Ethan Walker
The Catholic Church does not have definitive teachings on whether Do Not Resuscitate (DNR) orders are ethically permissible. However, the Church's guidance on end-of-life care and the ethical discernment of its followers have sparked debates on the morality of DNRs. The Church's teachings emphasise the sanctity of life and the rejection of euthanasia and suicide. This conflicts with the reality of DNRs, which instruct healthcare providers to forgo resuscitation efforts in the event of cardiac or respiratory arrest. The Church's stance on the rejection of over-zealous or extraordinary treatment that imposes undue burdens on patients and their families further complicates the discussion. While DNRs can be seen as a legitimate refusal of excessive treatment, they also raise concerns about misuse and ethical complexities, especially in balancing the benefits of CPR with its potential burdens.
| Characteristics | Values |
|---|---|
| Definition of DNR | A "do not resuscitate" order is signed by a physician and instructs health care providers not to perform cardiopulmonary resuscitation (CPR) if a patient’s heartbeat or breathing stops |
| Catholic Church's teaching on DNR | The Catholic Church does not have any definitive teaching on whether DNRs are ethically permissible. |
| US Conference of Catholic Bishops' teaching on DNR | A person may forego extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient's judgment do not offer a reasonable hope of recovery or entail an excessive burden or impose excessive expense on the family or the community. |
| Vatican's teaching on DNR | Pope Saint John Paul II stated that we are not morally required to employ every means available to save the life of a patient no matter what the burden or cost. |
| Circumstances where DNR is moral | When the burdens and consequences of treatment are out of proportion to the beneficial results anticipated. |
| Circumstances where DNR is immoral | When DNR is misused or implemented in a discriminatory manner, such as in the case of COVID-19 patients with learning disabilities. |
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What You'll Learn
DNRs and the Catholic Church's stance on euthanasia
The Catholic Church's stance on euthanasia is that it is morally wrong. The Church teaches that human life is sacred and a gift from God, and that human beings are made in God's image, and therefore, no one has the authority to take the life of any innocent person. The Church also emphasizes the importance of not interfering with the natural process of death. This belief is reflected in the Church's teachings on euthanasia, which is considered a grave violation of the law of God and the "'culture of death' in modern society". The Church regards any law permitting euthanasia as an intrinsically unjust law.
The Church's stance on Do Not Resuscitate (DNR) orders is more nuanced. A DNR is a specific medical order instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing or heart stops. While the Church rejects the idea that all means must be employed to save a patient's life, it also affirms the moral obligation to care for oneself and allow oneself to be cared for. The Church teaches that treatments that do not offer a reasonable hope of benefit or entail an excessive burden can be refused. This distinction between "ordinary/proportionate" and "extraordinary/disproportionate" treatment is key to understanding the Church's position on DNRs.
Some Catholics believe that DNRs are acceptable within the Church's teachings. They argue that DNRs do not hasten death but rather accept the human condition in the face of death. In certain circumstances, DNRs can be seen as a legitimate refusal of "over-zealous" treatment that imposes an undue burden on the patient and their family. The Church recognizes that the objective situation of the patient is relevant, and that the burdens of resuscitation may outweigh the benefits in some cases.
However, the Church also cautions against the potential misuse of DNRs. Some institutions and medical professionals may seek DNRs for economic cost reduction or due to a culture of death that devalues certain lives. The Church emphasizes that careful discernment is necessary when considering a DNR to ensure that it is not a form of euthanasia or suicide, which are considered morally unacceptable.
Ultimately, the decision to have a DNR in place should be made by the patient if they are competent or, if not, by their legally entitled proxy decision-maker. The Church teaches that the patient's reasonable will and legitimate interests must always be respected, and that ordinary care for a sick person should not be interrupted, even if death is imminent.
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DNRs and the Catholic Church's stance on suicide
The Catholic Church has long opposed suicide, considering it as morally evil and akin to rejecting God's sovereignty and loving plan. Historically, the Church refused to perform funeral rites for those who had taken their own lives, but this ban has since been lifted. The Church acknowledges that factors such as grave psychological disturbances or anguish can diminish the responsibility of an individual who commits suicide. While the Church's stance on suicide remains firm, it has adopted a more lenient approach to personal responsibility in light of developments in psychology and social sciences.
In the context of Do Not Resuscitate (DNR) orders, the Catholic Church's stance is nuanced. While the Church is pro-life and rejects suicide and euthanasia, it also recognises the potential burden and cost of certain medical treatments. According to the Vatican Declaration on Euthanasia, it is morally wrong to impose treatments that impose undue burdens on the individual, their family, or the community. The Church teaches that one is not obligated to employ every means available to save a life but should provide what is necessary, such as nutrition and hydration.
Some Catholic bioethicists argue that a DNR can be moral in certain circumstances. They distinguish between "ordinary/proportionate" and "extraordinary/disproportionate" treatments, with the latter referring to treatments that do not offer a reasonable hope of benefit or impose excessive burdens or expenses. In such cases, foregoing extraordinary or disproportionate means is not considered suicide or euthanasia but rather an acceptance of the human condition in the face of death.
The decision to implement a DNR should be made carefully, taking into account the specific circumstances of the patient. While a DNR can safeguard a peaceful and painless death, it is important to exercise caution and not view it as a means to hasten death or reduce economic costs. The Church emphasises the importance of respecting the patient's autonomy or, if they are unable to decide, the reasonable will and legitimate interests of those legally entitled to act on their behalf.
In summary, while the Catholic Church strongly opposes suicide, its stance on DNRs is more complex. The Church recognises the potential ethical validity of DNRs in certain circumstances, emphasising the need to balance the duty to preserve life with the understanding that allowing a natural death is not the same as causing it. The Church's teachings on DNRs focus on the proportionality of treatments and the autonomy of the patient or their proxy decision-maker.
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DNRs and the Catholic Church's stance on hospice
The Catholic Church does not consider Do Not Resuscitate (DNR) orders and hospice care to be sins. The Church teaches that it is morally wrong to impose treatments that do not offer reasonable benefits or are futile and impose undue burdens on the patient, their family, and the community. DNRs and hospice care do not hasten death and can be legitimate by discontinuing medical procedures that are burdensome, dangerous, or disproportionate to the expected outcome.
The Church's stance on DNRs and hospice care aligns with its teachings on euthanasia and the sanctity of life. While the Church rejects euthanasia and suicide, it also recognises that not all means of saving a life are morally required or beneficial to the patient. The Church emphasises the importance of balancing the moral obligation to preserve life with the understanding that allowing a natural death can be an expression of acceptance of the human condition.
In the context of hospice care, the Catholic Church believes that terminally ill patients should be kept free from pain and provided with comfort and dignity until they die a natural death. Catholic patients are encouraged to guide their healthcare decisions as long as they are mentally and physically capable. The Church does not promote preserving physical life at all costs but instead focuses on virtues like fidelity, compassion, and individual dignity.
When considering DNRs and hospice care, Catholics may seek guidance from the Church's teachings on extraordinary and disproportionate treatments. Treatments that do not offer a reasonable hope of benefit, entail excessive burdens, or impose excessive expenses are considered disproportionate and can be refused. However, foregoing feeding or the removal of life support is not acceptable under Catholic dogma.
While Catholics acknowledge the importance of hospice care and palliative care, studies have shown that they select hospice services less frequently than their population percentage would predict. This could be due to various factors, including the influence of conservative Pro-Life beliefs and the preference for traditional burial practices.
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DNRs and the Catholic Church's stance on the right to die
The Catholic Church does not have a definitive teaching on whether Do Not Resuscitate (DNR) orders are ethically permissible. However, the Church's stance on the right to die is informed by its pro-life position and its ethical duty to reject suicide or euthanasia. The Church teaches that we are stewards, not owners, of the life God has entrusted to us; it is not ours to dispose of.
The United States Conference of Catholic Bishops' "Ethical and Religious Directives for Catholic Health Care Services" (ERD) provides some general guidance on when a DNR may be ethically permissible. According to the ERD, a person has a moral obligation to use ordinary or proportionate means to preserve their life. Proportionate means are those that, in the patient's judgment, offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community.
The Vatican Declaration on Euthanasia and the United States Conference of Catholic Bishops affirm that a person or their proxy health care decision-maker can rightly refuse treatments that do not offer a reasonable hope of benefit, entail an excessive burden, or impose excessive expense. This distinction between "ordinary/proportionate" and "extraordinary/disproportionate" treatment is key to understanding the Catholic perspective on DNRs.
In the Catholic tradition, a means of treatment is considered useless if the benefits it promises are insignificant compared to the burdens it imposes. This criterion of usefulness helps determine whether a treatment is "extraordinary" or "disproportionate." Additionally, the Church rejects the view that we are morally required to employ every means available to save a life, regardless of the burden or cost. Instead, it emphasizes the need to balance the moral obligation to preserve life with the understanding that allowing a person to die is not the same as killing them when the burdens of keeping them alive become excessive.
In summary, while the Catholic Church does not have a definitive stance on DNRs, its teachings on the right to die and the ethical discernment surrounding end-of-life care inform how Catholics approach DNR decisions. The key considerations include the patient's particular medical situation, the potential benefits and burdens of CPR, and the concept of ordinary versus extraordinary means of treatment.
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DNRs and the Catholic Church's stance on the patient's family
A Do Not Resuscitate (DNR) order is a legally recognised advance directive that gives a person or their healthcare proxy the authority to prevent cardiopulmonary resuscitation (CPR) or to withdraw it if it has already begun. The Catholic Church does not consider DNRs to be sinful, and faithful Catholic bioethicists agree that a DNR can be moral in some circumstances. The Church teaches that it is morally wrong to impose treatments that do not offer reasonable benefits or are futile and impose undue burdens on the patient, their family, and the wider community.
The Vatican Declaration on Euthanasia and the United States Conference of Catholic Bishops affirm that a person or their proxy healthcare decision-maker can refuse treatments that do not offer a reasonable hope of benefit, entail an excessive burden, or impose excessive expense on the family or community. The Church's stance is that it is not morally required to employ every means available to save a patient's life, regardless of the burden or cost. Pope Saint John Paul II stated that while there is a moral obligation to care for oneself, this duty must consider concrete circumstances and determine if the available treatment is proportionate to the prospects for improvement.
The Catholic Church's position on DNRs considers the potential physical and financial burdens of resuscitation on the patient and their family. The Church recognises that the benefits of some treatments may be insignificant compared to the burdens they impose. The Church also acknowledges the potential for emotional blackmail and graphic descriptions used to push patients or their families into agreeing to a DNR. The Church emphasises the need for careful discernment and ethical consultation when considering end-of-life care choices, including the appropriateness of a DNR.
In the case of a patient who is unable to make their own medical decisions, such as the grandmother in the provided scenario, the Catholic Church teaches that the decision-making authority should fall to those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected. The Church's guidance on this matter prioritises the patient's autonomy and the best interests of all involved, recognising the complexity and emotional weight of such decisions.
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Frequently asked questions
The Catholic Church does not have any definitive teaching on whether DNRs are ethically permissible. However, the Church teaches that it is morally wrong to impose on anyone the obligation to accept treatments that impose undue burdens on them, their family, and the wider community or to accept treatments that do not offer reasonable benefits. The Church rejects the view that we are morally required to employ every means available to save a patient's life.
DNR stands for "Do Not Resuscitate". It is a specific medical order instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or their heart stops beating.
The main consideration in determining whether a DNR is morally permissible is whether the benefits of CPR outweigh the burdens. The patient's particular medical situation must be taken into account, and the decision should be made on a case-by-case basis.
