Some Questions of Medical Ethics and Extraordinary Care

I’ve been mulling over the concept of extraordinary care lately and am not entirely sure I have it down. I’d like to present some scenarios to ya’ll and I’d like your input if I have it correct or not.

Firstly, my understanding is that it is morally permissible to cease extraordinary care even if it results in a death. It is however not ok to cease ordinary care that would result in a death. My confusion comes over where “extraordinary” and “ordinary” intersect. I understand that providing basic sustenance is ordinary. However:

Say a man is in the hospital with some type of condition where he is only being kept alive with a breathing machine. Is that extraordinary, since he is living solely because of a machine, or ordinary because we are talking about merely breathing?

Next, say a man has a terminal illness. He could receive a treatment that potentially extends his life an additional 15 years. He or a guardian decide not to do it and simply live out the rest of his days until the illness kills him. Is that denying ordinary care?

I guess boiled down my questions are, at what point do we “Royal we” become morally culpable? What makes care “extraordinary”?

Thanks for any insight

Interesting question that I don’t know the solid answer to. I’m assuming that “extraordinary care” means care in which the patient is not expected to recover. If the man on the breathing machine has no chance (or a very small chance) of recovering to the point of being able to live on his own without the machine, I think that’s extraordinary care. But the other treatment seems like ordinary care. I think that the expectation of certain or almost-certain death in which this expectation cannot be reversed would be the qualifier for “extraordinary care.” But I’m not sure.

Nutrition and hydration (food and water) are essential and always should be provided unless they cause more harm than withholding. You might say a ventilator is extraordinary care, but if it is known to be required for a definitive period, may be not.

I would suggest spending some time at this website: National Bioethics Center. The more I explore, the more I realize how much I have to learn.

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Good reading at the National Catholic Bioethics Center:

https://www.ncbcenter.org/

In your second case, the answer is likely no. We are, in most cases, not required to accept medical treatment. It might be different if he has young children who require care.

Thanks for the links guys I will check it out.

Here is the USCCB’s document on the issue:

http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf

Regarding the refusal of treatment here are two relevant points:

  1. Free and informed consent requires that the person or the person’s surrogate receive
    all reasonable information about the essential nature of the proposed treatment and its benefits; its risks, side-effects, consequences, and cost; and any reasonable and morally legitimate alternatives, including no treatment at all.

  2. While every person is obliged to use ordinary means to preserve his or her health, no
    person should be obliged to submit to a health care procedure that the person has judged, with a free and informed conscience, not to provide a reasonable hope of benefit without imposing excessive risks and burdens on the patient or excessive expense to family or community.

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