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New book offers a primer on what the Church teaches (and why) about end-of-life care
Virtually nobody likes to talk about dying or wants to imagine themselves lying on their deathbed. But that reluctance deprives us of opportunities to have some really important discussions, said Father Jeffrey Kirby.
“I tell people, ‘Look, it can be awkward, but sit down and have these conversations,'” said Father Kirby, 44, a priest of the Diocese of Charleston, South Carolina.
In his book, “We Are the Lord’s: A Catholic Guide to Difficult End-of-Life Questions” (TAN Books, $16.95), Father Kirby leans on his background as a pastor and professor of moral theology to discuss various scenarios that often come up in conversations about death. The topics he touches on include pain medications, extraordinary care versus ordinary care, what to do if a loved one refuses food and drink and how to handle a do-not-resuscitate request.
In an interview with Our Sunday Visitor, Father Kirby discussed his book, which he intended to be a handy reference guide and spiritual resource for families and individuals seeking answers to one of life’s great mysteries.
Our Sunday Visitor: Why did you write this book?
Father Jeffrey Kirby: The book was written because I noticed there were certain questions that kept coming up among people in terms of end-of-life concerns. Also, a lot of times, people didn’t understand the answers. They didn’t have the context. I just kept seeing this come up, both as a pastor in terms of people’s lives and the lives of families, and also in my academic work in teaching.
So I thought, let’s just have one easy, very approachable resource where people can receive the answers and a broad explanation of the answers. I wanted it to be understandable and accessible. I didn’t want a heavy philosophical book or an overly medical book. I just wanted something that any family could pick up, especially a family that’s in a crisis situation, and know the answer to something and why.
Our Sunday Visitor: So this topic was something where you already had a working knowledge?
Father Kirby: My doctorate is in moral theology, and I have a master’s degree in bioethics. I wanted to provide strong answers in a way that people can understand. That’s the part that was very important to me with “We Are the Lord’s” — that people could understand why something is the right answer.
At the beginning of “We Are the Lord’s,” I tell people, “If you’re picking up this book and you’re in an ICU unit or you’re next to a loved one in a hospital, go to Chapter 7, which has the Q&A. But if you’re not in that situation, and you’re able to give it more time, then I said, “Please read the whole book, but especially Chapter 6, which goes into a lot of the principles behind why we teach what we teach.”
Our Sunday Visitor: What are the general principles you present in Chapter 6?
Father Kirby: There are three main principles. The first one is our human dignity and moral goodness. The second is the human vocation that we all share together. If my neighbor is hungry and I have food, then I’m called to give that person food. If a person is hurt and I’m able to help, I’m called to help that person. The third principle is discerning if something is ordinary or extraordinary. Ordinary means we are morally obliged to do it. Extraordinary means it’s a morally optional decision. Sometimes people are surprised when they realize as Catholics that we say there might be times when it’s OK to say no to treatment and to allow the natural process of death to play itself out.
Our Sunday Visitor: How much of this book was guided by your experience as a pastor?
Father Kirby: I’d say the whole book is very much colored by my pastoral experience and the quick response questions that I chose. I asked myself, “What are the top questions that come up, pastorally?” And those are the ones that are listed in Chapter 7.
Our Sunday Visitor: What is the most common end-of-life concern that people have?
Father Kirby: The No. 1 issue, by far, which is a real battleground, is nutrition-hydration when it’s artificially administered. When we have to give food and water through a breathing tube, for example. That is the No. 1 question in the debate, and the reason why is because medical personnel classify that as an extraordinary measure. But in Catholic Social Teaching, we say that as long as the body can assimilate the food, then it should be given. It doesn’t become extraordinary until the body can no longer receive the food. Because of that conflict between our teachings and the medical professionals, that becomes a real battleground.
Our Sunday Visitor: Does that conflict reflect something ominous in our culture?
Father Kirby: Yes, very much so. I think so much of our culture is motivated by a view that our dignity is defined by utility and pleasure, and if a body or person can’t fulfill that, then what’s the point? If a person is dying, then why give them food? It doesn’t matter; they’re dying anyway. That is not our understanding. We give people food as long as they’re hungry and as long as their body can take it.
Our Sunday Visitor: Do you find that people, in general, don’t like talking or thinking about this topic until they’re in that situation?
Father Kirby: Very much so, and I think oftentimes that hurts us. A lot of people don’t want to talk about death and suffering. And because of that, sometimes families don’t know what a person wants. Whether it’s their care when things get serious or it’s about details for their funeral, a lot of times people just don’t want to talk about it. My hope for the book is that we can tell people, “Look, this isn’t something we have to be afraid of. This is going to happen, and the best thing we can do for ourselves and our loved ones is to have these conversations and make sure everything is in order.”
Our Sunday Visitor: In what way does that reluctance hurt us?
Father Kirby: I’ve seen, pastorally, situations where family members don’t know what their loved one wanted, and then they have to make some really hard decisions. And they have to live with those decisions. I still have people who are very much weighed down by guilt. They had to come to peace with their decisions, and it’s a guilt they shouldn’t have to bear. They made a morally good decision, but because they didn’t know what their spouse, parent or loved one wanted, they carry that guilt.
Our Sunday Visitor: For some people, can these conversations be an entryway into the Church?
Father Kirby: Absolutely, and I would say in two perspectives: One is that they may not return right away, but they had a positive experience of the Church’s care, and it gets in their hearts. Of course, we see cases where it does lead to a conversion, and the person comes back to the Church and the practice of the Faith. They realize the Faith is something that’s important to them, and they want to make it a part of their life.
Our Sunday Visitor: How has working with the dying and their loved ones affected your priestly ministry?
Father Kirby: For me personally, I was looking forward to this part of my priestly ministry. It’s such a sacred moment and experience to be with someone as they’re preparing to pass from this life to the next. I find it very grace-filled and helpful. When someone knows their life is coming to an end, there’s a profound wisdom and counsel that comes from them in what they recall, what they want to pass on, sometimes their regrets. To be with someone when they’re going through that process in their own minds and hearts, but also receiving this wisdom, it’s a tremendous blessing, especially when someone is preparing for a holy death and really has a strong relationship with the Lord. To be able to see that is really beautiful and inspiring.
Our Sunday Visitor: Your book touches on pain and suffering. How do you explain that to people who struggle with the idea that a loving God permits evil in the world?
Father Kirby: I tell people, in terms of the mystery of evil and suffering, that God is on our side. He is a force for good and is fighting the evil in our world, and that fight is going to continue until the end of time. People will say, “He’s all-powerful. Why doesn’t he just stop all this?” I tell people, “He will.” He is delaying that for our benefit so we can work out our salvation in the interim, but God is all-powerful. He’s all-good. He’s here, fighting in this world.
Brian Fraga is a contributing editor for Our Sunday Visitor.