A PhysicianÕs Way of the Cross
Reflections on euthanasia with the Scriptural Way of the Cross
Introduction: A Call to Watch and Pray
In
the lead up to Holy Week, I am struck by the scene of the Apostles falling
asleep, while Jesus asks them to Òwatch and pray.Ó Last year at the
Catholic physicians' conference in Calgary, Dr. John Scott, a palliative
care physician from Ottawa, spoke about the role of a physician at the end of
life as one of Òwatching withÓ the Lord, that is, to accompany our patients
with care and compassion, to a natural death.
The
readings from Wednesday of Holy Week offer encouragement from Isaiah (50:4-9)
for a conscientious objector: ÒThe Lord God has given me a well-trained tongue,
that I might know how to speak to the weary a word that will rouse them.
Morning after morning he opens my ear that I may hear; and I have not rebelled,
have not turned backÉ The Lord is my help, therefore I am not disgraced.Ó
We can also make the Psalm (69) our own words: ÒFor your sake I bear
insult, and shame covers my faceÉ because zeal for your house consumes me, and
the insults of those who blaspheme you fall upon me.Ó I
am also struck by the lament of how physicians would now begin treating their
patients: ÒThey gave me poison for food, and for my thirst they gave me
vinegar to drink.Ó And finally a message of hope: ÒYou who seek God, may
your hearts revive! For the Lord hears the poor, and his own who are in bonds
he spurns not."
The
reflections below on the Scriptural Way of the Cross are
to provide some points for meditation for physicians and caregivers on care at
the end of life.
First Station: In the Garden
Jesus
admits in his agony in the garden that he is Òsorrowful unto deathÓ (Matt
26:38), sharing in our human experience of existential angst at the end of
life. This is a common human experience, requiring consolation for loved
ones and caregivers, a consolation that Jesus requested when he asked the
disciples, ÒCould you not watch with me one hour?Ó (Matt 26:40). But he found
them sleeping.
Reflecting
on the scene of the disciples falling asleep in the garden, I canÕt help but
think that physicians have Òfallen asleepÓ regarding care at the end of life by
giving in to the cultural pressures to legalize euthanasia and assisted
suicide. Indeed, many people who will request euthanasia are Òsorrowful
unto death,Ó but a compassionate response (compassion is from the
Latin "to suffer with") is not to end the sufferer but
instead to suffer with them - to accompany them with medication and attention.
The claim that euthanasia ends suffering is absurd, if the person does not live
to experience relief from suffering, then it cannot be said that euthanasia
Òends suffering.Ó Indeed, euthanasia is the ultimate abandonment of
patients, a refusal to suffer with, to stay awake, and instead
handing people over to be killed. We must wake up, watch and pray at the
end of someoneÕs life, rather than fall asleep in the way we care for our
patients.
Even
Christ asked His Father, ÒLet this cup pass from meÓ (Matt 26:39) - and we must
acknowledge that if our Lord asked for relief, it is not surprising that our
brothers and sisters ask for a relief from the cup of suffering. Jesus
then adds, ÒFather, if this cannot pass unless I drink it, your will be doneÓ
(Matt 26:42) - and immediately after this he looks for his disciples support
and finds them sleeping. This is a rally call to us as caregivers and
physicians not to abandon our patients who are Òsorrowful unto deathÓ and who
are asking for some relief - whether it be some relief from pain or some
accompaniment through compassion. Jesus places his life in his FatherÕs
hands, and in deferring to his FatherÕs will, shows that we cannot ask for
death in the way and at the time we wish, since only our Heavenly Father knows
the hour when our time will come.
Second Station: Jesus is betrayed by Judas and arrested
As
caregivers, our falling asleep at the end of our patient's life is part of a
bigger picture of moral and cultural amnesia. Our culture has forgotten
its origins and lost its way. In response to this cultural amnesia, we
must help by pointing out what has been lost. Pope Benedict speaks of
conscience as an Òanamnesis (remembrance) of the originÓ - a discovery within ourselves of the natural law, of the truth written on our
hearts. Conscience is a remembering. And now, as conscience is
being trampled on through the legislative and regulatory process of euthanasia
and assisted suicide, we are no longer seeing an Òanamnesis of the originÓ but an Òamnesia of the origin.Ó Our culture needs to
wake up to the gentle voice of the Word who was in the beginning, calling on us
to Òwatch and prayÓ rather than to fall asleep while our patients are being
handed over to death.
Judas
lost his way and in his betrayal of Jesus, demonstrates a moral amnesia that we
must not imitate. While our country accepts euthanasia and assisted
suicide as a form of health care, we must provide our colleagues, families and
friends with constant reminders that we cannot hand our patients over to death.
Third Station: Jesus is condemned by the
Sanhedrin
ÒHe
came unto his own, and his own received him not" (John 1:11). We
feel betrayed - by our Supreme Court, by our government, by our medical
profession, who have all accepted the lie that death is a form of caring.
So quickly things have changed. Not too long ago, the thought of
euthanasia was shunned by parliament and medical associations found it
unthinkable. For over 2000 years of Hippocratic medical traditions, the
sanctity of life was preserved in the art of medicine, and now all of this
seems to be rejected.
So
quickly we become a minority who want to protect life at every stage, from
conception to natural death. We might even be silenced by
peers for our Òextreme views.Ó Mocked, despised, and perhaps down
the road, our licenses and livelihoods threatened for our unwillingness to
include death as just one other medical option.
Fourth Station: Jesus is denied by Peter
Even
we ourselves are susceptible of falling asleep like Peter. Our courage to
care heroically fails at times. We must admit that there are times when we
have missed the mark and our lack of compassion, our lack of willingness to
suffer with our patients, may lead patients to request a more convenient death,
a release.
Not
only is our care lacking at times, but sometimes we
might provide a false witness. We might be tempted to participate either by
referral or collaborating with the authorities to facilitate euthanasia for a
patient. We might even make excuses to justify our actions. And if
we do, we must turn back to our Lord and repent. Let Mary be our example
of faithfulness to the end.
Fifth Station: Jesus is judged by Pilate
Our
Supreme Court has issued its decree and death is named as the solution to a
problem. The crowd mentality overtakes common sense and even, it would seem,
Christians join in the chorus of praising the new option for death on
demand. Even as all around us cry, "Crucify him!" We will not
be shaken in our resolve to watch and wait with our Lord. We will be
faithful to the memory of Him who asked us to watch and wait, and like Mary we
will keep our eyes fixed on our Lord hidden in those we minister to.
Sixth Station: Jesus is scourged and crowned with thorns
Jesus
is our example of compassion - He suffers with us, and every
mark of the scourging on his body is a reminder to us that He suffers with us
and for us. When our patients are suffering, we must suffer with them,
realizing that our shared suffering is part of the passion of our Lord.
Yet at the same time we want to relieve the suffering as much as possible and
provide comfort to those in our care. The comfort we provide to each
person we encounter is a comfort provided to our Lord.
As
Jesus is crowned with thorns, we also have to crown our pride, knowing that we
donÕt have all the answers, and that there are times when, despite our best
efforts, we cannot end all aspects of suffering. It is at these times that we
need to come close to patients and their families and remind them that Christ
suffers with them, and that He will not let their suffering last forever.
Seventh Station: Jesus takes up his cross
Jesus
asks us to take up our own cross and follow Him. We need big shoulders to
carry our love for the sick, to be attentive to their needs, to be called on at
all hours of the day and night. We also need to carry this cross with a
smile, knowing that there is a line of people following us with their crosses
too, and seeing our smile is an encouragement to them (ÒA joyful heart is good
medicineÓ -Proverbs 17:22). In the long line of crosses, we are thankful
to those who have mentored us and shown us the way ahead, and accept the
responsibility to guide those entrusted to us
who are carrying their crosses behind.
In
our struggle to bear the small contradictions of the day, the annoyances, the
difficult patients, we find the means to strengthen us for those times when we
need to empathize with our patients who are struggling to bear their own
cross.
Eighth Station: Jesus is helped by Simon of Cyrene to carry
his cross
We
must be Simons for our patientÕs crosses. Certainly medication has a
place in lifting our patientsÕ burdens, but we must also recruit all of the
human virtues as well - patience, humility, tenderness, demonstrating that we
are willing to go the extra mile. Certainly there are times when our
beloved sick no longer have the strength to hold up under the weight of pain,
disability, and infirmity. They are waiting for a Simon, and we must show
them that we are opportunists when it comes to lifting othersÕ crosses.
Not only are they waiting for a Simon to help them with their cross, we - as
Simons - are eagerly waiting for Christ to pass by so we can help. Behind
every exam room door is Christ, hoping to meet Simon in us.
Ninth Station: Jesus meets the women of Jerusalem
Families
weep too; they cry out for those who might offer their loved one help. We
must develop the ability to Òspeak to the weary with a word to rouse themÓ
(Isaiah 50:4). Our consolation for others must lead them out of themselves
- not from inward looking weeping, but an outpouring of tears for the sake of
another. Jesus tells the women of Jerusalem and us that our weeping must
be turned into intercession: to go deeper than simple pity, to go right to the
heart of the matter: to care for souls.
As
we care for our patients, we should care as deeply for their souls as we do for
their bodies. And as we embrace their family who weeps for them, we
broaden our catch and care for the souls of the whole family as well.
Tenth Station: Jesus is crucified
The
end is near. When a patient is actively dying, we are attentive to
everything. The sound of their breathing, the dryness of their mouth,
each time their eyes open. We want to surround their bed, which is their
cross, with family at all hours - to accompany them right to the end.
We
want to respond to their thirst and sponge their mouth. We want to help
their breathing and ensure that they are not asphyxiated like Christ was.
We want to relieve their pain.
In
addition to those actively dying, I think also of the image of someone going
into surgery with their arms outstretched - on another cross. They spread
out their arms wide in abandonment, in total trust, to the physicians who will
remove or treat the diseased organ.
When
they are naked and stripped (often they feel this way of their dignity), or
perhaps they have no ability to speak, no ability to eat and drink being unable
to swallow - do we palliate them (literally Òto cloakÓ)? Do we cover
their nakedness by treating their body with dignity? Do we look on them
with MaryÕs eyes, the eyes of a mother, who always provides the best seamless
garment for our dignity?
Eleventh Station: Jesus promises his kingdom to the
repentant thief
Let
us never give up on our colleagues or friends who have different views than our
own. We must carry out a quiet apostolate with those around us, so that
they might see our good witness. Not only will we not give up on our
colleagues, whom we would like to influence, but we
will also not give up on our patients. Certainly many College documents
have seemed discriminatory to conscientious objectors by saying we Òmust not be
judgmentalÓ and that we Òmust not abandon patientsÓ in our approach. I
fully agree - let us not jump to conclusions in judging a request for
euthanasia as something fixed or that would lower our opinion of the person,
but instead see it as a cry for help, a cry from someone like our Lord who is
Òsorrowful unto death.Ó Our response is never to abandon them to the
impulsiveness of a system that is only to eager to fulfill such a request -
instead, we must stay awake, remain alert, and enkindle in ourselves a desire
to care to the end, and hope that such a witness would lead our patients to ask
our Lord to remember them, to stay with them until their natural end.
Twelfth Station: Jesus entrusts Mary and John to each other
How
moving is MichelangeloÕs Pieta, with Mary holding the lifeless body
of her Son. We must entrust our patients into the loving arms of our
Mother, who cares for each one individually, who wants to hold them in their
dying hours - in the midst of their suffering and pain. She was there at
the cross, and is there for each of our crosses.
We
are also entrusted with the Church, who also cares for our souls like a good
mother. And as we see souls at the end of life, we must ensure that for
our Catholic patients, and all those who request it, the sacraments are made
available to them.
We
must constantly pray for the grace of a good death for all our patients, and do
what is in our power to help them to this end. If there is a request and
the opportunity, we must ask for the sacrament of the sick, viaticum, or even a
deathbed baptism. We should also not shy away from being part of these
great moments, since this is part of how we care for a patientÕs life
holistically.
Let
us take Mary into our home, so that when our patients come to our medical home,
they will find her there.
Thirteenth Station: Jesus dies on the cross
With
what reverence do you determine someoneÕs death, looking for the usual signs of
life, realizing that this momentÕs tenor depends on you?
Do
you kneel at the bedside when your patients die? Do you put a cross on
their forehead and whisper a prayer and a goodbye? Let us not rush away,
but show the family that death is a natural part of life. I am reminded
of the last line of John DonneÕs Holy Sonnet X: ÒDeath be not proudÉ Death,
thou shalt die.Ó We must allow our words of comfort for the family or
even our moments of silence have the last word.
You
have journeyed with them all this time, with medications, with compassion, with
words of consolation. Now there is the peace that there is final relief
from the cross, and a hope of what is to come.
Fourteenth Station: Jesus is laid in the tomb
As
we were Simons, so now we must be Josephs, caring for the body with gentle
confidence. In all of these stations, we must never forget the constant
care of the nurses, who are the Josephs par excellence in removing the IV nails
in the hands and easing the body down from the cross to the arms of the
awaiting Mother.
We
should also ensure that family have the time they need to take it all in, and
confirm that arrangements are in place, to find out that the funeral home has
been contacted. Perhaps it might be the case that we attend certain
funerals as well.
As
we sign the death certificate, and write down the diagnosis and other details,
we might reflect on how Joseph and Nicodemus, like the funeral home staff,
prepared JesusÕs body for the tomb with linen cloths and spices, and how the
women also prepared spices and ointments.
Finally,
when they are each laid in the ground, we must never forget that here is a soul
to be prayed for, and hopefully given the care we showed them, they might also
be our strong intercessors from heaven.
Written by:
Thomas
P. Bouchard MD
Family
Medicine Physician
Calgary,
Alberta, Canada
ÒExcerpt
used with permission from The Measure of My Days, ISBN/Justin PressÓ