It is best to execute a DPAHC while healthy and of sound mind and able to discuss these matters thoroughly and calmly with your family and future agent (s). Don't put it off until you reach old age or poor health; serious accidents or sudden catastrophic illnesses can happen at any age. Don't wait until an emergency admission to a hospital, when anxiety, medical procedures, and perhaps the illness itself prevent due reflection and discussion with your future agent(s).

How does this Roman Catholic DPAHC Form differ from other DPAHC's?

The DPAHC form accompanying this brochure is an attempt to facilitate an ethically informed approach to health-care decision making by explicitly incorporating key sanctity-of-life principles as taught by the Roman Catholic Church. It is usable by non-Catholics as well as Catholics.

What are the Sanctity-of-Life principles reflected in this DPAHC?

There is a long tradition of Catholic moral teaching on this topic that has been refined over the past several centuries. The most authoritative statement of the Catholic Church's teaching is the Declaration on Euthanasia. (Promulgated by the Sacred Congregation for the Doctrine of the Faith.) Its essential points can be summarized as follows:

1. Value of Human Life
   Human life is a gift from God, of which we are stewards, not masters. It must be treated and valued as such. Therefore, no direct taking of an innocent human life is acceptable, whether one's own or that of another.

2. Attitude Toward Death and Suffering
   Death is neither to be feared and avoided at all costs, nor to be sought and directly procured, but rather to be accepted whenever, wherever, and however God wants. Suffering is not the ultimate evil; for a Christian it has the positive value of uniting the person with the sufferings of Christ and constitutes participation in His redemptive sacrifice. The ultimate evil, rather, is sin.

   On the other hand, the use of painkillers is both permitted and generally helpful. If a painkiller shortens life, however, its use is permitted if the pain is severe and if it does not interfere with the patient's primary relationship with God and the carrying out of other moral duties. For the patient unable to communicate, the presumption should be made to alleviate pain.

3. Definitions of Euthanasia and Suicide
   "Euthanasia" is the intentional ending of the life of another, whether by act or omission, in order to relieve suffering. It is always objectively wrong, because it usurps God's dominion over human life.

   "Suicide" is the intentional ending of one's own life, whether by act or omission. Even in circumstances where someone is not morally culpable, it is always objectively wrong.

4. Due Proportion in Use of Life-Sustaining Treatments
   Everyone has a duty to care for his or her own health or to seek such care from others; however, it is not always necessary to use all life-sustaining treatments. Indeed, one does not have an obligation to use a treatment which is morally extraordinary, i.e., the risks or burdens of the treatment are disproportionate to its expected results.

   In considering the concept of "burden," the individual should take into account the treatment's type, complexities, cost, possibilities of use, and the pain or discomfort it imposes. The comparison of these factors with the expected result should also take into account the totality of the sick person's circumstances, including his or her physical and moral resources.

   It is important to understand that the morally relevant burdens and benefits are those pertaining to the proposed treatment, not the burdens of life itself. Therefore, a person is obligated to accept nonburdensome life-sustaining treatments.

It is impossible for anyone to formulate informed treatment preferences in advance for every conceivable medical scenario. The condition of patients often changes in sudden and unexpected ways, and what might be appropriate treatment at one moment might be inappropriate at another. Also, what others, including your doctor and the courts, will understand by your words in a particular medical situation will not necessarily be exactly what you had in mind when you filled out the form (see DPAHC part 4, pp. 3 & 6). Doctors may be legally bound to do what you have written, whether or not you would have intended it in that circumstance, even if it means your death. Phrases such as "terminal illness", "imminent death", "no reasonable hope for recovery", "incurable or irreversible condition" being kept alive "artificially", "heroic" or "extraordinary" treatment, and even "medical treatment" are open to multiple interpretations.

For example, many people who fill out these documents may not realize that the term "medical treatment" is now interpreted in most hospitals and courts to include food and water provided by tube. Thus, by rejecting "medical treatment" in a particular situation, you could be forced to die of starvation and dehydration, even though what you had in mind when filling out the document might have been things like breathing machines, chemotherapy, or dialysis.

Therefore, it is best not to undermine the advantages of the DPAHC by tying the hands of your doctor and your agent through overly general and ambiguous terminology in this section of the form. It is wiser merely to authorize someone you trust to make health-care decisions for you if you become unable to do so. If you choose a person who shares your values and moral principles and discuss those principles together, that is the best possible assurance that medical decisions made for you will be those that you would have wanted.

Prepared by the Archdiocesan Catholic Life Issues Commission
© Roman Catholic Archdiocese of Los Angeles 1991

Copies of the Durable Power of Attorney For Health Care Form can be purchased for $2 each ($1 each in quantities of 100) from:

Archdiocese of Los Angeles
Office of Respect Life
3424 Wilshire Blvd
Los Angeles, CA 90010
213 637-7621