Masterpieces and POLST


Few of us are likely to think of ourselves as masterpieces. Once in a while we may get carried away and be full of ourselves. But the common feeling is closer to unfinished: a rough piece of work that needs shaping and polishing.
The ads and TV commercials aimed at women are built on that premise. While you’re “worth it,” they say, you will be more worthy with this shampoo, this lipstick, this perfume.
A very different premise is proposed for American Catholics to think about this month. October is Respect Life Month, an annual observance promoted by the bishops to keep the focus on persons as technology and culture change. This year’s theme is a statement: “Each of us is a Masterpiece of God’s creation.”
It comes from a message of Pope Francis to the Day for Life observance last year in England and Wales. “Even the weakest and most vulnerable, the sick, the old, the unborn and the poor are masterpieces of God’s creation,” the pope declared. Each of us in all of our various conditions is made in “God’s own image, destined to live forever, and deserving of the utmost reverence and respect.”
Lipstick and perfume have nothing to do with our worth. Our ultimate value and our destiny are already living within every person.
But the rush of technology and business efficiency is always trying to gain the advantage. The latest evidence is in the rise of POLST. The letters stand for Physician Orders for Life-Sustaining Treatment. The bishops’ pro-life program calls attention to this development and warns us to be wary.
Touted as a way for people to “take control” of their end-of-life medical judgments, it can also mean losing control. That’s because a POLST document signed by a physician and the patient is also a future medical orders form. Other advance medical directive forms and designations of a proxy for medical care do not fix future actions. They only indicate patient preferences in time, and retain openness to change. While POLST forms may ask the doctor to use them only if he or she thinks the patient has less than a year to live, this may not be followed.
The medical profession is rightly trying to do better with all kinds of “communication” issues in the field, from sharing clinical information across specialties to seeking patient consent at more points of treatment. Still, communication between experts and the unknowing patient is never an equal exchange. A frail elderly woman may imagine she would not want to continue living hooked up to machines with “tubes.” But there are tubes and machines of various purposes, most intended for temporary use while natural human functions are restored. They aren’t all merely keeping a body warm.
It can be tempting for the expert to “communicate” in a way that favors efficiency. Why not avoid the messy uncertainties around end-of-life questions, and the cost in dollars, that may roil families and add emotional strain to the practice of medicine? Why not allow a little understandable ambiguity that eases treatment judgments down the road? Mercy killing doesn’t always come in the front door. It is more likely entry is in a side door cloaked in compassion. Medical professionals today are under enormous pressure to be more efficient, to operate like a business. The Church is trying to help them keep their balance with reminders to focus on persons first.
Efficiency is useful, but never forget to respect every human being, every patient no matter how old and useless, as God’s masterpiece.
Frank Wessling

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