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A woman sits at the bedside of her mother in 2016 at de Greeff Hospice house in St. Louis, in this file photo. The Archdiocese of San Francisco is organizing a ministry team to help families with end-of-life care in a Catholic moral context. (CNS photo/Lisa Johnston, St. Louis Review)
Sept. 3, 2020
Christina Gray
Catholic San Francisco
The Archdiocese of San Francisco will begin training volunteers who will help parishes support the faithful in making end-of-life decisions for themselves and loved ones informed by Catholic teaching.
“A lot of parishioners, they struggle with these issues, especially nowadays,” said Deacon Fred Totah, director of pastoral ministry for the archdiocese.
Deacon Totah will participate with 25 others from all three counties of the archdiocese in a five-week Zoom training beginning Sept. 16. It is the first such training that will ultimately be extended to volunteers from individual parishes as they form their own end-of-life ministries.
Deacon Totah was tapped by Archbishop Salvatore J. Cordileone earlier this year to locally implement Caring for the Whole Person, a response by the California bishops and Catholic health care leaders to the state’s legalization of physician-assisted suicide in 2015.
The bishops intend for the church to take a leading role in “transforming the way in which society cares for the chronically and terminally ill,” according to a description of the initiative on the bishops’ websitePhysician-assisted suicide is legal in eight U.S. states including California, Hawaii, New Jersey, Colorado, Oregon, Vermont, Maine and Washington, as well as the District of Columbia, according to deathwithdignity.org. Individuals must have a terminal illness as well as a prognosis of six months or less to live.
Public opinion polls reveal that more than 65% of U.S. voters support legalizing physician-assisted suicide.
Deacon Totah said that even Catholics may be confused between what is legal and what is moral, or assume they are the same.
“What is legal may not be moral from the church’s standpoint,” Deacon Totah said. “The church teaches that life is sacred from the womb to the tomb.”
The Caring for the Whole Person Initiative is a collaborative organized through California Catholic Conference and the Alliance of Catholic Health Care. It hopes to ensure that Catholic parishioners are loved and supported in end-of-life decisions.
Growing public support is indicative of a deep crisis in the U.S. health care system, the bishops say.
“For good reasons, many Americans do not trust that they and their loved ones will be appropriately and effectively cared for when they experience a terminal illness,” the initiative reads.
A 2014 Institute of Medicine report revealed that the experience of dying in the United States is often characterized by “fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families.
“Clearly, a transformation is needed in the way society – not merely our health care system – cares for seriously ill people and supports family caregivers,” they said.
The bishops recognize that physician-assisted suicide, “while legal, is not yet an entrenched cultural or clinical reality.”
The initiative commits dioceses to developing together, and in collaboration with other leaders in the palliative care field, a medical and pastoral approach to care through the end of life that provides a dignified, compassionate, and loving alternative to physician-assisted suicide for seriously ill people and their families.
Deacon Totah said that a number of doctors, nurses, hospice workers and clergy are included on his core team of end-of-life ministers in training, but that such expertise is not a requirement of being trained to serve at the parish level.
The only requirements are compassion, empathy and an ability to listen. “God gave us two ears and one mouth for a reason,” he said.
“Next to birth, death is probably the most profound experience we'll encounter,” said Deacon David Bernstein of St. Raphael Parish, who will be on the core team of trainees. “I want to be well prepared to support my sisters and brothers to face death in a dignified and graceful manner.”
Our Lady of Angels parishioner Susan Peloquin, a retired neonatal intensive care nurse, is also a trainee.
“I am interested in being a leader with this program, because through education and support, parishioners who are facing a life-limiting illness can enhance their quality of life in a Catholic way,” she said.
The training includes an introduction to the difference between hospice and palliative care; an overview of Catholic Social Teaching as it applies to end-of-life issues; best practices on supporting parish families physically, spiritually and emotionally; and planning in advance for death through Advanced Health Care Directives, funeral wishes and other practical details.
Deacon Totah said his hope is that every parish eventually will have an end-of-life ministry. The ministry might also be combined with an existing parish ministry, he said, such as grief and consolation, Legion of Mary or ministry to the sick and homebound.
“I hope it will be accomplished,” he said, adding that it could also be a collaboration between parishes. “I think that’s the least I think we can do for our fellow brothers and sisters who are going through hard times.”The California End of Life Option Act signed by former Gov. Jerry Brown took effect on June 9, 2016. It allows certain terminally ill patients to request and obtain a prescription for medication to end their own lives.
To qualify for a prescription of medication under existing physician-assisted dying laws, the patient must be a mentally competent adult resident of California diagnosed with a terminal illness that will lead to death within six months.
The patient must be capable of communicating his or her own health care decisions and be able to self-administer and ingest the prescribed medication.
Two physicians must determine whether all these criteria have been met. The process entails two oral requests, one written request, waiting periods and other requirements.
In 2019, 618 individuals received prescriptions for aid-in-dying drugs, and 405 individuals died following ingestion, according to the latest California Department of Health annual report on the law's implementation.
From 2016 through Dec. 31, 2019, aid-in-dying prescriptions have been written for 1,985 people, of whom nearly two-thirds have died from ingesting the medications. More than 85% of those who died were receiving hospice or palliative care, or both.
Almost 75% of the patients were 60-89 years of age and about 14% were 90 and older.
The median age of those requesting physician-assisted death was 76 years.