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                 BELOW ARE MORE CATHOLIC ARTICLE EXPLAINING DIFFERENT TEACHINGS OF THE CATHOLIC CHURCH

                  END OF LIFE QUESTIONS ON PALLIATIVE CARE INCLUDING MORPHINE:

Catholic Understanding and Teaching concerning Morphine Drip

Isn't a morphine drip just another way to hasten a terminal patient's death? What is the difference between that and assisted suicide?

A morphine (a strong opiate that offers the best, most common approach to severe pain relief) "drip" or continuous infusion (an efficient and convenient intravenous application) is often used when a terminally ill patient is experiencing progressive or intense pain. A morphine infusion (drip) is not prescribed to hasten a terminally ill patient's death, but to provide comfort to the patient. There is a method of gradually increasing strength of pain medicines as the pain changes with disease progression. Both the dosage and type of medicine can be changed to meet the individual's unique needs for relief and prevention of pain and discomfort. Beginning with mild, to moderate to strongest medications, the physician has options to maintain control over the person's pain over time.

There is a distinct difference between the action of prescribing pain medication for a terminally ill patient and prescribing a lethal drug for a terminally ill patient. In the first case, the intent of the prescriber is to relieve pain and the drug of choice would be an opiate such as morphine. In the second case the intent of the prescriber is to purposefully hasten death and the choice of drug would be a barbiturate. While it is true that the terminally ill patient's life may be somewhat shortened as a result of the ingestion of an opiate-that is not the intent of the prescriber. Catholic moral theology recognizes and accepts this situation-calling it the "rule of double effect. " (See discussion below.) Often the person who has struggled with pain for some time may be finally able to "let go" and die peacefully once they are no longer suffering. This can happen simultaneously but is rarely a direct result of the medication. The health care providers must assess and monitor and adjust the medication to achieve the proper dose and comfort balance.

"It is worth recalling here a statement of Pius XII that is still valid. A group of physicians had asked: 'Is the removal of pain and consciousness by means of narcotics... permitted by religion and morality to both doctor and patient even at the approach of death and if one foresees that the use of narcotics will shorten life?' The pope answered: 'Yes, provided that no other means exist and if, in the given circumstances, the action does not prevent the carrying out of other moral and religious duties... death is by no means intended or sought, although the risk of it is being incurred for a good reason; the only intention is to diminish pain effectively by use of the painkillers available to medical science.'"

What is the rule of "double effect"?

The rule of double effect, found in Catholic moral theology, has a long history of use by bioethicists and philosophers as a means to resolve a particular type of ethical conflict in clinical cases. Basically the rule comes into play when a proposed action (such as administering morphine to a terminally ill patient in pain) has two known outcomes. One outcome is intended and desired (relief of pain). The other outcome is neither desired nor intended (hastening death), although it may be foreseen.

Is it wrong to offer increasingly high doses of morphine to a terminally ill patient in severe pain? Won't the patient become addicted?

No, it is not wrong-even knowing that the medicine may actually, although not intentionally shorten the life of a terminally ill person (See discussion of "double effect.") A well informed physician is not worried about "addiction" but about providing adequate pain relief. Addiction is only a problem for those who are receiving curative care and who anticipate resuming ordinary life, or who have no underlying cause for pain and are taking strong pain medicine for the emotional high or escape from the euphoria. When a physical cause for pain exists it is utilized by the body and may need to be increased over time as the body adapts to it and changes occur in condition.

One of the primary purposes of medicine in caring for the dying is the relief of pain and the suffering caused by it. Effective management of pain in all its forms is critical in the appropriate care of the dying. Patients should be kept as free of pain as possible so that they may die comfortably and with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason.

Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person's life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering. When a person is more comfortable they have the energy and ability to focus on family, relationships, living as well as possible for whatever time they have. Relief of pain can improve the time and duration of life and provide a window of meaningful celebration of one's life. Family can then use the time to share stories, have gatherings, create lasting loving memories, using the time well with good pain relief. Family's benefit from pain relief just as patient does. When one suffers, the other does too.

A terminally ill patient (or those advocating for him or her) would be wise to seek out a physician who is well informed about pain management. One of the advantages of hospice care is that the medical personnel are well informed and well trained in the application of adequate and appropriate pain medication. Adequate pain relief is a right of every person and should be expected with good hospice or end of life care as well as during earlier treatment phase, as needed.

                              WHAT IS CONSIDERED A “SERIOUS REASON” TO MISS MASS?

Evidently, when you should stay home from Mass on a Sunday or holy day of obligation is something a lot of Catholics wonder about.

What is the obligation?

Let’s begin by looking at what the Church says regarding the obligation to attend Mass on Sundays and holy days. The Code of Canon Law states: On Sundays and other holy days of obligation, the faithful are obliged to assist at Mass. They are also to abstain from such work or business that would inhibit the worship to be given to God, the joy proper to the Lord’s Day, or the due relaxation of mind and body (canon 1247).

The Catechism of the Catholic Church reiterates this precept of the Church (CCC 2180), but gives the following proviso: The Sunday Eucharist is the foundation and confirmation of all Christian practice. For this reason the faithful are obliged to participate in the Eucharist on days of obligation, unless excused for a serious reason (for example, illness, the care of infants) or dispensed by their own pastor. Those who deliberately fail in this obligation commit a grave sin (CCC 2181, emphasis added).

Confusion sets in though at what constitutes “serious reason.” If you are in doubt regarding other serious reasons for missing Mass on a Sunday or holy day, I strongly urge you to talk to your pastor who has the authority to dispense you.

Health Reasons which constitutes a “serious reason” to miss Mass

Am I contagious? Every year during cold and flu season, parish bulletins issue standard pleas to congregants to avoid the sign of peace and receiving the precious blood from the chalice when ill. But when you know you have an illness that is easily spread to other people, why would you go to a large gathering of people in the first place—especially when there may be people in that gathering who are not sick now, but whose health is fragile and who can easily fall seriously ill from someone else’s minor cold? Perhaps more pastors should be using the bulletin to tell people who are contagious to stay home.

Do I look ill? If you have red, watering eyes, a runny nose, or a recurring sneeze, people around you are going to assume you are contagious, whether you are or not. Even if what you have is a sinus infection or an allergic reaction, your appearance likely is going to worry all of the congregants who are seated near you. How well will they be able to concentrate on the Mass when they hear you blowing your nose or see you wiping your streaming eyes?

Can I sit through Mass? Without getting specific, there are certain medical conditions that may not be contagious, but that may require you to either walk around or visit the restroom frequently. Unless you know for certain you can sit near an exit or a restroom, your constant movement may cause distraction for others and should be considered when deciding whether to go to Mass.

Can I travel safely? Are you driving yourself, or riding with someone else? If you are driving yourself, are you taking medication that could cause you to become sleepy? Could your symptoms inhibit your driving ability? For example, constantly streaming eyes or a hacking cough that causes you to close your eyes may make you an unsafe driver.

Would I go to work? A handy rule of thumb is; if I am ill enough that I would take a sick day from work, I was ill enough to stay home from Mass. If I am in doubt as to whether I would choose to take a sick day, I ask myself if my supervisor would send me home to convalesce because of my symptoms.

Keep in mind that the Catechism of the Catholic Church does not say that you must be “seriously ill” to have just reason to miss Mass. It says that illness (without qualification) constitutes a “serious reason” that justifies missing Mass on a Sunday or holy day. One must make a decision concerning your good and the good of others and be at peace with your decision.

What about obligatory work, bad weather or the care of a sick person? The Catechism of the Catholic Church explains that a person may be excused from the obligation to attend Sunday Mass without sin for “serious reasons” including the care of infants (or any other sick person(s) who cannot be left alone).

We know, likewise, that God expects parents to provide for their families and that employment is a good thing. If work schedules are absolutely incompatible with attendance at Mass, God does not expect the impossible and it would not be a sin to miss Mass so long as the situation continues.

Another sufficient reason to miss Mass would be bad weather. If it would be dangerous to travel, for example due to a blizzard, hurricane, tornado, etc., there would be no sin in staying home.

Another sufficient reason to miss Mass would be civil unrest or rioting in areas that you would need to be traveling through.

  THE EVIL OF USING AN OUIJA BOARD

‘Do not turn to mediums or wizards; do not seek them out, to be defiled by them; I am the Lord your God.’ (Leviticus 19:31)

Question: A friend of mine has used a Ouija board on several occasions. I have advised him against using it, but he insists it is used just for fun and that it is harmless. Is this true?

Answer: No. The Ouija board is far from harmless, as it is a form of divination (seeking information from supernatural sources). The fact of the matter is, the Ouija board really does work, and the only “spirits” that will be contacted through it are evil ones.

It’s true that many people view the Ouija board as harmless. They often claim, “Oh, I don’t believe in it,” or something to this effect. However, a disbelief in something does not necessarily mean that something isn’t real. The Ouija board has an objective reality that exists apart from a person’s perception of it. In other words, it’s real even if you don’t believe in it. And we know this because God himself tells us so.

The Lord repeatedly condemns any and all occultic practices, including divination. While many Bible passages could be cited, the following one is typical of his view of occultic practices: “Let no one be found among you who sacrifices his son or daughter in the fire, who practices divination or sorcery, interprets omens, engages in witchcraft, or casts spells, or who is a medium or spiritist or who consults the dead. Anyone who does these things is detestable to the Lord” (Dt 18:10–12, NIV).

On the experiential side of the issue, we have the testimony of the Church’s exorcists. Their experience shows that Ouija boards are far from harmless. Some investigating supernatural phenomena from a Catholic perspective have gone so far as to say that 90 percent of their very worst cases involving demonic activity have been linked to the use of the Ouija board.

Simply put, nothing positive can ever come from the use of the Ouija board, and God warns us against such things for our own spiritual safety.

                                           Why Do Bad Things Happen to Good People?

                                                             Christian lessons to shed light on such mysteries as suffering

                                      By Monsignor Charles Pope on June 2, 2022 taken from the National Catholic Register

One of the great mysteries to believer and nonbeliever alike is that of evil and suffering. If there is a God who is omnipotent and omniscient, how can he tolerate evil, injustice and the suffering of the innocent? Where is God when there are shootings in a school in Uvalde, Texas, a supermarket in Buffalo, New York, a church in Los Angeles, or when, during a parade in Waukesha, Wisconsin, participants are brutally mowed down by an irate man in a SUV? Where is God when a woman or young girl is raped, an elderly person is assaulted, an infant is aborted, when genocide is committed, or when evil men hatch their plots? Why did God even conceive the evil ones and allow them to be born? Add to this the many natural disasters that occur in the world. Where is God, and why does he allow comparatively innocent people, even children, to suffer so?

The problem of evil cannot be answered simply. It is a mystery. Its purpose and why God permits it are caught up in our limited vision and understanding. Scripture says, “All things work together for the good of those who love and trust the Lord and are called according to his purposes” (Romans 8:28). But in many circumstances, it is difficult for us to see how this is so.

Anyone who has ever suffered a tragic and senseless loss or who has observed the disproportionate suffering that some must endure cannot help but ask, “Why?” And the answers aren’t all that satisfying, for suffering is ultimately mysterious in many ways.

I have some respect for those who struggle to believe in the wake of tragedies. I understand and respect despair’s depths and the dignity of such questioning. At the end of the trail of questions, often asked in anguish, is God who has chosen not to supply simple answers. And even if he did, our simple minds could not comprehend them anyway. We are left to decide, often in the face of great evil and suffering, whether God exists or not.

Perhaps the most perplexing aspect of suffering is its uneven distribution. Some people seem to skate through life strong, wealthy and well-fed, while others endure suffering, disease, inexplicable and sudden losses, financial setbacks, injustice and other burdens. Some suffering comes from poor choices, substance abuse and lack of self-control. But some suffering seems completely unrelated to any of these reasons — or any reason at all.

A respectful exposition of the Christian understanding of evil might include some of the following points. Note that these are not explanations per se (for suffering is a great mystery), and they are humble because they acknowledge their own limits.

1. The Scriptures teach that God created a world that was a paradise. Though we only get a brief glimpse of it, death and suffering were not part of it.

2. But even in the Garden of Eden, the serpent coiled from the branch of a tree called the Tree of the Knowledge of Good and Evil. So even in paradise, the mystery of evil lurked. In a way, the tree and the serpent had to be there because we were made to love; love requires freedom, and freedom requires choices. The “Yes” of love must permit the “No” of sin. In our rebellious “No,” both we and the world unraveled, and death and chaos entered in. Paradise was lost and a far more hostile and unpredictable world remained. From this came all of the suffering and evil we endure. Our sins alone cause an enormous amount of suffering on this earth — the vast majority of it, by my reckoning. The suffering caused by natural phenomena is also linked to Original Sin, wherein we preferred to reign in a hellish imitation of paradise rather than to serve in the real paradise.

3. So Adam and Eve chose the way of suffering death over the Garden of Eden. And the Lord did not cancel their choice but worked with it. Our Savior, Jesus Christ, meets us at the crossroads of suffering and death and, not exempting himself, allows suffering and death to have a redemptive meaning, a way back to him and a road to glory.

4. This link of evil and suffering to human freedom also explains God’s typical lack of intervention in evil matters. Were God to intervene routinely, it would make an abstraction of human freedom and thus remove a central pillar of love. But here, too, there is mystery: The Scriptures recount that God did sometimes intervene to put an end to evil plots, to turn back wars, and to shorten famines and plagues. Why does he sometimes intervene and sometimes not? Why do prayers of deliverance sometimes get answered and sometimes not? Here, too, there is a mystery of Providence.

5. The lengthiest biblical treatise on suffering is the Book of Job. In it, God showed an almost-shocking lack of sympathy for Job’s questions about his suffering and set a lengthy foundation for the conclusion that the mind of man is simply incapable of seeing into the depths of this problem. God saw fit that Job’s faith be tested and strengthened. But, in the end, Job was restored and reestablished with even greater blessings in a kind of foretaste of what is meant by heaven.

6. The First Letter of Peter also has a partial explanation of suffering: “In this you rejoice, although now for a little while you may have to suffer through various trials, so that the genuineness of your faith, more precious than gold that is perishable, even though tested by fire, may prove to be for praise, glory and honor at the revelation of Jesus Christ” (1 Peter 1:6-7). In other words, our sufferings purify us and prepare us to meet God.

7. Does this mean that those who suffer more need more purification? Not necessarily. It could also mean that a greater glory is waiting for them. For the Scriptures teach, “Therefore, we are not discouraged; rather, although our outer self is wasting away, our inner self is being renewed day by day. For this momentary light affliction is producing for us an eternal weight of glory beyond all comparison” (2 Corinthians 4:16-17). Hence, suffering “produces” glory in the world to come. Those who suffer more, but with faith, will have greater glory in the world to come.

8. Regarding the apparent injustice of uneven suffering, it should be noted that the Scriptures teach of a great reversal, in which the last shall be first (Matthew 20:16), the mighty will be cast down while the lowly are exalted, and the rich will go away empty while the poor are filled (Luke 1:52-53). In this sense, it is not necessarily a blessing to be rich, well-fed and unaccustomed to any suffering. In the great reversal, the first will be last. The only chance that the rich and well-healed have to avoid this end is to be generous and kind to the poor and those who suffer (1 Timothy 6:17-18).

9. Finally, as to God’s apparent insensitivity to suffering, we can only point to Christ, who did not exempt himself from the suffering that we chose by leaving Eden. He suffered mightily and unjustly but also showed that this would be a way home to paradise. In this regard some also question that, if God is love, why does he let terrible things happen? It does not seem to be very loving. However, there is a tendency today to equate love with mere kindness. While kindness is an aspect of love, so is rebuke and challenge. As any loving parent knows, it is sometimes necessary to lead children through challenges and difficulties and to allow them to experience some of the consequences of their decisions. Doctors too must often employ strong medicines and invasive surgeries to bring ultimate healing. Love, therefore, is not always a pleasant thing, and God who is love has to lead us through some difficult patches in this “paradise lost” in which we have chosen to live. It is, however, a firmly held truth that God never permits suffering or evil except that he can bring greater good out of it.

10. St. Thomas Aquinas addressed the mystery of iniquity and suffering by speaking of our inability to see the whole picture. He imagined a great painting of which we can only see a few pixels, or a mere brushstroke of dark colors. “What is this dark ugliness?” we might cry out. But if we could back out and see the whole picture, we might see its beauty and understand that it is a play of light and darkness and that the darkness frames the light and gives way to it.

To these points I am sure you will add, but be careful with the problem of evil and suffering. It has mysterious dimensions that must be respected. Simple answers may not help those who struggle with it. Understanding and an exposition that shows forth the Christian struggle to come to grips with this may be the best way. The “answer” of Scripture requires faith, but it also appeals to reason and calls us to humility before a great mystery of which we can see only a small part.

In the end, why is there suffering and evil in the world? We don’t fully know. But why is there love, loyalty or beauty? Why is there anything at all? These sorts of questions are imponderables, questions with no exact or certain answer. But God knows — and he will requite every injustice, and those who have died unrepentant will answer to him. For now, we wait and accept the truth that God has permitted suffering and death as a way back to him and a path that leads to glory if we are faithful.

In this life we seek to accompany and pray for those who suffer. This is part of the good that God seeks to draw from tragedies. Friendships and alliances form; people make new commitments to build a more just world and to reject the violence and lack of regard for human life that is too evident today. Only light can drive out darkness; only love can conquer hate. As we mourn recent tragedies, we can only trust the Lord’s promise: “Blessed are those who mourn, for they will be comforted” (Matthew 5:4).