, divorce our political initiatives from this realm of personal and familial pain, pray for the peace of Terri Schiavo and her family, and after taking a hard look at how we feel about politicians who are willing to manipulate even personal pain in an effort aimed at political gain, decide what we are going to do about our democracy.
Sincerely,
C. Welton Gaddy
3/21/2005
...and from the Episcopal News Service:
Daybook,
from Episcopal News Service
March 22, 2005 - Tuesday To Note & To Read
Episcopal Church offers resources for end-of-life issues
[Episcopal News Service] While the Episcopal Church’s General
Convention has not specifically addressed the situation of Terri
Schiavo—the Florida woman who suffered severe brain damage in 1990
and has relied on a feeding tube to keep her alive since—several
resolutions have been passed regarding end-of-life issues. These
include a 1991 resolution regarding prolongation of life.
A helpful resource for Episcopalians seeking to understand the
issues is the following book:
Faithful Living, Faithful Dying: Anglican Reflections on End of
Life Care
paperback
by The End of Life Task Force of the Standing Commission on National
Concerns
Morehouse Publishing
March 1, 2000
176 Pages
$15.95
What do faithful living and faithful dying mean as we near life's
end? With all the technology and choices available to us today,
making decisions about the end of life grows ever more difficult. As
a result of all the theological and ethical issues that have arisen
around the dying process in recent years, the 72nd General
Convention of the Episcopal Church created a task force to study and
report on these concerns. This is the report of the End-of-Life Task
Force. In it, the Task Force responds to the broad range of
theological, ethical, pastoral and policy issues that are generated
by the need to provide loving and fitting care at the end of life.
Intended as a teaching document, Faithful Living, Faithful Dying
will be useful as a discussion tool for the church, for individuals
facing difficult decisions, for professionals, such as clergy and
health care providers, and for those who make public policy.
Reviews for Faithful Living, Faithful Dying
"This book will prove most worthwhile for pastors and parish
ministers and ministry committees, a very useful study/discussion
guide for small groups, and a helpful tool for chaplains who
continue to seek ways to bring the spiritual and prophetic voices
into the arenas of healthcare and ethical decision-making." --
Resources Hotline, August 2000
Resolution Number: 1991-A093
Title: Establish Principles With Regard to the Prolongation of
Life
Legislative Action Taken: Concurred As Amended
Final Text:
Resolved, the House of Bishops concurring, That this 70th General
Convention set forth the following principles and guidelines with
regard to the foregoing of life-sustaining treatment in the light of
our understanding of the sacredness of human life:
1. Although human life is sacred, death is part of the earthly
cycle of life. There is a "time to be born and a time to die" (Eccl.
3:2). The resurrection of Jesus Christ transforms death into a
transition to eternal life: "For as by a man came death, by a man
has come also the resurrection of the dead" (I Cor. 15:21).
2. Despite this hope, it is morally wrong and unacceptable to
intentionally take a human life in order to relieve the suffering
caused by incurable illness. This would include the intentional
shortening of another person's life by the use of a lethal dose of
medication or poison, the use of lethal weapons, homicidal acts, and
other forms of active euthanasia. Palliative treatment to relieve
the pain of persons with progressive incurable illnesses, even if
done with the knowledge that a hastened death may result, is
consistent with
theological tenets regarding the sanctity of life. However, there
is no moral obligation to prolong the act of dying by extraordinary
means and at all costs if such dying person is ill and has no
reasonable expectation of recovery.
3. In those cases involving persons who are in a comatose state
from which there is no reasonable expectation of recovery, subject
to legal restraints, this Church's members are urged to seek the
advice and counsel of members of the church community, and where
appropriate, its sacramental life, in contemplating the withholding
or removing of life-sustaining systems, including hydration and
nutrition.
4. We acknowledge that the withholding or removing of
life-sustaining systems has a tragic dimension. The decision to
withhold or withdraw life-sustaining treatment should ultimately
rest with the patient, or with the patient's surrogate
decision-makers in the case of a mentally incapacitated patient. We
therefore express our deep conviction that any proposed legislation
on the part of national or state governments regarding the so called
"right to die" issues, (a) must take special care to see that the
individual's rights are respected and that the responsibility of
individuals to reach informed decisions in this matter is
acknowledged and honored, and (b) must also provide expressly for
the withholding or withdrawing of life-sustaining systems, where the
decision to withhold or withdraw life-sustaining systems has been
arrived at with proper safeguards against abuse.
5. We acknowledge that there are circumstances in which health
care providers, in good conscience, may decline to act on request to
terminate life-sustaining systems if they object on moral or
religious grounds. In such cases we endorse the idea of respecting
the patient's right to self-determination by permitting such patient
to be transferred to another facility or physician willing to honor
the patient's request, provided that the patient can readily,
comfortably and safely be transferred. We encourage health care
providers who make it a policy to decline involvement in the
termination of life-sustaining systems to communicate their policy
to patients or their surrogates at the earliest opportunity,
preferably before the patients or their surrogates have engaged the
services of such a health care provider.
6. Advance written directives (so-called "living wills,"
"declarations concerning medical treatment" and "durable powers of
attorney setting forth medical declarations") that make a person's
wishes concerning the continuation or withholding or removing of
life-sustaining systems should be encouraged, and this Church's
members are encouraged to execute such advance written directives
during good health and competence and that the execution of such
advance written directives constitute loving and moral acts.
7. We urge the Council of Seminary Deans, the Christian
Education departments of each diocese, and those in charge of
programs of continuing education for clergy and all others
responsible for education programs in this Church, to consider
seriously the inclusion of basic training in issues of prolongation
of life and death with dignity in their curricula and programs.
Citation: General Convention, Journal of the General
Convention of...The Episcopal Church, Phoenix, 1991 (New York:
General Convention, 1992), p. 383.