Grant Proposal -- Gerard Health Foundation
3/16/2009
To: Jack Malloy
Gerard Health Foundation
JMalloy@Gerardhealth.org
I would like to make the following proposal to Gerard Health Foundation for the funding of a new pro-life initiative. At some point in your evaluation of this proposal, I ask you to read a brief story about a close personal friend, Fr. Gerard Ream, whose death by involuntary euthanasia in April 2008 was the catalyst for this request. (I have included his story as an Addendum at the end of this proposal. Though it is brief, it is not a formal element of this proposal.) After reading the CNS article last month about the Gerard Health Foundation, and recalling the role of St. Gerard in Fr. Ream's life, I felt compelled to research the scope of the problem of involuntary euthanasia, as well as the current pro-life efforts devoted to providing education and concrete alternatives and assistance in cases like his.
1) How many lives can you save?
As our population ages, more tax dollars are being spent on medical and nursing care for the sick and dying than ever before. One of the bitter fruits of abortion is a population inversion whereby there are more older citizens than younger, and fewer taxpayers paying into the system to support the social welfare of the older generations. As this trend accelerates, the pressure to control costs and ration care also increases, and elements of this were seen in a recent federal stimulus/spending bill. One growing method of controlling costs and rationing care is involuntary euthanasia. (See, for example, the recent Telegraph article 'Right to die' can become a 'duty to die.')
Most of the problems of involuntary euthanasia are occurring within the framework of hospice and palliative care. The original idea of hospice care is noble and consistent with Christian ideals. Hospice Patients Alliance has an excellent summary: "...all human life is inherently valuable ... the role of hospice nurses, physicians and all other staff is to alleviate suffering and provide comfort for the sick and dying without sanctioning or assisting their suicide. A death with dignity allows for a natural death in its own time, while doing everything possible to assure relief from distressing symptoms." Their article, Making a Difference in This World: End-of-Life Activism has a good summary of the scope of the problem to be addressed. Many hospices and palliative care providers continue to hold and fulfill this original ideal. On the other hand, during his stay in palliative care, Fr. Ream received no water, no food, no IV, only Morphine. This type of killing has indeed become routine.
Unlike abortion, there is no hard data on the present rates of involuntary euthanasia in America. However, statistics on hospice services in general are readily available, and certain inferences can be drawn from them. According to the March 2006 "Hospice Facts and Statistics" from the National Association for Home Care and Hospice, "For calendar year (CY) 2004, 797,117 [Medicare] enrollees received hospice services." This does not include numbers for Medicaid and private insurance enrollees. According to Caring Connections, a program of the National Hospice and Palliative Care Organization, "Currently these programs serve more than 1.2 million patients and their families each year."
Again, from "Hospice Facts and Statistics," "The balance between hospice patients with cancer diagnoses and those with non cancer diagnoses has shifted dramatically since 1992." Non cancer hospice patients have increased from 24% of the total in 1992 to 49% of the total in 2000. Non cancer diagnoses in current hospice care include congestive heart failure, stroke, dementia, Alzheimers, ALS, Parkinson's, lung disease, kidney disease, liver disease, and chronic infections. Obviously, not all of these non cancer patients are truly terminal.
A conservative estimate would be that only 1 in 10 patients in hospice care are being involuntarily euthanized, as in Fr. Ream's case. If 1.2 million patients receive this type of care yearly, this represents 120,000 lives lost yearly to involuntary euthanasia.
Numerous polls and studies have shown that at least one in three Americans are philosophically pro-life. If only the individuals and their families who are already pro-life can be assisted in resisting involuntary euthanasia, then 40,000 lives could be saved annually by these new efforts.
2) What will you do to save these lives?
There are excellent educational resources available regarding involuntary euthanasia. The International Task Force on Euthanasia and Assisted Suicide has superb online resources to educate society on all aspects of the problem. The USCCB, Human Life International, Priests for Life and American Life League all have excellent resource pages on Euthanasia.
Unfortunately, while there is a cohesive infrastructure of pro-life abortion alternatives, assistance, ministries, and educational efforts, no such corresponding cohesive system exists for those facing involuntary euthanasia. In relating this to the pro-life movement in general, this would be similar to having pro-life educational books, pamphlets, websites, and speakers -- but no crisis pregnancy centers, no sidewalk counselors, no homes for expectant mothers, no adoption agencies, no adoptive parents, etc. When a patient or their family or friends face the increasing reality of involuntary euthanasia, educational materials and speakers alone are not enough to help them avoid this evil.
There is no need to recreate the wheel concerning educational materials, as links above illustrate. There is a desperate need to build the rest of a pro-life infrastructure specifically targeted at preventing involuntary euthanasia. We need the functional equivalent of crisis pregnancy centers, sidewalk counselors, homes for expectant mothers, adoption options, etc.
The culture does not understand Divine Providence, i.e., the redemptive nature or value of suffering, or the grace that God makes available to the soul at every moment of life and especially through Final Perseverance during the time of natural death. At this point, the culture no longer remembers that food and water are not medical treatments that can be arbitrarily withdrawn, but basic human rights. They forget that the measure of a life is not some subjective utilitarian notion of "quality of life." Life has value because God gives it, and He makes available the graces to endure every moment of each life -- be they moments or work, joy, prayer, sacrifice or suffering -- from conception to natural death. Depriving the soul of the grace of those final moments can cause the eternal loss of that soul and many others for whom the suffering of that soul would otherwise serve as reparation.
Obviously, this is a spiritual battle, and I propose establishing the Divine Providence Association, an Association of Lay Faithful who will serve the sick and dying through the Corporal and Spiritual Works of Mercy. This Association would work to create the infrastructure that will address involuntary euthanasia in a cohesive fashion. Unlike a religious order that builds a nursing home or hospice and brings people in, the Divine Providence Association would go out into the homes of the sick and dying and assist them and their families in their hour of need. In the patients' homes as well as nursing homes, hospitals, hospices and palliative care units, they would provide discreet consultation on the dangers of involuntary euthanasia, and guidance on working within the system for patient rights. Keeping patients in their homes, surrounded by family and friends, would be a primary goal of this work.
This Association would produce materials that introduce the Apostolate to Catholic Churches, Dioceses, pro-life organizations, etc., and offer to speak to these groups and train participants for this specialized work. This Association would network with the well established pro-life groups around the country, sharing the vision of a cohesive approach to fighting involuntary euthanasia, and encouraging them to also offer concrete options in addition to the educational materials already available.
The Spiritual formation of the Associates would emphasize devotion to Divine Providence so that they may enter the homes of the sick and dying as holy places, with great respect for this moment of grace, and under the patronage of Mary as Mother of Divine Providence. Through the Corporal and Spiritual Works of Mercy, they would assist the patient in spiritual preparation for dying, with special attention to arranging the Sacraments of Confession, Last Rites, and Viaticum (Holy Communion prior to natural death.) This will have the further effect of helping to re-build families and the Church.
The Divine Providence Association would also conduct research to document the prevalence of involuntary euthanasia at present, to assist in legislative and societal efforts to confront this growing threat to human rights.
3) On what basis (scientific research, past experience, etc.) do you believe this many lives can be saved?
In the past, I have served on the board of the National Headquarters of Mom's House Inc., and I presently serve as a board member of The Polycarp Research Institute. I have planned and participated in medical missionary trips to Haiti. My wife and I taught Natural Family Planning for ten years as an ethical, Catholic, pro-life alternative to abortifacient contraceptives. I have authored articles in Catholic and secular periodicals on moral and ethical issues, and in the 1990s I sat on the medical ethics committees of two hospitals where I was on staff.
I have witnessed the direct results -- the alleviation of suffering and the saving of lives -- from these and other well conceived and well executed pro-life efforts. I believe that the Divine Providence Association is also well conceived and will be well executed, saving thousands of lives.
As a physician practicing in a geriatric medical specialty, I recognize the danger posed to my patients by involuntary euthanasia. In the context of numerous home visits for house calls, I have seen the impact on the lives of the sick and the elderly that even brief moments of compassion and listening can bring. I know that many patients and their families would and could resist the forces of involuntary euthanasia, if they knew they were not alone in their struggles and that there was assistance available and compassionate men and women willing to come into their homes to assist them and guide them.
4) How many dollars do you need to accomplish your objective?
The primary expenses of establishing the Divine Providence Association will be associated with networking with existing pro-life groups, traveling, purchasing, printing and distributing educational materials, establishing an internet presence, and engaging in the spiritual formation of the members who will volunteer in this work.
Extrapolating from the expenses of running a successful small business such as my Podiatry practice, and other pro-life ministries with which I have been involved, I believe I can successfully start and operate the Divine Providence Association with an initial grant of $-----.
Thank you for your time and consideration. May God Bless and Prosper your work with the Gerard Health Foundation.
Dr. Brian J. Kopp
ADDENDUM:
Fr. Gerard Ream's Story - The death of a faithful priest by involuntary euthanasia
I first met Fr. Gerard Ream in 1998 while doing a house call for his mother, Dorothy. A brief initial conversation with them revealed that he was living in a small apartment only a block from my Podiatry practice, and that we shared many common traditional Catholic and pro-life interests. Dorothy later told me that after several years of marriage, she and her husband thought they could not have children, and they prayed to St. Gerard Majella for a child. After several years, Fr. Ream was born, and was named after St. Gerard. A first class relic of St. Gerard was one of Fr. Ream's prized possessions, and Dorothy maintained a deep devotion to St. Gerard until her death at age 101.
Fr. Ream soon became a close friend, and we met frequently for meals. I assisted him with various tasks around his apartment, and he called me frequently for fellowship. He got to know my wife and children well and relied on us for help, as his only brother lived in West Virginia. Fr. Ream eventually developed Parkinson's disease. We offered to take him into our home, but he declined, and entered a nursing home. We continued to visit him often and took him out to dine at his favorite restaurants.
In late 2007 and early 2008, Fr. Ream's health declined rapidly. He left a voice message on my cell phone late on a Wednesday in April 2008, asking me to stop to visit. By the time I was able to visit him two days later, he had been admitted to a local hospital for aspiration pneumonia, and had been diagnosed as "terminal" by the treating physician. He was transferred to the palliative care unit and the treating physician and Fr. Ream's brother, citing his Living Will, insisted that Fr. Ream wanted no extraordinary care to prolong his life.
I was shocked that he was receiving no water, no food, no IV, only Morphine. His Parkinson's was advancing and the aspiration pneumonia was a crisis, but neither were imminently terminal. We were permitted to wet a sponge to moisten his lips, and he would try to suck all the moisture from the sponge, but we were forbidden to give him a drink of water, ostensibly because of the risk of further aspiration pneumonia. Fr. Ream had shared with me his opposition to euthanasia in the past, and he was trying to talk to me, but he had become so dehydrated that he could not form any words.
When the attending physician made rounds, I told him my concern that Fr. Ream was receiving no food or water. The physician asserted that their hospice rules forbid IVs as it only "prolonged the process." A Catholic father of six himself, this doctor then stated, "The public has a misconception that death by dehydration is torturous, but that's not true. Its the most humane way to do this, with the least discomfort. We'll control any discomfort with the Morphine. That's what we're going to do." And with that he looked me in the eye defiantly, turned on his heel and left.
I was speechless. I pleaded with Fr. Ream's brother that he would never have consented to euthanasia by dehydration, to no avail.
I have always been pro-life. I had even attended pro-life conferences about euthanasia and I sat on the medical ethics committees of two hospitals in the mid 1990's. I had staff privileges at the hospital in question. But in April 2008, in Fr. Ream's specific case, I simply did not know what to do. I called four good pro-life priests locally, begging for advice.
They all agreed that "You have to do something, Brian!" but none could offer any specific advice, and none could personally intervene to help save their fellow priest. Another priest I consulted recommended I request a medical ethics committee consultation.
Late on a Thursday evening, eight days after Fr. Ream had left the voice message on my cell phone, I spoke with a physicians assistant who was on call for the ethics committee. I told her that he was a good priest and a faithful son of the Church who would never agree to being euthanized, and I discussed with her the relevant documents from Rome and the USCCB and Pennsylvania bishops. She asked me to enter these documents in Fr. Ream's chart, and the medical ethics committee would be happy to review the case Friday morning during rounds.
Relieved that there was something I could finally do for this good priest, I went to the hospital Friday morning at 7:00am, asked the unit clerk to formally enter the documents into his chart for the ethics committee consultation, and headed down the hall to visit him.
His room was already empty. Fr. Ream had died of dehydration several hours earlier.
3/16/2009
To: Jack Malloy
Gerard Health Foundation
JMalloy@Gerardhealth.org
I would like to make the following proposal to Gerard Health Foundation for the funding of a new pro-life initiative. At some point in your evaluation of this proposal, I ask you to read a brief story about a close personal friend, Fr. Gerard Ream, whose death by involuntary euthanasia in April 2008 was the catalyst for this request. (I have included his story as an Addendum at the end of this proposal. Though it is brief, it is not a formal element of this proposal.) After reading the CNS article last month about the Gerard Health Foundation, and recalling the role of St. Gerard in Fr. Ream's life, I felt compelled to research the scope of the problem of involuntary euthanasia, as well as the current pro-life efforts devoted to providing education and concrete alternatives and assistance in cases like his.
1) How many lives can you save?
As our population ages, more tax dollars are being spent on medical and nursing care for the sick and dying than ever before. One of the bitter fruits of abortion is a population inversion whereby there are more older citizens than younger, and fewer taxpayers paying into the system to support the social welfare of the older generations. As this trend accelerates, the pressure to control costs and ration care also increases, and elements of this were seen in a recent federal stimulus/spending bill. One growing method of controlling costs and rationing care is involuntary euthanasia. (See, for example, the recent Telegraph article 'Right to die' can become a 'duty to die.')
Most of the problems of involuntary euthanasia are occurring within the framework of hospice and palliative care. The original idea of hospice care is noble and consistent with Christian ideals. Hospice Patients Alliance has an excellent summary: "...all human life is inherently valuable ... the role of hospice nurses, physicians and all other staff is to alleviate suffering and provide comfort for the sick and dying without sanctioning or assisting their suicide. A death with dignity allows for a natural death in its own time, while doing everything possible to assure relief from distressing symptoms." Their article, Making a Difference in This World: End-of-Life Activism has a good summary of the scope of the problem to be addressed. Many hospices and palliative care providers continue to hold and fulfill this original ideal. On the other hand, during his stay in palliative care, Fr. Ream received no water, no food, no IV, only Morphine. This type of killing has indeed become routine.
Unlike abortion, there is no hard data on the present rates of involuntary euthanasia in America. However, statistics on hospice services in general are readily available, and certain inferences can be drawn from them. According to the March 2006 "Hospice Facts and Statistics" from the National Association for Home Care and Hospice, "For calendar year (CY) 2004, 797,117 [Medicare] enrollees received hospice services." This does not include numbers for Medicaid and private insurance enrollees. According to Caring Connections, a program of the National Hospice and Palliative Care Organization, "Currently these programs serve more than 1.2 million patients and their families each year."
Again, from "Hospice Facts and Statistics," "The balance between hospice patients with cancer diagnoses and those with non cancer diagnoses has shifted dramatically since 1992." Non cancer hospice patients have increased from 24% of the total in 1992 to 49% of the total in 2000. Non cancer diagnoses in current hospice care include congestive heart failure, stroke, dementia, Alzheimers, ALS, Parkinson's, lung disease, kidney disease, liver disease, and chronic infections. Obviously, not all of these non cancer patients are truly terminal.
A conservative estimate would be that only 1 in 10 patients in hospice care are being involuntarily euthanized, as in Fr. Ream's case. If 1.2 million patients receive this type of care yearly, this represents 120,000 lives lost yearly to involuntary euthanasia.
Numerous polls and studies have shown that at least one in three Americans are philosophically pro-life. If only the individuals and their families who are already pro-life can be assisted in resisting involuntary euthanasia, then 40,000 lives could be saved annually by these new efforts.
2) What will you do to save these lives?
There are excellent educational resources available regarding involuntary euthanasia. The International Task Force on Euthanasia and Assisted Suicide has superb online resources to educate society on all aspects of the problem. The USCCB, Human Life International, Priests for Life and American Life League all have excellent resource pages on Euthanasia.
Unfortunately, while there is a cohesive infrastructure of pro-life abortion alternatives, assistance, ministries, and educational efforts, no such corresponding cohesive system exists for those facing involuntary euthanasia. In relating this to the pro-life movement in general, this would be similar to having pro-life educational books, pamphlets, websites, and speakers -- but no crisis pregnancy centers, no sidewalk counselors, no homes for expectant mothers, no adoption agencies, no adoptive parents, etc. When a patient or their family or friends face the increasing reality of involuntary euthanasia, educational materials and speakers alone are not enough to help them avoid this evil.
There is no need to recreate the wheel concerning educational materials, as links above illustrate. There is a desperate need to build the rest of a pro-life infrastructure specifically targeted at preventing involuntary euthanasia. We need the functional equivalent of crisis pregnancy centers, sidewalk counselors, homes for expectant mothers, adoption options, etc.
The culture does not understand Divine Providence, i.e., the redemptive nature or value of suffering, or the grace that God makes available to the soul at every moment of life and especially through Final Perseverance during the time of natural death. At this point, the culture no longer remembers that food and water are not medical treatments that can be arbitrarily withdrawn, but basic human rights. They forget that the measure of a life is not some subjective utilitarian notion of "quality of life." Life has value because God gives it, and He makes available the graces to endure every moment of each life -- be they moments or work, joy, prayer, sacrifice or suffering -- from conception to natural death. Depriving the soul of the grace of those final moments can cause the eternal loss of that soul and many others for whom the suffering of that soul would otherwise serve as reparation.
Obviously, this is a spiritual battle, and I propose establishing the Divine Providence Association, an Association of Lay Faithful who will serve the sick and dying through the Corporal and Spiritual Works of Mercy. This Association would work to create the infrastructure that will address involuntary euthanasia in a cohesive fashion. Unlike a religious order that builds a nursing home or hospice and brings people in, the Divine Providence Association would go out into the homes of the sick and dying and assist them and their families in their hour of need. In the patients' homes as well as nursing homes, hospitals, hospices and palliative care units, they would provide discreet consultation on the dangers of involuntary euthanasia, and guidance on working within the system for patient rights. Keeping patients in their homes, surrounded by family and friends, would be a primary goal of this work.
This Association would produce materials that introduce the Apostolate to Catholic Churches, Dioceses, pro-life organizations, etc., and offer to speak to these groups and train participants for this specialized work. This Association would network with the well established pro-life groups around the country, sharing the vision of a cohesive approach to fighting involuntary euthanasia, and encouraging them to also offer concrete options in addition to the educational materials already available.
The Spiritual formation of the Associates would emphasize devotion to Divine Providence so that they may enter the homes of the sick and dying as holy places, with great respect for this moment of grace, and under the patronage of Mary as Mother of Divine Providence. Through the Corporal and Spiritual Works of Mercy, they would assist the patient in spiritual preparation for dying, with special attention to arranging the Sacraments of Confession, Last Rites, and Viaticum (Holy Communion prior to natural death.) This will have the further effect of helping to re-build families and the Church.
The Divine Providence Association would also conduct research to document the prevalence of involuntary euthanasia at present, to assist in legislative and societal efforts to confront this growing threat to human rights.
3) On what basis (scientific research, past experience, etc.) do you believe this many lives can be saved?
In the past, I have served on the board of the National Headquarters of Mom's House Inc., and I presently serve as a board member of The Polycarp Research Institute. I have planned and participated in medical missionary trips to Haiti. My wife and I taught Natural Family Planning for ten years as an ethical, Catholic, pro-life alternative to abortifacient contraceptives. I have authored articles in Catholic and secular periodicals on moral and ethical issues, and in the 1990s I sat on the medical ethics committees of two hospitals where I was on staff.
I have witnessed the direct results -- the alleviation of suffering and the saving of lives -- from these and other well conceived and well executed pro-life efforts. I believe that the Divine Providence Association is also well conceived and will be well executed, saving thousands of lives.
As a physician practicing in a geriatric medical specialty, I recognize the danger posed to my patients by involuntary euthanasia. In the context of numerous home visits for house calls, I have seen the impact on the lives of the sick and the elderly that even brief moments of compassion and listening can bring. I know that many patients and their families would and could resist the forces of involuntary euthanasia, if they knew they were not alone in their struggles and that there was assistance available and compassionate men and women willing to come into their homes to assist them and guide them.
4) How many dollars do you need to accomplish your objective?
The primary expenses of establishing the Divine Providence Association will be associated with networking with existing pro-life groups, traveling, purchasing, printing and distributing educational materials, establishing an internet presence, and engaging in the spiritual formation of the members who will volunteer in this work.
Extrapolating from the expenses of running a successful small business such as my Podiatry practice, and other pro-life ministries with which I have been involved, I believe I can successfully start and operate the Divine Providence Association with an initial grant of $-----.
Thank you for your time and consideration. May God Bless and Prosper your work with the Gerard Health Foundation.
Dr. Brian J. Kopp
ADDENDUM:
Fr. Gerard Ream's Story - The death of a faithful priest by involuntary euthanasia
I first met Fr. Gerard Ream in 1998 while doing a house call for his mother, Dorothy. A brief initial conversation with them revealed that he was living in a small apartment only a block from my Podiatry practice, and that we shared many common traditional Catholic and pro-life interests. Dorothy later told me that after several years of marriage, she and her husband thought they could not have children, and they prayed to St. Gerard Majella for a child. After several years, Fr. Ream was born, and was named after St. Gerard. A first class relic of St. Gerard was one of Fr. Ream's prized possessions, and Dorothy maintained a deep devotion to St. Gerard until her death at age 101.
Fr. Ream soon became a close friend, and we met frequently for meals. I assisted him with various tasks around his apartment, and he called me frequently for fellowship. He got to know my wife and children well and relied on us for help, as his only brother lived in West Virginia. Fr. Ream eventually developed Parkinson's disease. We offered to take him into our home, but he declined, and entered a nursing home. We continued to visit him often and took him out to dine at his favorite restaurants.
In late 2007 and early 2008, Fr. Ream's health declined rapidly. He left a voice message on my cell phone late on a Wednesday in April 2008, asking me to stop to visit. By the time I was able to visit him two days later, he had been admitted to a local hospital for aspiration pneumonia, and had been diagnosed as "terminal" by the treating physician. He was transferred to the palliative care unit and the treating physician and Fr. Ream's brother, citing his Living Will, insisted that Fr. Ream wanted no extraordinary care to prolong his life.
I was shocked that he was receiving no water, no food, no IV, only Morphine. His Parkinson's was advancing and the aspiration pneumonia was a crisis, but neither were imminently terminal. We were permitted to wet a sponge to moisten his lips, and he would try to suck all the moisture from the sponge, but we were forbidden to give him a drink of water, ostensibly because of the risk of further aspiration pneumonia. Fr. Ream had shared with me his opposition to euthanasia in the past, and he was trying to talk to me, but he had become so dehydrated that he could not form any words.
When the attending physician made rounds, I told him my concern that Fr. Ream was receiving no food or water. The physician asserted that their hospice rules forbid IVs as it only "prolonged the process." A Catholic father of six himself, this doctor then stated, "The public has a misconception that death by dehydration is torturous, but that's not true. Its the most humane way to do this, with the least discomfort. We'll control any discomfort with the Morphine. That's what we're going to do." And with that he looked me in the eye defiantly, turned on his heel and left.
I was speechless. I pleaded with Fr. Ream's brother that he would never have consented to euthanasia by dehydration, to no avail.
I have always been pro-life. I had even attended pro-life conferences about euthanasia and I sat on the medical ethics committees of two hospitals in the mid 1990's. I had staff privileges at the hospital in question. But in April 2008, in Fr. Ream's specific case, I simply did not know what to do. I called four good pro-life priests locally, begging for advice.
They all agreed that "You have to do something, Brian!" but none could offer any specific advice, and none could personally intervene to help save their fellow priest. Another priest I consulted recommended I request a medical ethics committee consultation.
Late on a Thursday evening, eight days after Fr. Ream had left the voice message on my cell phone, I spoke with a physicians assistant who was on call for the ethics committee. I told her that he was a good priest and a faithful son of the Church who would never agree to being euthanized, and I discussed with her the relevant documents from Rome and the USCCB and Pennsylvania bishops. She asked me to enter these documents in Fr. Ream's chart, and the medical ethics committee would be happy to review the case Friday morning during rounds.
Relieved that there was something I could finally do for this good priest, I went to the hospital Friday morning at 7:00am, asked the unit clerk to formally enter the documents into his chart for the ethics committee consultation, and headed down the hall to visit him.
His room was already empty. Fr. Ream had died of dehydration several hours earlier.
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