by Ted Griggs

In the wake of the Terri Schiavo case, government officials, private individuals and healthcare providers are grappling with end-of-life care and who decides whether to continue it.

The Louisiana Legislature is nibbling around the edges of the issue with a proposed law that would prevent an abusive husband who puts his wife in a coma from making the decisions involving life support.

Although the Schiavo's death has focused more attention on the question, and allowed Vatican officials to reiterate the church's position, little has changed for the Catholic healthcare facilities run by the Franciscan Missionaries of Our Lady Health System. FMOL is the parent of Our Lady of Lourdes Regional Medical Center in Lafayette and Our Lady of the Lake Regional Medical Center in Baton Rouge, two of the area's larger hospitals.

"Decisions about forgoing life-sustaining treatment are often very complex and heart-wrenching times for patients and their families," said Cindy Heine, vice president of mission integration for the FMOL Health System. "Living wills and especially the appointment of a durable power of attorney for healthcare, someone who can make decisions when a patient is unable to do so, are important ways to ensure that care and treatment are provided in keeping with a patient's wishes."

Hospitals in the FMOL system are required to ask patients about Advanced Directives before admitting them to the hospital, Heine said.

An Advanced Directive is the patient's written instructions about the type of care he or she wants in the event of a terminal illness or life-threatening issue. An advanced directive lets healthcare providers know the patient's wishes when he or she can't. Schiavo didn't have one.

Schiavo died earlier this year following years of legal battles between her husband, who wanted to remove her feeding tube, and her parents, who wanted the tube to remain.

In addition to asking patients about Advanced Directives, Heine said, each hospital can support a person who wants a living will with proper forms and guidance from the facility's pastoral care areas.

Heine said institutional policies are developed in keeping with the teachings of the church by the leadership of the hospital. In general, the policies are established at the facility level and reviewed by the FMOL system to ensure consistency systemwide.

Under Louisiana law, feeding tubes are included under the definition of life support. The tubes can be removed if the patient's living will says he or she doesn't want to be kept on life support. Earlier this session, a proposed bill to prohibit all feeding tubes from being withdrawn from any patient, even if they had a living will, failed to make it out of the Senate Finance Committee.

Officials with Dallas-based Christus Health System, which owns or manages 15 Louisiana facilities, mainly in the northern part of the state, could not be reached for comment. However, the Christus Web site contains information on living wills and advanced directives, instructions on what they should contain, and links to download printable forms of both. In south central Louisiana, Christus has St. Patrick and Dubuis hospitals in Lake Charles, Dubuis and St. Francis Cabrini hospitals in Alexandria, and Natchitoches Parish Hospital.

Although some critics have said Catholic hospitals answer to their local bishops, not the patients, Heine said the FMOL system facilities are "blessed" to have strong relationships with their communities' bishops.

"Those relationships include guidance from our bishops related to issues of medical ethics," Heine said.

Heine also discounted the possibility that the Vatican's stance on end-of-life care might make patients reconsider going into a Catholic hospital.

"Catholic hospitals believe that holistic care — care of mind, body and spirit — best serves the needs of those persons entrusted to our care," Heine said.

The Church teaches that life is a gift from God and therefore sacred and has done so for centuries, Heine said. The Church also teaches that dignity of every person is of the utmost importance.

The FMOL system applies this teaching in the policies and practical operations of its facilities, Heine said.

"We believe the communities we serve recognize our value and contributions as healthcare providers," she said.