Maryland pastoral letter on sick and dying sparks interest

Two weeks after Maryland’s Catholic bishops unveiled their June 6 pastoral letter on caring for the sick and dying, more than 3,000 people in 28 states requested copies of the 35-page document.

Richard J. Dowling, executive director of the Maryland Catholic Conference, said he has received at least 200 requests for individual copies of the letter and large-scale orders from Catholic health care providers. A pastor in Montgomery County ordered 800 copies for the families in his parish, Mr. Dowling said.

“Comfort and Consolation: Care of the Sick and Dying” emphasizes the dignity of every human life, offering moral guidance on questions about medical care and treatment, nutrition and hydration, pain-relieving medication, pregnancy and imminent death from terminal illness. It includes a four-page form Catholics can use to tell health care providers how they wish to direct their care.

Mr. Dowling, who represents Maryland’s Catholic bishops in Annapolis, said he received calls from Catholics who described the letter as a “godsend” for the clear guidance it offers on complex ethical questions.

“We couldn’t be more pleased with the response so far,” he said. “We’re counting on clergy and people in health care ministries, Catholic lawyers and parish religious education directors to do their part to get this important message into the hands of people they serve.”

Joan Jennings, a parishioner of St. Gabriel in Woodlawn, said she has been reading about church teachings on end-of-life issues for the last several years. She ordered the pastoral letter to deepen her knowledge on the topic.
“It’s possible I might be in some position when I might have to make these decisions myself,” said Ms. Jennings, a widow.

Ms. Jennings said it was important to let her family members know her desires if she is no longer able to make medical decisions. That’s why she completed an advance directive, a legal document individuals may use to direct their care.

“I would want my son to consult with someone who has the medical background and also with a priest,” she said.

Ms. Jennings said she was heartened that the pastoral letter explains nuances in church teachings. The document states that while there is a clear presumption in favor of continuing nutrition and hydration for terminally ill patients, there may be certain circumstances when it may be morally sound to discontinue tube feeding.

The document adds that “the prudent course of action is to consider the facts of the particular case and to determine whether a patient’s need for nourishment and fluid can be met effectively through a medical intervention whose use does not impose excessive burdens” on the patient.

“You have to balance the benefits of continuing treatment with how it will affect the patient,” Ms. Jennings said.

The bishops noted that in the case of someone in a persistent vegetative state, medically assisted nutrition and hydration must not be refused or withdrawn. Such people have a right to basic health care, they said.

Marguerite Patricia Gilner, director of the HOPE Palliative Care Program at St. Agnes Hospital in Baltimore, said the pastoral letter is helpful to Catholic health care providers because it reminds them of their responsibility to “do everything we can to respect and honor the patient and to continue to offer dignity at all phases of care.”

St. Agnes encourages patients to develop advance directives that respect their religious beliefs, she said.

“Our role is to help them to honor their wishes,” she said.

The document gives more options to patients, Ms. Gilner said, and it helps them clarify their desires to other family members.

St. Agnes, St. Joseph Medical Center in Towson, Mercy Medical Center in Baltimore and Bon Secours Hospital in Baltimore are forming a regional organization tentatively called the “JAMB Coalition” which will focus on palliative and end-of-life care decisions, Ms. Gilner said.

Likely to debut in September, she said the coalition will examine ways for the Catholic hospitals to “provide the best care for patients with all respect for Catholic teachings.”

A discussion of the pastoral letter will be on the agenda for the group’s first meeting, she said.

For information on purchasing copies of the pastoral letter, call 410-269-1155 or go to The letter is $6 (including postage/handling), with discounts for bulk purchases.

Catholic Review

The Catholic Review is the official publication of the Archdiocese of Baltimore.