Catholic medical ethics

Does anyone know what the Church’s position is regarding open-heart surgery, whether a patient can in good conscience refuse this type of radical intervention as “extraordinary”? Or is open-heart surgery considered ordinary today? Is refusal passive euthanasia, or not?

What about refusing a ventilator?

It is difficult to imagine open heart surgery as ordinary care, same with ventilation.

If coronary blockage is the issue there have been significant gains from less invasive treatments. But that involves “extraordinary” strictness of diet and exercise.

See Dr Dean Ornish, Dr Caldwell Esselstyn, and Dr T. Colin Campbell.

Ordinary and extraordinary do not mean “easy” or “difficult.” It is more like “basic” or “not basic.” They pretty much don’t “change.” Providing food and water to someone who can’t eat or drink without help is ordinary care. Providing a blood transfusion is not.

If you are dealing with some specific issue with a real person, go talk to a flesh and blood expert. Call your diocese and they can refer you.

As medical science and techniques continue to improve, I think the line between “ordinary” and “extraordinary” can move somewhat. I found one statistic that said as of several years ago, a record 500,000 coronary bypass operations had been performed in that year. I was surprised to find that in 2012, there were over 2,300 heart transplants (those, I would still consider “extraordinary” though).

My own take is the surgeons skills are given by God. What was considered revolutionary ten years ago is now routine. My wife is a specialist cardiac nurse. Don’t waste these wonderful skills

You’ll get the best answers from the National Catholic Bioethics Center. I suggest you contact them:

ncbcenter.org/about-us/contact-us/

Best,
Ed

I’m getting ready to update my will, it’s quite a few years old. A likely condition i may have to face is heart valve replacement. The whole concept is repulsive to me. I wouldn’t choose to go through it unless it’s a moral imperative.
I will take the advice to contact my local diocese and ask for direction. Thanks.

I will. Thanks

You’re welcome.

Best,
Ed

How on earth could a life saving medical procedure be considered repulsive? God expects us to look after our health and bodies and he gave us skilled doctors and surgeons to help us.
Would you allow your children to die rather than have surgery?

My Dad had this procedure done.

Pig heart valves are used when a human heart valve is replaced. Some people probably can accept this, and some probably have difficulty with it. My Dad didn’t have any problem with accepting that he was going to have a pig valve used to replace the damaged valve in his heart.

I think another factor in whether a certain treatment is considered “ordinary” or “extraordinary”, is that the same treatment could have a totally different risk/benefit profile, based on who you are; your age, your medical conditions, etc.

Some debilitated patients aren’t even offered the option of open heart surgery, because the chance of the dying from the surgery itself, is much higher than the chance the surgery will help them at all.

Many people who have DNR orders, are those who have some kind of terminal condition such as end-stage cancer, that means they’re probably (1) not going to survive CPR anyway, or (2) may survive, but in a very impaired condition, dependent on mechanical ventilation for the rest of their lives – and AFAIK, mechanical ventilation IS considered “extraordinary” care by the Church.

On the other hand, I suspect most medical providers, even secular ones, would be very uncomfortable with following a DNR/DNI order on, say, an 18 year old with asthma who may need to be on ventilator for 2 or 3 days during a bad attack, but who are probably going to be fine after that.

Also, note that even people who DO refuse mechanical ventilation often make an exception for general anesthesia, because that is usually given through the same kind of tube used to hook people up to ventilators.

ETA: I’d also note that I actually know people who work for Catholic hospitals, and sometimes treat Jehovah’s Witnesses. Such patients are allowed to refuse blood transfusions, though some hospitals do require them to sign a form that releases the hospital from responsibility for anything bad that happens if they don’t get it, including death. (Some people also refuse blood from non-religious grounds too, some people are still afraid of getting HIV from blood, for example.)

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