Washington Archbishop Donald Wuerl, also a board member of the National Catholic Bioethics Center in Philadelphia, is one of the authors of the pastoral letter "Comfort & Consolation: Care of the Sick and Dying." He spoke recently with Our Sunday Visitor to discuss Church teachings on end-of-life matters and other related issues.

Our Sunday Visitor: It's been nearly 15 years since the bishops of Maryland issued a pastoral letter on the issue of end-of-life care. Why did the bishops decide to focus on this topic by updating and reissuing this pastoral?

Archbishop Donald Wuerl: I think this is an issue that is always going to be with us. We are always going to be dealing with people making these serious choices, particularly with regard to the end of life. This said to us that we ought to be offering our people a fresh look, or at least an updated look, and to provide some helpful pastoral guidance to the Catholic faithful as they deal with the very serious choices that come at the end of life or when facing a serious illness.

OSV: When did the bishops of Maryland begin working on this letter?

Archbishop Wuerl: The revisions began over a year ago, right before I came [to Washington]. One of the first things I got to do [as archbishop] was go through the draft. I think it is a beautifully written document and an inviting pastoral letter.

OSV: The letter is organized by first focusing on Church teachings on end-of-life care and on the redemptive value of suffering. It then provides counsel on a variety of possible scenarios before calling the reader to prudent thinking and prayer in making such decisions. How did the authors decide on this format?

Archbishop Wuerl: I think the wisdom of putting the theology first is so you know what the Church actually says and why it says it. Each person is going to have to reach a judgment in making end-of-life decisions, and I think people want that judgment to be one that conforms to the teachings of Christ and his Church.

OSV: What is the biggest challenge or challenges you see standing in the way of Catholics understanding and practicing Church teachings on end-of-life care issues. Is it misunderstanding about applying teachings to specific instances?

Archbishop Wuerl: The biggest challenge is getting [the teaching] into the hands of the Catholic faithful and to present it in a way that they can see it in a positive manner. I think one of the things we need to remember as Catholics is that we look at sickness, suffering and even death from a completely different perspective.

Thus sickness is not something that simply ends in death. Rather, death is part of our human condition that Christ has raised to the level of sanctity.

One part of our ministry is to help someone who is suffering and for whom medicine might not be providing intended relief to understand the transforming power of their suffering. Love is what transformed Christ's suffering and death to a redemptive act. When we offer our sufferings, we are invited to join Christ in his redemptive action.

For a Catholic, sickness and illness should not be seen solely as negative, but in such a way that we have the power to transform them with faith and love into something holy.

OSV: So in short, how should Catholics approach the issue of caring for the sick and dying?

Archbishop Wuerl: What we might want to do is keep before us the example of Pope John Paul II. He underwent needed medical treatments, but when it became clear that the end was approaching, he decided, as far as we understand, to do nothing more and to let the natural close of his life occur with faith and love in God and God's plan.

As Catholics, we are not obliged to do everything and anything that is possible to extend a life that is clearly coming to an end. What we are not allowed to do is to deliberately end a life or shorten a life. Today, we, as members of the Catholic Church, recognize there is a time to die, a time when all medicine fails. We surround a dying person with prayer, love and the sacraments for a transition to the life to come.

OSV: In a day and age in which people appear to be placing increased emphasis and value in a person's productivity to work, earn money and "contribute" to society, how difficult will it be for Catholics and society as a whole to embrace the notion that the suffering and frail are not burdens, but rather gifts from God that bring us closer to Christ?

Archbishop Wuerl: We have to, as a society, respect the intrinsic dignity and value of life. What gives us value is that we are created in the image and likeness of God. Our worth isn't something that a state or legislation confers on us. Externals do not determine our intrinsic worth or value.

If we listen to what is sometimes presented in today's culture, it's almost as if we were to accept that something outside us determines our value, such as our productivity or a legislature. We teach that life is a gift from God, that we are made in the image and likeness of God and that our value doesn't come from any other source but God.

OSV: At a practical level, what should Catholics do to ensure the decisions they make on end-of-life issues are in accord with Church teachings?

Archbishop Wuerl: We have to help the Catholic faithful understand that they should not avoid this topic. One of the things we are asking people to consider doing is make sure they are upfront in indicating what they would like to have done and what they would not like to be subjected to. The idea is to do an advanced directive and to appoint a health care delegate.

OSV: The letter stresses that each person faces a unique set of circumstances and that there is no one-size-fits-all approach to end-of-life care that could be covered in an advanced directive. As such, what can a Catholic do to help ensure the care they receive at such times is in accord with Church teachings?

Archbishop Wuerl: There is no way you can put together an advanced directive anticipating everything that is going to happen. But you can appoint a health care delegate who will know your mind, heart and Catholic faith and that Church teachings deserve to be followed when contending with end-of-life decisions.

OSV: What, in your view, is the most important message or element of this pastoral letter?

Archbishop Wuerl: For me, the most important part of this document -- after the teachings and discussion about advanced directives and having a health care agent -- the really important part -- is helping people understand that dying is not something we need to dread and try to put off at all costs. Rather, it is part of the life process, and dying is our entrance into new and eternal life.

OSV: Where does the issue of end-of-life care fall with regard to your work on the board of the National Catholic Bioethics Center, and what issues is the center currently focusing on?

Archbishop Wuerl: The National Catholic Bioethics Center (NCBC) has earned over decades the recognition of being the premier Catholic center for reflection on bioethics and the life sciences. One of the great contributions that the NCBC brings to all of the issues of end-of-life care is highly competent command of the scientific data and medical technology that is then viewed from the perspective of the Gospel of life and the principles of Catholic moral teaching.

Currently, among the many issues the center is focusing on are questions dealing with stem-cell research and all the associated issues and challenges, as well as helping Catholic health care institutions deal with the moral issues that arise out of increasing state legislation that infringes upon the freedom of Catholic health care institutions to carry out their mission in a conscientious manner.

The importance of the NCBC, I believe, can be seen in the fact that it is regularly consulted by so many bishops throughout the world and that its biennial medical moral workshop for bishops, sponsored by the Knights of Columbus, is so highly respected and well attended.

Get a copy

To order "Comfort & Consolation" and its advance directive, call (410) 269-1155 or (301) 261-1979, e-mail info@mdcathcon.org or send $6 (includes postage and handling) to the Maryland Catholic Conference, Francis St., Annapolis, MD 21401.Bulk prices are also available.For more information, visit www.mdcathcon.org.