While human beings can use extraordinary means, they are not morally obligated to do so, because earthly life is not an absolute good for man, and because medical interventions will eventually become ineffective and/or because the costs and burdens of medical interventions are disproportionate to the good of earthly life they are supposed to serve. (Catholic Medical Association 2007, 2A) Exceptional care: generally used for medical treatments that, in the given circumstances, impose an unreasonable physical or personal burden on the patient or that do not significantly improve the patient`s condition, but simply prolong his death. Exceptional care is considered ethically optional and not mandatory. Since health care is not free here, many families find that a loved one`s latest illness puts them under enormous financial pressure, especially if the illness is longer or complicated. A family should do everything they can reasonably do to care for their loved one, but there may come a time when the proposed treatment, such as a ventilator, is simply too expensive, or if the treatment is prolonged, such as dialysis, is underfunded. They may even decide to remove their sick loved one from the hospital and spend their remaining time at home. The Church clearly teaches that everything practically possible must be done, such as providing basic care to the person and providing adequate nutrition and hydration. However, there will be times when the family simply will not be able to afford further care and this is considered exceptional treatment. Exceptional treatments, drugs and surgeries that place a heavy burden on the patient and that cannot be obtained or used without excessive cost, pain or other discomfort, or that, if used, would not give a reasonable expectation of benefit to the patient. Exceptional treatments, such as excessively expensive treatments or surgeries that go far beyond reasonable effort or family budget, are optional and not morally obligatory. The Catholic Medical Association (USA) states in its guidelines that a simple step could be to remind doctors who work far from their home countries not only to enjoy the benefits and salary of their new home, but also to take into account the medical misfortune of many compatriots in their country.
I call on all Filipino doctors, especially the many who work in the United States, in some of the most progressive hospitals and institutions in the world, to resist the temptations of careerism and materialism and instead waste a thought, a prayer, and perhaps even a dollar on millions of their brothers and sisters who do not have access to basic health care. Christ`s call, “I was sick and you healed me” (Matthew 25:36) can remind them of the duty of their mission: not only to become materially prosperous, but also to be rich in mercy and compassion. The American Life League states that ordinary care can become exceptional care in certain situations. [5] How do you know if a treatment is ordinary (i.e. morally obligatory) or exceptional (only optional)? The Church gives us useful advice: “examining the nature of the treatment to be applied, its degree of complexity or risk, its costs and the possibilities of its application, and comparing these elements with the result to be expected, taking into account the condition of the sick and his physical and moral resources” (Sacred Congregation for the Doctrine of the Faith, 1980, Part IV).5 Unfortunately, the language of “ordinary” and “extraordinary” means can confuse those who are not familiar with the Catholic moral tradition. Many people use these moral terms in the same way that these terms can be used in medicine – that is, ordinary or extraordinary forms of medical treatment in which “extraordinary” is equated with rare or experimental procedures. This is not the case with regard to the moral meaning of these words. What distinguishes “ordinary” from “extraordinary” in Catholic moral theology is not whether the treatment is used “ordinary” in the sense of normal or frequent, but rather whether the treatment is useful (ordinary) or excessively stressful (extraordinary) for the patient. Thus, ordinary treatment in the medical sense may be an “extraordinary means” in the moral sense if it is excessively burdensome or poses an excessive risk to the patient. For example, many forms of chemotherapy today would be considered “ordinary medical care” for cancer patients. However, for a particular cancer patient, especially in the later stages of cancer, the same treatment can become an “extraordinary remedy” because it can no longer benefit the patient and causes a lot of discomfort and pain.
Unscientific summary: In many countries, the poor have limited access to health care. Even a single episode of illness often places the patient and his family under a considerable financial burden. Often, they simply cannot afford to pay for even basic treatments. This is a scandal and an injustice that affects us all. The Church teaches that when treatment becomes very expensive, it can be considered “extraordinary care” rather than morally obligatory. It would be useful to further disseminate this teaching of the Catholic Church and to help families avoid unnecessary treatment, especially in critical or end-of-life situations. Sometimes a loved one`s latest illness can cause various family tensions. A real-life scenario (based on a similar case) illustrates this: an 85-year-old grandmother, suffering from heart failure and respiratory failure, has a family that loves her very much and wants to do everything to “save” her. A girl who has lived with her for many years and takes care of her peacefully accepts that the end is near.
But a son who has spent years in the United States wants his mother to live so he can spend time with her. In these situations, there may be conflicting views in the family. Dialogue is important to clarify the position of each individual.