Preparing for one’s death is not high on many people’s to-do list. Preparing – as a faithful Catholic – for the possibility that you might have to make decisions surrounding the death of a loved one, even less so.
But, as the author of the new book Now and at the Hour of Our Death points out, death will come to everyone, ready or not.
The author, Nikolas T. Nikas, and co-author Bruce W. Green wrote Now and at the Hour of Our Death to provide help in “Making Moral Decisions at the End of Life,” which is the book’s subtitle.
Nikas is president and general counsel of the Bioethics Defense Fund, and Green is a former constitutional and pro-life litigator, dean, and law professor. Nikas said that he hopes the book will help people come to terms with their own mortality, as well as help anyone who suddenly finds himself in a situation of having to make life-and-death decisions.
He said the book, published by Ignatius Press, is written for “the average Catholic.”
“You don't have to be a professor or professional or anything,” he told Aleteia. “We're all going to face our own death and those of our loved ones, and we made it a book of 123 questions and answers so that it would be accessible for people.
"So for someone who doesn't want to read a whole book about end of life decision-making but might want to know, 'Well, what does the Church teach about this or that particular issue?' they could go to the specific question or a series of questions, and hopefully find some good answers.”
Below is an edited transcription of Nikas’ conversation with Aleteia.
What are some of the things that you believe Catholic readers will find most surprising in your book?
Nikolas T. Nikas: For most people, they just haven't been taught what the Church teaches on end-of-life issues. They really want to understand it, but because it's the intersection of modern medicine and moral principles they probably haven't heard about before, it's confusing. So I think the response we're getting is two-fold: "Wow, this really informs things I had never heard about before." And two, it's more than just how to make moral decisions. It's also how to prepare spiritually for one's death, whether that is weeks away or 30 years away.
And people are pleasantly surprised, I think, to know that there's more to it than just like an algorithm, you know, “Put these three facts in, blink twice, and you get the right answer.” There's a component of the book that really deals with how to approach death from a Catholic perspective and how to prepare ourselves spiritually.
What would be your advice for a Catholic family that suddenly finds itself having to make an extremely difficult decision regarding the end of life of a loved one. Just basic advice, aside from reading your book, obviously.
Nikas: Obviously, the title is from the “Hail Mary.” We want the Blessed Mother to intercede for us now and at our death.
But it's also kind of a message to the readers that now is the acceptable time to prepare. Don't wait for the crisis, because when the crisis hits, whether it's an accident or quick onset disease or something that just overwhelms people, you can't think rationally and morally, necessarily, when you're overwhelmed with emotion.
So “now and at the hour” is really to say, prepare now, before there's a crisis, sit down, understand what the Church teaches. Spouses should talk to each other. Parents should talk to their grown children. Let them know beforehand they’ve decided that the first child or the third child, whoever it’s going to be, is going to make these decisions for us if we're incapacitated.
So really, preparation, I think, is the thing I would say, because people are going to die in so many different ways that if there’s someone who's looking for an algorithm, they're not going to find it in this book. What they're going to find is: “Here are the moral principles that the Church teaches,” and to use prudence to apply them, but also prepare now. Do not wait until the crisis hits because it's almost impossible to think rationally.
Such a time of crisis is often a time when you're looking for someone reliable to talk to. What kind of advice would you have about contacting a local priest or moral theologian at the seminary or someone like that, if you're in such a situation?
Nikas: We wrote this book hoping that priests and deacons and seminarians would use it also because, you know, it's not clear whether a parish has a priest or deacons whose formation may or may not be fully up to speed on what the Church teaches.
And so, yes, we would say, first form your own conscience. That's our obligation as Catholics to form it in the Church's teaching, not from modern movies or music or popular culture. So form your own conscience in the Church's teachings.
Both of us [authors] are licensed attorneys, but we're not offering legal advice. If we say we think this Advanced Directive is better, we always say it in the context “morally” better. We're very clear that as far as the actual legal documents are concerned, find a licensed and competent attorney and have that drafted for you. But everything in the book, hopefully, is aimed at “Why?” – why would, say, durable healthcare power of attorney be morally better, potentially than, say, a living will?
I would mention that the National Catholic Bioethics Center has a hotline if there was a moral question.
First I would go, of course, to [your] pastor or a deacon if you thought that they had been well formed. But again, I think the obligation is on us as laypeople to form our conscience as best we can, because you may not always find someone either available or knowledgeable.
And sometimes you find yourself in a situation where you're fighting against people in the hospital – physicians or other care providers who are encouraging you to take a certain direction and you kind of have a feeling that it's not right. You’re not sure.
Nikas: Absolutely. You cannot assume that any doctor, nurse, or other care professional is going to see the world the way the Church sees it, of course.
And yes, that's right, that's one of the reasons we would again recommend, but only as a moral, not as a legal recommendation, a durable healthcare power of attorney. Find one who's well formed or is willing to get well formed in the Church's teaching, and have them advocate for you – respectfully, but forcefully if they have to – that you only want healthcare consistent with the teachings of the Church. That's hard to do because of the profound, unequal knowledge between a healthcare professional and the average person. But that doesn't mean that it shouldn't be done.
There are two extremes today in our modern, technological, medically advanced world. One is pushing people to death too soon. The other is keeping people alive when there's no moral reason to do so. You have to negotiate between those two extremes.
What do you see as the biggest danger our society is facing in terms of end of life issues today?
Nikas: Well, I think if you look at the back of our book, there are several blurbs, and one of the reviewers makes the point – I think it's very well stated – that there are two extremes today in our modern, technological, medically advanced world. One is pushing people to death too soon. The other is keeping people alive when there's no moral reason to do so. You have to negotiate between those two extremes. Again, that's not something that's easy, but preparation and formation will help.
One other thing I would throw out there: When I talk to people in parishes, I say, don't assume, when you use a term, that someone else means the same thing. You always hear, of course, the term “death with dignity,” and I always tell people, “Well, you should ask your interlocutor, ‘What do you mean by dignity?’” Some people, of course, mean assisted suicide, or the new euphemism “Medical Aid in Dying,” which has got to be an oxymoron of high level.
But I say, “Here's what a Catholic means by death with dignity: You've received last Confession, last Eucharist, last rites. You have forgiven anyone who's sinned against you, you have asked for forgiveness of anyone that you have offended. And while you're with your family gathered around you, you’re hearing Scripture and the singing of your favorite hymn, and you slip into eternity.” That’s true dignity, but of course, that is not what many people mean when they talk about death with dignity or dignity at the end of life.
So one thing, hopefully, the book will help readers is to ask people, "What do you mean?" Don’t assume that they have a Catholic understanding of that term.
