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EPISODE#239
OC CATHOLIC RADIO: DR VINCENT NGUYEN ON “THE WHITE MASS” FOR MEDICAL PROFESSIONALS

Welcome to another episode of Orange County Catholic Radio, featuring host Rick Howick.

On this week’s program, Rick welcomes Dr. Vincent Nguyen to the studio. Dr. Nguyen is the Director of Palliative Care at Hoag Hospital in both Newport Beach and Irvine. Our primary topic of conversation is the concept and purpose of the “White Mass” for those working in the medical profession. It takes place annually at Christ Cathedral.

Rick and Dr. Nguyen also take a moment to reflect on the passing of Hank Evers, a good friend and longtime employee of the Diocese of Orange.

This is a fascinating conversation. Be sure to share this podcast with a friend!

 

 

 

 

 

Originally broadcast on 10/16/21

PALLIATIVE CARE IS NOT ENOUGH — CATHOLICS MUST SHARE CHRIST’S HOPE, SAYS VATICAN

Vatican City, Sep 22, 2020 / 10:00 am (CNA) – Palliative care for the dying is important, but medical interventions are not enough; Catholics have a responsibility to be with the suffering and to communicate the hope of Christ, a new Vatican document on euthanasia said Tuesday.

While palliative care is “essential and invaluable,” it is not enough, a letter from the Congregation for the Doctrine of the Faith said.

“Palliative care cannot provide a fundamental answer to suffering or eradicate it from people’s lives,” the congregation said. “To claim otherwise is to generate a false hope, and cause even greater despair in the midst of suffering.”

“Medical science can understand physical pain better and can deploy the best technical resources to treat it. But terminal illness causes a profound suffering in the sick person, who seeks a level of care beyond the purely technical,” it continued.

“Palliative care in itself is not enough unless there is someone who ‘remains’ at the bedside of the sick to bear witness to their unique and unrepeatable value. Pain is existentially bearable only where there is hope.”

The CDF presented the 45-page letter, Samaritanus bonus: on the Care of Persons in the Critical and Terminal Phases of Life, at a press conference Sept. 22. It was approved by Pope Francis on June 25 and signed by CDF prefect Cardinal Luis Ladaria and secretary Archbishop Giacomo Morandi.

The letter reaffirmed Catholic teaching on a range of end-of-life issues, underlining the moral impermissability of euthanasia and assisted suicide, and recalling the obligation of Catholics to accompany the sick and dying through prayer, physical presence, and the sacraments.

The Vatican document also pointed out what it described as cultural obstacles obscuring the intrinsic value of every human life: the notion of “dignified death” as measured by a person’s so-called “quality of life,” a false understanding of compassion, and an individualism which sees the other as a limitation or threat to one’s freedom.

So-called “compassionate” euthansia holds that it is better to die than to suffer, the CDF noted. “In reality, human compassion consists not in causing death, but in embracing the sick, in supporting them in their difficulties, in offering them affection, attention, and the means to alleviate the suffering.”

Cardinal Ladaria said Sept. 22 that “a compassion that is not accompanied by the truth, by respect for human life in all its phases of existence, is a compassion that is not just, is not right.”

Catholics need to know how to show authentic compassion and to witness to Christian hope, the CDF document argued.

“In the face of the challenge of illness and the emotional and spiritual difficulties associated with pain, one must necessarily know how to speak a word of comfort drawn from the compassion of Jesus on the Cross,” it said. “It is full of hope — a sincere hope, like Christ’s on the Cross, capable of facing the moment of trial and the challenge of death.”

“The hope that Christ communicates to the sick and the suffering is that of his presence, of his true nearness,” the letter explained. “To contemplate the living experience of Christ’s suffering is to proclaim to men and women of today a hope that imparts meaning to the time of sickness and death. From this hope springs the love that overcomes the temptation to despair.”

The document said that Catholic priests and others should avoid any active or passive gesure which might signal approval for euthanasia and assisted suicide, including remaining in a room while the act is performed.

But to someone who is considering taking that action, the presence of a witness to truth, charity, and hope can be powerful, Ladaria said.

“The witness of Christians, the witness of Christian healthcare workers, the witness of all the Christian relatives of this person, etc. can be something very determinative” in helping a person to turn away from the decision to end his or her own life, he said.

Ladaria encouraged offering a “witness of presence” to those who were seriously ill and dying.

When a person sees no other hope than assisted suicide, “if he sees someone who clearly does not accept this solution, but is there beside him, and does not abandon him, and is next to him, maybe this can be a factor which helps him to reflect,” he said.

“I believe that in every man there is some reserve of hope,” the cardinal stated. Communicating the truth with charity, being present to someone who feels hopeless, could help them to think and reflect, it “makes this person see that there is, however, hope, there is hope. That hope never ends!”

Priestly ministry to the sick at the end of life, a symbol of the solicitude of Christ and the Church, “can and must have a decisive role,” and makes proper priestly formation vital in this area, Samaritanus bonus said. It also noted that because priests cannot always be present at a bedside, physicians and healthcare workers need formation in Christian accompaniment too.

“In this essential mission it is extremely important to bear witness to and unite truth and charity with which the gaze of the Good Shepherd never ceases to accompany all of His children,” it stated.

HOPE MATTERS

The virtue of hope responds to the aspiration to happiness which God has placed in the heart of every man;… it keeps man from discouragement; it sustains him during times of abandonment; 

—Catechism of the Catholic Church

 

“The most rewarding thing about my career is the opportunity to give patients and families hope,” says Brian Boyd, M.D., Program Director, Oncology Palliative Care and Medical Director, St. Joseph Hospital Palliative Care. When a patient receives a life-altering diagnosis, hope can make all the difference by reshaping sadness into determination or alleviating fear through consolation.  

A diagnosis such as heart disease, lung disease, cancer etcetera is not necessarily fatal, but management of symptoms during treatment is indispensable. Palliative care is medical care that is focused on easing suffering and improving quality of life for anyone faced with a serious illness at any time, regardless of diagnosis, prognosis or treatment. This involves advanced symptom management (most commonly pain) as well as goal clarification. People do not have to have a terminal illness to benefit from palliative care.  

If as time goes on, it becomes clear that a cure is not possible, the focus shifts to comfort during end of life and supporting patients and families during that time. 

“When a patient’s life expectancy is six months or less, they can choose to transition to hospice,” says Boyd. “Our emphasis is not just on treating pain, we take a whole person approach for the body, mind and spirit of both the patient and their loved ones.” 

St. Joseph Hospital is part of Providence St. Joseph Health, a 50-hospital health system that serves communities in seven states. One of the areas of focus is providing care that not only meets medical needs but takes into account personal values and goals.  

“Studies show that when patients face end-of-life issues their number one fear is unrelieved pain, and number two is abandonment. Providence St. Joseph Health focuses on whole person care, including families,” says Boyd.  

Concerns about pain can be allayed though education on pain management options. “There is no reason for a patient to experience uncontrolled pain. The medical staff works closely with the family to involve them in the process and make the journey for them as gentle and positive as possible, as Boyd explains, “There is a difference between giving up and letting go. One is a struggle; the latter is acceptance. Communication is so important to understand the profound difference between prolonging life and prolonging death. Our approach is to allow natural death in a compassionate setting.”  

With the recent opioid epidemic, many patients fear that the medicine to relieve pain will ultimately lead to an even bigger problem of addiction. “Opioids are extremely helpful with cancer pain, but if a patient has a history of addiction, pain management can be more challenging, but it can be achieved,” Dr. Boyd said. 

Through Providence St. Joseph Health’s commitment to whole person care, the focus is not only on the symptoms, but on the emotional, social and spiritual needs of the patient and their loved ones.  For example, St. Joseph Hospital’s palliative care services include social workers, spiritual care from a variety of beliefs including a Buddhist, and psychological support.   

Providence St. Joseph Health’s efforts to transform care during serious illness and at end of life are led by Dr. Ira Byock, Founder and Chief Medical Officer for the Institute for Human Caring of Providence St. Joseph Health. Dr. Byock oversees efforts to measure, monitor and improve the whole-person health care systemwide. He is the author of numerous books on death and dying. His first book “Dying Well” has become the standard in the field of hospice and palliative care.  

Support for palliative care extends to Rome where Dr. Byock recently participated in the Pontifical Academy for Life’s initiative called the PALLIFE project. 

Palliative care is the pro-life solution and a compassionate alternative to California’s physician-assisted suicide. It allows patients and their loved ones to manage the passage from this life to the next peacefully and sometimes even joyfully.  Regardless of a person’s spiritual beliefs, or lack of belief, the team guides them respectfully and at their own pace. Quality of life is the goal, even as the patient approaches death.  

“It is a privilege to walk the final journey with patients and families,” Dr. Boyd said, “Hope changes hearts to live each day to the fullest and enjoy relationships.”  

EPISODE#122
OC CATHOLIC RADIO: GUEST IS DR. VINCENT NGUYEN

Host Rick Howick interviews guests on a variety of topics. On this week’s program, Rick welcomes Dr. Vincent Nguyen to the studio. Dr. Nguyen is the Director of Palliative Care at Hoag Hospital in both Newport Beach and Irvine. Among the topics discussed today are physician-assisted suicide and end-of-life care. Be sure to listen in to this powerful discussion!

 

 

 

 

Originally broadcast on 11/16/17

PALLIATIVE CARE: COMPASSION AND COMFORT FOR THE DYING

Many people are unfamiliar with the term “palliative care”—until someone close to them is at the end stage of life in the hospital, or very ill and in pain.

Palliative care is the comprehensive, compassionate care given to those with serious illness or who are dying. It includes pain relief, spiritual counseling, emotional support and more for the patient and his or her entire family.

It is a fully developed discipline of medicine to which St. Joseph Hoag Health is deeply committed. Several of its Orange County affiliated hospitals offer palliative care programs, including St. Joseph Orange, St. Jude, Mission Hospital, and Hoag, as well as St. Mary’s in Apple Valley.

With California’s Aid-in-Dying Bill (which allows doctor-assisted suicide for dying individuals who choose it) now law – it became effective June 9 – Orange County residents might want to explore the options that palliative care programs provide.

 

End of life care and comfort

“The goal of palliative care is to offer the best end-of-life care possible,” says Kevin Murphy, VP, Theology and Ethics at St. Joseph. “It offers a multidisciplinary approach, addressing the body, mind and spirit. Palliative care uses evidence-based techniques and approaches that help a patient at this stage of their life.”

Palliative care includes the whole family because everyone is affected. “End of life conversations are not easy, and palliative clinicians are skilled in having these conversations, and in facilitating advance care planning,” says Murphy. One example of a robust program could be a patient “life review” says Murphy, where a dying individual gets the chance to reflect on significant events in his or her life and integrate the last stage into the whole story for a sense of completion.

In the past, and even sometimes in the present, a terminal diagnosis has been received with fear or even silence. Sometimes families think it’s best to not even tell the patient, believing it could cause the patient to give up hope.

But when patients are told about their diagnosis, it’s the experience in palliative care that patients don’t lose hope, though they do go through a cycle of emotions. And there is a time when a dying patient will reach a level of acceptance. “That’s a process any human being can go through—and palliative care guides you through that process,” says Murphy.

In fact, he adds, patients who engage in this kind of palliative care actually live a longer life. “This is because body, mind, and spirit issues are getting addressed,” Murphy says. “When patients’ symptoms of pain or distress are addressed, they experience, peace, acceptance and relief.”

 

Dignity for the dying

Dr. Vincent Nguyen, Medical Director of the Hoag Palliative Care program, says his team addresses the unique needs of each patient and those of family members.

“We treat the patient holistically,” says Dr. Nguyen. “With the care we offer, we can improve the quality of life —and many cases we then prolong life —of patients.”

Dr. Nguyen’s team includes doctors, nurses and social workers with palliative care training. One of their key duties is to facilitate communication between the treating doctors, the family and patient, so that everyone is clear about the prognosis and treatment options. “People are afraid,” says Dr. Nguyen. “And they want doctors to be honest with them.”

Addressing fear is a major part of palliative care. “Whenever any of us gets news of a particular pathology we have and prognosis, anxieties and concerns arise,” says Murphy. “The goal of palliative care is to help patients express—and address—those concerns.”

“St. Joseph Health advocates for palliative care as the gold standard for end-of-life care,” he says.

THE GIFT OF PALLIATIVE CARE

If you’ve ever known someone who was extremely ill or dying, then you’ve probably experienced the confusion, frustration and pain of seeing that person suffer – and you likely understand the importance of a growing area of medicine called palliative care.

Comprehensive, compassionate care given to the very ill or dying to ease their suffering and help them make informed decisions about treatment is relatively new.

St. Joseph Hospital, Orange offers a Palliative Medicine Program that includes pain and symptom management, counseling and coordination of outpatient services. The primary focus is to maximize the quality of life for patients by treating each one individually – addressing physical, emotional, social, spiritual and financial needs.

“We treat the patient holistically,” says Dr. Vincent Nguyen, the Director of St. Joseph Hospital’s Palliative Medicine Program. “With the care we offer, we can improve the quality of life – and many cases we then prolong the lives of patients.”

 

Palliative care emerged out of a growing concern in the medical community that when doctors feel compelled to do something to help a very ill patient, too often the resulting treatments cause more harm than good.

“More treatment is not necessarily better,” says Nguyen. “With advanced cancer, for instance, with a third or fourth round of chemo treatment, a patient may not be restored to a previous level of health.”

This is a major shift that some prominent doctors say is long overdue. “You don’t have to spend much time with the elderly or those with terminal illnesses to see how often medicine fails the people it is supposed to help,” writes physician and author Atul Gawande in his 2014 bestselling book “Being Mortal: Illness, Medicine and What Matters in the End.” Gawande makes the case for doctors helping patients to make the decisions brased on the quality of life – and being clear about these options.

“Families need help when they are faced with these decisions,” says Nguyen. “People are afraid – and they turn to their doctors, and want doctors to be honest with them.”

As baby boomers age, palliative care will only become more important and relevant. More than 43 million people in the United States are 65 and older, according to the U.S. Department of Health and Human Services.

And older people are living longer: In 2012, the number of people who were between 65 and 74 was more than 10 times larger than in 1900.

But palliative care is not just for the elderly. Patients can receive it at any point during an illness, not just at the end stages – and wherever they are, whether it’s a hospital, at home, in a long-term care facility or in hospice care.

Nguyen’s team at St. Joseph Hospital includes doctors, nurses and social workers with palliative care training. One of their key responsibilities is facilitating communication between the treating doctors and the family and patient, so that everyone is clear about the prognosis and treatment options. The team eases stress and anxiety by offering counseling and spiritual guidance to patients. When faced with a patient who is dying, it’s not unheard of for a treating doctor to withdraw from contact with that patient and the family. Palliative care offers an opposite approach – with finely tuned care, communication and support, even death can be more bearable.

According to a study reported in the March 2015 issue of the “Journal of Palliative Care,” family members of patients who died while receiving care in a palliative care unit reported higher overall satisfaction and emotional support before death as compared to usual care.

Facts about palliative care

 

  • From 2000-2012, the number of hospitals with a palliative care team increased from 658 to 1,734 – an increase of 163.5 percent.
  • Palliative care effectively relieves physical symptoms and emotional suffering.
  • Palliative care strengthens patient-family-physician communication and decision-making.
  • Palliative care ensures well-coordinated care across health care settings.
  • Palliative care is an important part of medical care, particularly because an increasing number of Americans are living with serious and chronic illness.
  • Palliative care eases the overwhelming caregiving burdens faced by patients’ families, through a strong partnership of patient, family and palliative care team.

Source: Center to Advance Palliative Care

‘A BOND OF COMMON CONCERN FOR THE HUMAN PERSON’

ANAHEIM—A group of medical professionals and Catholic clerics, speaking to an audience of nearly 500 at Servite High school, examined in depth one of the most contentious questions currently facing state lawmakers—physician assisted suicide—and called for the defeat of a proposed law that would legalize the practice in California.

The presentations were part of an April 11 conference titled “Dignity and Courage at the End of Life: A Compassionate and Faith-Filled Response to the Push for Assisted Suicide.” The event was a comprehensive response to SB 128, the so-called “End of Life Option Act” that is currently under scrutiny by the State Legislature. The bill would allow California physicians to prescribe lethal drugs on request to patients with terminal illnesses.

Calling the push for the bill’s defeat a “bond of common concern for the human person,” Bishop Kevin Vann called on the audience to be “a voice for the voiceless” in advocating compassionate end-of-life care for those with limited resources or means.

Much of the content of the speakers’ presentations were concerned with debunking misconceptions surrounding such end-of-life issues as pain management, depression and the intrinsic worth and dignity of individuals, as well as illuminating the numerous potential problems—political, social, economic, moral and ethical—raised by the possibility of legal physician-assisted suicide.

Advocating compassionate hospice care, Father Robert Spitzer, S.J., the president of The Magis Institute, said that 90 percent of requests for assisted suicide are reversed “if pain and depression can be adequately treated. And hospice is really very good at it. People don’t want to die [by suicide], and this is what we’ve got to defend.”

Acceptance of assisted suicide, said Father Robert, puts “pressure on the disabled and vulnerable” and moves society “toward a culture of death. This is really a disaster area. Dealing with challenge bravely is a part of our lives.”

Many current approaches to end-of-life issues brand disability or dependence as undesirable, “that if you need assistance there’s something wrong with you,” said Father Robert. “We’re moving toward an indignity of assistance. But there’s nothing wrong with needing people.”

Passage of SB 128, said Father Robert, would initiate a “slippery slope” that would further legitimize the idea of suicide. “What becomes legal becomes socially acceptable and soon becomes moral,” he said. “This is crazy. We will undermine not just the sacredness of life, but the goodness of life. We will become nothing more than the stoic Roman culture that imploded under its own cruelty. This is not just a darkening of the culture, but a darkening of the souls within it.”

The true duty of those caring for terminal patients, according to Catholic teaching, is not to unnecessarily prolong life by artificial means, nor to cut it short by assisted suicide, but to “soothe suffering,” said Father Joseph Nguyen, the lead chaplain at UCI Medical Center. “Palliative care is the proper Christian response to suffering,” he said. “Our first duty is to alleviate pain.”

Noting that suicide is the third leading cause of death for persons in their teens and 20s and the tenth leading cause for adults, Dr. Aaron Kheriaty, the director of the Program in Medical Ethics at UCI, asserted that a request for physician-assisted suicide “is almost always a cry for help. It’s not a desire to die. These people don’t want to die. They want to escape what they see as intolerable suffering.” However, he added, SB 128 would weaken efforts at suicide prevention.

Worse, he said, the law would “lead to the medical abandonment of vulnerable individuals” such as the poor, the disabled, the suggestible, the depressed or those pressured by family and others. In some documented cases, he said, insurance companies have shown a willingness to pay for lethal drugs to be used for suicide, but not for more compassionate—and more expensive—end-of-life medical treatment. This practice, he said, “is against medical ethics and contradicts our role as healers. We must communicate to each and every patient: You are not a burden.”

Dr. Vincent Nguyen continued to emphasize the significance of the individual patient in his presentation about the state of palliative care. Nguyen, a palliative care specialist who has treated, by his estimation, more than 20,000 patients over two decades, said that terminally ill patients often fear becoming a burden to their families, suffering a loss of autonomy and being unable to do the things they once enjoyed, in addition to the fear of suffering—real or imagined—that accompanies death. These fears, he added, can create a desire for more control, and assisted suicide can become a more attractive idea as a result.

Palliative care, particularly in a hospice environment, he says, “is about life. It’s about how to help the person live with whatever time they have left and giving them the best life possible.” Physicians practicing palliative care “help patients to discover the meaning and the purpose of life.”

Assisted suicide, said Nguyen, “is fundamentally incompatible and conflicts with the physician’s obligation” to alleviate pain and treat the whole patient in a comprehensive and compassionate manner.

“Do not be afraid,” he said. “We have the technology to help you.”

Watch the entire conference below

 

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THE PROMISE OF PALLIATIVE CARE

I have had the privilege of spending the last two nights with my father as he is preparing for his journey into eternal life. This has been a chance for me to return thanks and give back to my parents, as I have been thinking of the many nights he and Mom stayed up with all of us when we were sick.

I have seen firsthand the love and care of all of the sisters, nurses and staff here at St. John’s Hospital hospice here in Springfield who care for him and administer his medications so he is not in pain nor alone in his journey. Their choice of living this life of compassionate care is a blessing to us all.

My father and so many others are fortunate that medicine today offers better alternatives for end-of-life care—alternatives that do not involve excessively burdensome interventions that have little chance of benefit. In fact, there is now a specific medical specialty devoted to the care and comfort of patients when cure has become impossible: it’s called palliative care. Good palliative care can offer tremendous solace and consolation to patients and families in the face of an inevitable death.

Good palliative care addresses the needs of the whole person—not just the biological aspects of disease or disability, but the psychological, social and spiritual needs of people in their final days. The work of palliative care in medicine is complemented by the hospice movement in nursing, which has made great advances in recent years in allowing patients to die in the comfort of their homes surrounded by loved ones, rather than in a hospital bed. With these approaches, the goals shift from curing the disease (which at some point becomes impossible) to caring for the person (which always remains possible). Good pain management, treatment of depression and anxiety, emotional and social support and spiritual care are among the building blocks of good palliative care. We understandably fear the effects of terminal diseases—pain, loss of functioning, isolation or becoming a burden to others. But with good palliative care, we need not fear that we will spend our last moments in intolerable pain, or alone, or subject to humiliating indignities.

While he was on this earth, our Lord Jesus Christ’s ministry was a ministry of healing. In imitation of Christ we are called to provide healing, comfort and care to the sick, especially those whose illnesses prove to be terminal. In addressing the end of life, medicine has made not only technological advances, but also advances in compassionate care, which we should embrace as Catholics. Our Catholic faith and morals do not require that we continue to pursue useless or excessively burdensome treatments that have little chance of benefit. However, Pope Francis has emphasized that the care we can provide for the dying can be of great benefit to the living: “Those who practice mercy,” said the pope, “do not fear death.”

Pope Saint John Paul II witnessed to this in his final days: he heroically bore the burdens of chronic Parkinson’s disease for years, but in his last days he decided to forgo further intensive medical treatments in a hospital, and instead lived out his final days in his apartment surrounded by caregivers and friends.

Medicine is built upon a long and venerable ethical tradition, stretching back to the Hippocratic Oath, which can be summarized: when possible to cure, always to care, never to kill. Palliative care is a merciful and compassionate modern means of achieving these worthy goals.

As Pope Francis has said, “There is no human life more sacred than another, just as there is no human life qualitatively more significant than another. The credibility of a health care system is not measured solely by efficiency, but above all by the attention and love given to the person, whose life is always sacred and inviolable.”

 

The Most Reverend Kevin W. Vann, Bishop of Orange