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End of Life Care: Do I have to spend my last days hooked up to machines?

We’ve probably heard this question before. No one wants to be hooked up to machines against their will–and no one should be forced to be hooked up to machines against their will. Patients should be allowed to determine what type of medical treatment and care they want and which they do not. No hospital or physician should force you to undergo any medical treatment against your wish.

With that said, it’s important to emphasize a few important principles. These “life principles” should be our guide as we make medical treatment and care decisions, including those at the end of our life and the lives of our loved ones.

First of all, human life is sacred, a gift from God that bears His image. Since God created us, He–and He alone–is the Author of our lives. Therefore, only God may determine when a person’s life will end. Because made in God’s image, every person’s life has equal, inherent worth and dignity. The “quality-of-life” mindset can lead to a judgment that a person’s life is of such “low quality” that he or she would be better off dead than living. This must be rejected. A person must not kill him/herself by act or omission. Human life, in all its stages and in all circumstances, must be defended and protected.

When a patient enters the hospital, there are many decisions that need to be made. While every illness cannot be cured, every patient must be cared for and treated with respect. When decisions need to be made on medical treatment, medication, a procedure or an operation, the “ordinary” versus “extraordinary means” standard should be applied. At a minimum, no one should be deprived of basic care, including food and water, hygiene, a comfortable environment, or effective, available medical treatments. Any act or omission which of itself or by intention causes the death of the patient should never be considered “medical care,” but is euthanasia.

Each person has an obligation to care for his/her life, to use “ordinary means” to preserve it. “Ordinary means” include any treatment, medication, procedure and operation which offer a reasonable hope of benefit without requiring heroic virtue–meaning virtue above and beyond the ordinary. An example of ordinary means is an effective treatment that does not cause excessive pain, unreasonable expense, or other grave burden on the individual patient.

All of us will die. Dying is part of life. Therefore, we are not required to accept every medical treatment suggested or available. “Extraordinary means” include any treatment, medication, procedure and operation that are gravely burdensome for the patient to bear or otherwise require heroic virtue. Means that involve excessive hardship–such as excessive pain, tremendous effort, or unreasonable expense–could be classified as extraordinary and optional for a particular patient.(1)

What about common treatments offered to those with a serious illness? For example, what about a ventilator, chemotherapy, or an operation?

Each individual case must be evaluated by the attending physician and the patient (or if applicable, the patient’s proxy) in light of the patient’s actual condition and the current medical circumstances. The physician must respect the sanctity of the patient’s life and must respect the patient’s (or proxy’s) decisions as long as such decisions do not cause or intend to cause death by act or omission of ordinary means.

A ventilator (commonly, but less accurately called a “respirator”) is used to move air and/or oxygen in and out of the patient’s lungs, which is vital for survival. More often than not, a ventilator is ordinary means of treatment and should be used. However, there are exceptional cases when the ventilator is extraordinary means and continuation of this breathing assistance might be optional. Ventilators are used to support life while healing occurs. Patients often can be “weaned off” ventilators to breathe without further help.

Patients should not be forced to undergo any form of treatment, including chemotherapy, radiation, any procedure or operation. For example, there might be situations in which the patient wishes to discontinue chemotherapy treatments because of the gravely burdensome side effect the treatments have on their body. Similarly, a specific operation might have little hope of benefit and will cause the patient excessive pain. For reasons such as these, patients generally are not obligated to choose each and every medical treatment at their disposal.

It is important to remember that you–as the patient–have control of your medical decisions. You should not be forced to undergo treatment that is completely ineffective or gravely burdensome for you. We must repeatedly remind ourselves, though, that our lives are not our own. They have absolute, inherent sanctity and quality, bearing the image of God who is their Author and keeper. We have an obligation to do our best to live the entire life span given to us by God. Therefore, when judging the worth of a particular medical treatment–its effect on the patient and his/her medical condition–we must be careful never to judge the “worth” of ours or anyone else’s life.

Let us all constantly pray for the wisdom and guidance necessary to be good stewards of the lives God has given us. Death is not necessarily something to be feared and avoided at all costs. It is vital, however, that those who respect the sanctity of human life remain vigilant to the constant and insidious attacks of the culture of death.


(1) Note that although generally optional, extraordinary means are obligatory for the patient if he/she is not reconciled with God or if the lives of others depend on the life of the patient. Alternatively, the patient may not use an extraordinary means if it would cause him/her to fail in some more serious duty.