“Ask a Priest: Is the ‘Five Wishes’ OK for End-of-Life Decisions?”

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Q: I will soon be 70 and in bad health. I need to know if I do the Five Wishes, by giving my daughter the power to allow me to die, like a living will? Is it considered a mortal sin? I don’t want her to have to pay for care, while watching me slowly die. I appreciate an honest answer and not just one to put me at ease. My soul is important — it is the only one I have. – J.R.

Answered by Fr. Edward McIlmail, LC

A: It is certainly good that you are focused on guarding your soul. Though the end of life can be difficult, it can also be a grace in that it gives us time to prepare to meet Our Lord.

However, living wills, especially the Five Wishes type, can be morally problematic.

The Five Wishes, in broad outline, are: 1) the person I want to make health-care decisions for me when I can’t; 2) the kind of medical treatment I want or don’t want; 3) how comfortable I want to be; 4) how I want people to treat me; and 5) what I want my loved ones to know.

The Five Wishes might have a certain appeal on first glance. But they can oversimplify things, and they imply that certain kinds of suffering render a life not worth living. This is not a Christian attitude.

The better route is that a patient and the person who might make decisions about the patient understand Catholic teaching on end-of-life issues. They might need to consult a Catholic bioethics expert in certain cases.

Certain principles need to be followed. For instance, there are times when treatment can be licitly withheld, but things such as hydration and basic nutrition must be given as long as a person can accept them.

The Catechism in No. 2278 says, “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.”

For more reading about living wills, see the posting on “Should I Have a Living Will?”

Other helpful reading in line with Catholic principles can be this guide on end-of-life decisions and an article on a revision of a health-care directive. I hope some of this helps.

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