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To Die Well: Discussing Hope at the End of Life With Catholic Neurosurgeon Dr. Stephen Doran

While we often avoid thinking or talking about death, having open and honest conversations about mortality is essential to prepare for the end of life. To help others navigate this challenging topic, Father Dave welcomes Dr. Stephen Doran to the show. Dr. Doran is a permanent deacon and bioethicist for the Archdiocese of Omaha, and highlights hope in his book, “To Die Well: A Catholic Neurosurgeon’s Guide to the End of Life.

Dr. Doran explains how he split his book into two sections, focusing on issues of morality and spirituality. He shares experiences from his 25 years as a neurosurgeon to introduce each chapter. “I take a story to introduce a particular topic, and use that as an entry point and put some meat on the bones, because [some subjects] can be abstract,” he says.

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The book’s section on morality discusses end-of-life medical decisions. Father Dave notes how we often want a clear delineation on these issues and asks, “Is it as easy as you just handing out a list and I can sign a document that says, ‘this is okay according to my faith and this is not’?” 

“Wouldn’t it be great if it were that simple?” Dr. Doran responds, and discusses the different approaches to making choices in end-of-life care. “Advanced directives are legal documents which are intended to help decision- making when you’re nearing death, if you can’t make those decisions for yourself. There are three basic ones: durable power of attorney for medical care, a living will, and then there’s this newer one called POLST, or Physician Orders for Life-Sustaining Treatment.”

“Basically, the latter two things [are] an attempt to do exactly what you said: I’m going to put down a list of do this, don’t do that. The problem with that is it’s impossible to anticipate the circumstances that might be present when you’re seriously ill or injured, and to try to make decisions in advance is almost impossible and can box people into a situation,” he continues.

Dr. Doran says, “If people remember anything from this talk, I would say the most important thing you could do is to have a power of attorney for your medical care. Talk to that person, don’t just put them down on your will. Someone you love, who knows you, who shares your faith, have some conversations [with them], so that they have an idea of what your desires are. Then in the event that you’re not able to make those decisions, they can make them for you.” He notes how this can be used in conjunction with a list of “do’s and don’ts,” as your power of attorney can interpret them for the actual situation at hand.

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They discuss the book’s section on spiritual issues when nearing death, and the line between respecting life while also not fearing death. Dr. Doran says, “I’m mindful of what St. Paul says: Whether I live for the Lord, or I die for the Lord, I’m the Lord’s. I always have to remember we are living or dying for the Lord and that our ultimate destiny is union with Him in heaven; death is the way by which we get there…we have to maintain this eternal perspective when we talk about these things.”

He expands on the concept of dying well. “Society wants to say dying well is a peaceful, quiet, pain-free death, surrounded by family, friends and loved ones. If that happens, that’s wonderful, but that is not the measure of a good death from a spiritual perspective. Look at Jesus: he had the most horrific death ever,” Dr. Doran says. “The good death comes by virtue of living a good life, St. Robert Bellarmine wrote about this…living a life of virtue, frequenting the sacraments, seeking reconciliation; that ultimately is what’s going to lead to a good death.”

“It’s not necessarily going to be pain free; it might be super messy and super hard,” he continues. “What we’re looking for is heaven and union with God. The death that is oriented towards God is indeed what a good death is.”