Bernardin: Modeling Church Teaching on Life-Sustaining Treatment

In June, 1995 Joseph Cardinal Bernardin was diagnosed with pancreatic cancer.  This diagnosis was quickly followed by surgery, and then a regimen of chemotherapy and radiation.  He remained free of cancer for fifteen months.  Then, in late August of 1996, it was discovered that the cancer had spread to his liver and was inoperable.  At this point, a different kind of chemotherapy was begun.  However, in mid-October the Cardinal made the decision to stop receiving chemotherapy.  He did this because the chemotherapy was not stopping the growth or diminishing the size of his tumors as it was supposed to do, and because of the serious side effects he was experiencing from the chemotherapy treatment.  The cancerous tumors continued to grow until they brought about his death on November 14, 1996. (Joseph Cardinal Bernardin, The Gift of Life)

In the way in which he handled his cancer treatment, Cardinal Bernardin provided a living model of the teaching of the Catholic Church on decisions to use or forgo life-sustaining treatments.

The Ethical and Religious Directives for Catholic Health Care Services from the National Conference of Catholic Bishops (1994) has given us the following principles for making these decisions:

A person has a moral obligation to use ordinary or proportionate means of preserving his or her life.  Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community. (no. 56)

A person may forgo extraordinary or disproportionate means of preserving life.  Disproportionate means are those that in the patient�s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community. (no. 57)

When Cardinal Bernardin was first diagnosed with pancreatic cancer, the treatments of surgery, chemotherapy, and radiation offered a real possibility of benefit for his health. These treatments could at least prolong his life, and possibly bring about a total cure.  From a moral point of view, he should have undertaken these treatments, as he did.  In fact, the treatments gave the Cardinal fifteen months of life �cancer free.�

Even when the cancer recurred and had spread to his liver, the Cardinal still undertook a new type of chemotherapy which was potentially beneficial to him; the tumors of some patients who had received it stopped growing or diminished in size.   It was only after an unsucessful trial of the chemotherapy that Cardinal Berdardin decided to forgo it entirely.  This decision was likewise in accord with the moral principles of the Catholic Church.  The chemotherapy did not offer �a reasonable hope of benefit� since the cancer continued to spread even with this treatment.  Moreover, the serious side effects of the chemotherapy were a truly �burdensome� aspect of this treatment for the Cardinal.

In November of 1996, very shortly before his death, Cardinal Bernardin wrote a letter to the United States Supreme Court in opposition to euthanasia and assisted suicide.  He began the letter in this way:

I am at the end of my earthly life.  There is much that I have contemplated these last months of my illness, but as one who is dying I have especially come to appreciate the gift of life.  I know from my own experience that patients often face difficult and deeply personal decisions about their care.  However, I also know that even a person who decides to forgo treatment does not necessarily choose death.  Rather, he chooses life without the burden of disproportionate medical intervention.

The Catholic Church maintains that there is a real and morally significant difference between euthanasia or assisted suicide and forgoing (that is, withholding or withdrawing) life-sustaining treatments.  And while the Church is pro-life, the Ethical and Religious Directives for Catholic Health Care Services also makes clear that �an insistance on useless or burdensome technology even when a patient may legitimately wish to forgo it� is an extreme to be avoided (Part Five, Introduction).

Prepared by Janine Marie Idziak, Ph.D.   Health Care Consultant, Archdiocese of Dubuque, IA   July 2000
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