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Nanodiapers in a brave new world

Here’s a spot of light in the news this week: Huggies has just announced a new diaper designed for babies who weigh under two pounds.

Under two pounds.  Two pounds is how much a large loaf of bread weighs.

It’s not just that these babies are so tiny, and need tiny diapers, but they need to be curled up like little bean sprouts, and their poor little skin is terribly sensitive. Huggies quotes “an infant development specialist at Memorial Hermann Southwest Hospital in Houston, Texas” as saying the new tiny diapers “conformed to the baby’s bottom without gapping or limiting leg movement. The thinner fasteners and less material at the waist provided a good fit for baby while still protecting their fragile skin.”

I mention all this because it’s good to remember that this is still a very excellent century to be alive. It was not so long ago that a baby born young enough to need a “nano preemie diaper” would never have a chance to need a diaper at all. Now such babies often survive, and even thrive.

In the same week, the Vatican has released a new Charter for Health Care Workers (the last one was in 1995; and that’s the Vatican site, so you’ll want to put on your parchment-filtering goggles so you can read it). It’s a directive for those who, among other things, care for premature babies and other that would have died in other centuries — and also for human beings who, in any other century, would have been allowed to live, but now may not.

Catholic Culture.org reports:

The Charter provides encouragement and guidance for health-care workers in coping with three stages of human life: “generating, living, dying.” Regarding “generating,” the document affirms the Church’s teaching on the immorality of abortion and destructive embryo research. It calls for treating infertility problems only by natural methods, and without destroying unborn lives.

The “living” section includes articles on topics as diverse as anencephaly, ectopic pregnancy, embryo reduction, vaccines, regenerative medicine, and the treatment of rare diseases with “orphan drugs.” The section on “dying” stresses the need to respect the dignity of the person, providing care but not extraordinary or burdensome treatment for those who are terminally ill.

A strange and terrible and wonderful time to be alive. Terrible and wonderful at the same time. As fast as medical gains are made, we dream up ways to exploit them. And so the Church rolls up her sleeves and sets to, giving guidance on problems that simply didn’t exist fifty, thirty, or even ten years ago.

I want to be a Catholic like the Church is a Catholic: looking clearly at life as it is right now, and saying, “There is good and bad here. How shall I help?”  It is no good pretending everything is fine, but it is no good pretending everything is dreadful, either.

In the meantime: Two-pound babies and one-pound babies are surviving. Thanks be to God.

***

photo credit: Mrs. Jenny Ryan Preemie Diaper via photopin (license)

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What the Catholic Church teaches about care for the dying

“Death with dignity” laws are both sensible and compassionate; religious prohibitions of suicide are both emotional and cruel.

Too often, that’s how the narrative goes when we discuss end-of-life issues and the laws surrounding them. Secular folks claim that, when Catholics and others protest against legalized suicide and euthanasia, our arguments are based in emotion, passion, or even a sadistic appetite for pain and suffering.

On the contrary, the Catholic Church’s teachings are both consistent and compassionate.

In light of recent discussions of Supreme Court nominee Neil Gorsuch and his views on assisted suicide and euthanasia, and in light of the story of a Dutch doctor who directed family members to hold down a struggling old woman so he could carry out her “assisted suicide,” I’m sharing again this article from 2013. The research I did for it corrected many of my own misconceptions about what it means to be pro-life at the end of life.

 

***

“Technology runs amok without ethics,” says Tammy Ruiz, a Catholic nurse who provides end-of-life care for newborns. “Making sure ethics keeps up with technology is one of the major focuses of my world.”

How do Catholics like Ruiz honor the life and dignity of patients, without playing God—either by giving too much care, or not enough?

Cathy Adamkiewicz had to find that balance when she signed the papers to remove her four-month-old daughter from life support. The child’s bodily systems were failing, and she would not have survived the heart transplant she needed. She had been sedated and on a respirator for most of her life. Off the machines, Adamkiewicz says, “She died peacefully in my husband’s arms. It was a joyful day.”

“To be pro-life,” Adamkiewicz explains, “does not mean you have to extend life forever, push it, or give every type of treatment.”

Many believe that the Church teaches we must prolong human life by any means available, but this is not so. According to the Catechism of the Catholic ChurchDiscontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment” (CCC, 2278).

Does this mean that the Church accepts euthanasia or physician-assisted suicide—that we may end a life to relieve suffering or because we think someone’s “quality of life” is too poor? No. The Catechism continues: “One does not will to cause death; one’s inability to impede it is merely accepted” (CCC, 2278).

Richard Doerflinger, associate director of Pro-Life Activities at the USCCB, explains that caregivers must ask, “What good can this treatment do for this person I love? What harm can it do to him or her? This is what Catholic theology calls ‘weighing the benefits and burdens of a treatment.’ If the benefit outweighs the burden, in your judgment, you should request the treatment; otherwise, it would be seen as morally optional.”

Palliative care is also legitimate, even if it may hasten death—as long as the goal is to alleviate suffering.

But how are we to judge when the burdens outweigh the benefits?

Some decisions are black and white: We must not do anything, or fail to do anything, with the goal of bringing about or hastening death. “An act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator (CCC, 2277).

The dehydration death of Terry Schiavo in 2005 was murder, because Schiavo was not dying. Withdrawing food and water had the direct goal of killing her.

But if a man is dying of inoperable cancer and no longer wishes to eat or drink, or his body can no longer process nutrition, withdrawing food and water from him might be ethical and merciful. He is already moving toward death, and there is no reason to prolong his suffering.

Moral Obligations

Our moral obligations are not always obvious. Laura Malnight struggled with doubt and fear as she contemplated the future of her tiny newborn quadruplets. Two of them had pneumonia.

“It was horrible to watch them go through what they had to go through to live, being resuscitated over and over again,” Malnight says.

One baby was especially sick and had suffered brain damage. The doctors who had pushed her to do “selective reduction” while she was pregnant now urged her to stop trying to keep her son alive. “They said we were making a horrible mistake, and they painted a terrible picture of what his life would be like in an institution,” Malnight says.

Exhausted and overwhelmed, Malnight was not able to get a clear answer about the most ethical choice for her children.

Everyone told her, “The baby will declare himself,” signaling whether he’s meant to live or die. “But,” says Malnight, “my only experience with motherhood was with these babies, in their isolettes. The thing was, we would put our hands over our son and he would open his eyes, his breathing would calm.”

“We just kind of muddled through,” she says. Her quadruplets are now 13 years old, and her son, while blind and brain-damaged, is a delightful and irreplaceable child.

Doerflinger acknowledges Malnight’s struggle: “Often there is no one right or wrong answer, but just an answer you think is best for your loved one in this particular situation, taking into account that patient’s own perspective and his or her ability to tolerate the burdens of treatment.”

The key, says Cathy Adamkiewicz, is “not to put our human parameters on the purpose of a human life.”

When she got her infant daughter’s prognosis from the neurologist, she told him, “You look at her as a dying system. I see a human being. Her life has value, not because of how much she can offer, but there is value in her life.”

“Our value,” Cathy says, “is not in our doing, but in our being. Doerflinger agrees, and emphasizes that “every life is a gift. Particular treatments may be a burden; no one’s life should be dismissed as a burden.”

He says that human life is “a great good, worthy of respect. At the same time, it is not our ultimate good, which lies in our union with God and each other in eternity. We owe to all our loved ones the kind of care that fully respects their dignity as persons, without insisting on every possible means for prolonging life even if it may impose serious risks and burdens on a dying patient. Within these basic guidelines, there is a great deal of room for making personal decisions we think are best for those we love.”

Because of this latitude, a living will is not recommended for Catholics. Legal documents of this kind cannot take into account specific, unpredictable circumstances that may occur. Instead, Catholic ethicists recommend drawing up an advance directive with a durable power of attorney or healthcare proxy. A trusted spokesman is appointed to make medical decisions that adhere to Church teaching.

Caregivers should do their best to get as much information as possible from doctors and consult any priests, ethicists, or theologians available—and then to give over care to the doctors, praying that God will guide their hearts and hands.

Terri Duhon found relief in submitting to the guidance of the Church when a sudden stroke caused her mother to choke. Several delays left her on a ventilator, with no brain activity. My husband and I couldn’t stand the thought of taking her off those machines. We wanted there to be a chance,” she says. But as the night wore on, she says, “We reached a point where it was an affront to her dignity to keep her on the machines.”

Duhon’s words can resonate with caregivers who make the choice either to extend life or to allow it to go: “I felt thankful that even though all of my emotion was against it, I had solid footing from the Church’s moral teaching. At least I wasn’t making the decision on my own.”

Adamkiewicz agrees. “It’s so terrifying and frustrating in a hospital,” she remembers. “I can’t imagine going through it without having our faith as our touchstone during those moments of fear.”

 *********

End of life resources

 

Ethical and Religious Directives for Catholic Healthcare Services (from the USCCB)

Evangelium Vitae

Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004 

NCBCenter.org provides samples of an advance directive with durable power of attorney or healthcare proxy.

This article was originally published in Catholic Digest in 2013.

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New Women’s Wellness and Fertility Center in NH includes NaPro surgeon (and they’re hiring!)

I keep forgetting to tell you! There’s a new women’s wellness and fertility center opening in Manchester, NH, right inside Catholic Medical Center. They offer standard OB/GYN services  and well woman exams, and their new doctor, Dr. Sarah Bascle, is a surgeon who is trained in NaProTechnology.

As you may know, NaPro is not only ethically sound for Catholics, but it often has a high rate of success treating women suffering infertility, repeat miscarriages, endometriosis, PCOS, and other fertility issues, bringing healing where standard medical procedures fail. NaPro isn’t magic, but it’s real medicine, not woo, and it can be life-changing.

The Women’s Wellness & Fertility Center of New England opens in winter of 2017, and they are now pre-registering patients. Check out their webiste here, or call 603.314.7595.

They are also still hiring for a few positions, including an experienced Certified Nurse Midwife. Here’s some more info about that.

Best of luck to them! Many couples will travel for hundreds of miles to work with a NaPRO-trained doctor, so I’m thrilled to finally have one in New Hampshire.

 

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An Ethically-Produced Shingles Vaccine?

vaccine elderly

Many pro-lifers still decline to use any vaccine that was not ethically derived, choosing instead to face the risk of contracting and spreading preventable, often fatal diseases.

Whatever is keeping Americans from taking full advantage of vaccines, this potential new shingles vaccine is a step in the right direction, and pro-lifers are rightly heartened by the possible advent of at least one ethically-derived vaccine. It’s a bit early to celebrate, though.

Read the rest at the Register.

 

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Pro-life Even at the End of Life: What the Catholic Church Teaches about Care for the Dying

End_of_life_(2967585466)

The Catholic Church has a consistent, compassionate approach to end-of-life issues, but many Catholics don’t know what the Church actually teaches. As a result, doctors, hospice care workers, and the guardians of patients in distress are branded “murderers” even when they’re doing their best to care for the sick and dying in a loving, responsible, and ethical way. 

I wrote this article for Catholic Digest in 2013.  I’m reprinting it today in light of recent conversationg surrounding Baby Jake and the court’s decisions about his future medical care.

Pro-Life Even at the End of Life

“Technology runs amok without ethics,” says Tammy Ruiz, a Catholic nurse who provides end-of-life care for newborns. “Making sure ethics keeps up with technology is one of the major focuses of my world.”

How do Catholics like Ruiz honor the life and dignity of patients, without playing God—either by giving too much care, or not enough?

Cathy Adamkiewicz had to find that balance when she signed the papers to remove her four-month-old daughter from life support. The child’s bodily systems were failing, and she would not have survived the heart transplant she needed. She had been sedated and on a respirator for most of her life. Off the machines, Adamkiewicz says, “She died peacefully in my husband’s arms. It was a joyful day.”

“To be pro-life,” Adamkiewicz explains, “does not mean you have to extend life forever, push it, or give every type of treatment.”

Many believe that the Church teaches we must prolong human life by any means available, but this is not so. According to the Catechism of the Catholic ChurchDiscontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment” (CCC, 2278).

Does this mean that the Church accepts euthanasia or physician-assisted suicide—that we may end a life to relieve suffering or because we think someone’s “quality of life” is too poor? No. The Catechism continues: “One does not will to cause death; one’s inability to impede it is merely accepted” (CCC, 2278).

Richard Doerflinger, associate director of Pro-Life Activities at the USCCB, explains that caregivers must ask, “What good can this treatment do for this person I love? What harm can it do to him or her? This is what Catholic theology calls ‘weighing the benefits and burdens of a treatment.’ If the benefit outweighs the burden, in your judgment, you should request the treatment; otherwise, it would be seen as morally optional.”

Palliative care is also legitimate, even if it may hasten death—as long as the goal is to alleviate suffering.

But how are we to judge when the burdens outweigh the benefits?

Some decisions are black and white: We must not do anything, or fail to do anything, with the goal of bringing about or hastening death. “An act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator (CCC, 2277).

The dehydration death of Terry Schiavo in 2005 was murder, because Schiavo was not dying. Withdrawing food and water had the direct goal of killing her.

But if a man is dying of inoperable cancer and no longer wishes to eat or drink, or his body can no longer process nutrition, withdrawing food and water from him might be ethical and merciful. He is already moving toward death, and there is no reason to prolong his suffering.

Moral Obligations

Our moral obligations are not always obvious. Laura Malnight struggled with doubt and fear as she contemplated the future of her tiny newborn quadruplets. Two of them had pneumonia.

“It was horrible to watch them go through what they had to go through to live, being resuscitated over and over again,” Malnight says.

One baby was especially sick and had suffered brain damage. The doctors who had pushed her to do “selective reduction” while she was pregnant now urged her to stop trying to keep her son alive. “They said we were making a horrible mistake, and they painted a terrible picture of what his life would be like in an institution,” Malnight says.

Exhausted and overwhelmed, Malnight was not able to get a clear answer about the most ethical choice for her children.

Everyone told her, “The baby will declare himself,” signaling whether he’s meant to live or die. “But,” says Malnight, “my only experience with motherhood was with these babies, in their isolettes. The thing was, we would put our hands over our son and he would open his eyes, his breathing would calm.”

“We just kind of muddled through,” she says. Her quadruplets are now 13 years old, and her son, while blind and brain-damaged, is a delightful and irreplaceable child.

Doerflinger acknowledges Malnight’s struggle: “Often there is no one right or wrong answer, but just an answer you think is best for your loved one in this particular situation, taking into account that patient’s own perspective and his or her ability to tolerate the burdens of treatment.”

The key, says Cathy Adamkiewicz, is “not to put our human parameters on the purpose of a human life.”

When she got her infant daughter’s prognosis from the neurologist, she told him, “You look at her as a dying system. I see a human being. Her life has value, not because of how much she can offer, but there is value in her life.”

“Our value,” Cathy says, “is not in our doing, but in our being. Doerflinger agrees, and emphasizes that “every life is a gift. Particular treatments may be a burden; no one’s life should be dismissed as a burden.”

He says that human life is “a great good, worthy of respect. At the same time, it is not our ultimate good, which lies in our union with God and each other in eternity. We owe to all our loved ones the kind of care that fully respects their dignity as persons, without insisting on every possible means for prolonging life even if it may impose serious risks and burdens on a dying patient. Within these basic guidelines, there is a great deal of room for making personal decisions we think are best for those we love.”

Because of this latitude, a living will is not recommended for Catholics. Legal documents of this kind cannot take into account specific, unpredictable circumstances that may occur. Instead, Catholic ethicists recommend drawing up an advance directive with a durable power of attorney or healthcare proxy. A trusted spokesman is appointed to make medical decisions that adhere to Church teaching.

Caregivers should do their best to get as much information as possible from doctors and consult any priests, ethicists, or theologians available—and then to give over care to the doctors, praying that God will guide their hearts and hands.

Terri Duhon found relief in submitting to the guidance of the Church when a sudden stroke caused her mother to choke. Several delays left her on a ventilator, with no brain activity. My husband and I couldn’t stand the thought of taking her off those machines. We wanted there to be a chance,” she says. But as the night wore on, she says, “We reached a point where it was an affront to her dignity to keep her on the machines.”

Duhon’s words can resonate with caregivers who make the choice either to extend life or to allow it to go: “I felt thankful that even though all of my emotion was against it, I had solid footing from the Church’s moral teaching. At least I wasn’t making the decision on my own.”

Adamkiewicz agrees. “It’s so terrifying and frustrating in a hospital,” she remembers. “I can’t imagine going through it without having our faith as our touchstone during those moments of fear.”

 *********

End of life resources

 

Ethical and Religious Directives for Catholic Healthcare Services (from the USCCB)

Evangelium Vitae

Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004 

NCBCenter.org provides samples of an advance directive with durable power of attorney or healthcare proxy.

This article was originally published in Catholic Digest in 2013.

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What can American parents learn from a doll?

Polio_sequelle

In wealthy, progressive Seattle, polio vaccination rates are lower than in Rwanda. Parents in Zimbabwe, Rwanda, Algeria, El Salvador, Guyana, Sudan, Iran, Kyrgyzstan, Mongolia and Yemen are doing more to protect their children from this crippling and often deadly disease than some American parents.

This dangerous trend is due, in part, to historical amnesia. There are fewer and fewer people around who remember the devastation of the polio epidemics of the late 1940′s and early 50′s.  Between 19445 and 1949, something like 20,000 American contracted polio. In 1952, there were 58,000 cases. Ten of thousands of American were paralyzed; many died. The nation was terrified, and rightly so.

Read the rest at the Register.

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NH Medicaid May Cut Payments for Circumcision

AS0016701FC20 Baby, visiting doctor, stethoscope examinationphoto courtesy of Wellcome Images

 

The state medicaid program should no longer pay for elective circumcisions in NH, says a proposed bill. 

The bill’s sponsor, state representative Keith Murphy of Bedford, describes the practice as unethical.

“To me there’s something fundamentally wrong about strapping a baby boy to a board and amputating perfectly healthy, normal tissue,” says Murphy.

The American Association of Pediatrics doesn’t agree that the practice is “fundamentally wrong.” In an August, 2014 statement, they said (emphasis mine):

Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it, however, existing scientific evidence is not sufficient to recommend routine circumcision. Therefore, because the procedure is not essential to a child’s current well-being, we recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions.

Sanest thing I’ve heard all year. Give the parents lots of sound, medical information, and then let them make up their own minds when they’re deciding how to get their kids the best care for their circumstances.