MADISON — Wisconsin’s Catholic bishops released the third edition of their pastoral letter on end of life health care decision-making and advance care planning, “Now and at the Hour of Our Death,” on Wednesday, May 29. The letter voices the bishops’ concern and compassion for those facing critical health care decisions, and shares a moral and ethical framework for making such decisions.

An electronic version of the pastoral is available at Printed copies will be released and available from local diocesan respect life or social concerns offices. A free copy can also be obtained by contacting the WCC at (608) 257-0004 or (multiple copies will include a shipping fee). This summer, the WCC will also release a Spanish language version of the document.

While the third edition does not include significant changes to the original versions, it incorporates an updated reference to the “Ethical and Religious Directives for Catholic Health Care Services” (ERDs), the fifth edition of which was distributed by the United States Conference of Catholic Bishops (USCCB) in 2009. Since the fifth edition of the ERDs includes a clarification on providing patients with nutrition and hydration, the third edition of the Wisconsin bishops’ letter now reflects this change.

It also offers additional guidance on the use of advance directives, with specific reference to the increasing use of Physician Orders for Life-Sustaining Treatment (POLST) in Wisconsin. The bishops caution against the use of POLST, citing their July 2012 pastoral letter, “Upholding the Dignity of Human Life.” The bishops have consistently encouraged Catholics to engage in advance care planning and recommended the preparation of a power of attorney for health care. Other changes include an expanded glossary and listing of resources.

The first edition of “Now and at the Hour of Our Death,” was published in April 2002 and four years later, the need for a reprint, presented an opportunity for revision of the statement to reflect ongoing developments in the area of end-of-life decision-making, according to a press release issued May 29 by the Wisconsin Catholic Conference, the public policy arm of the state’s bishops.

According to John Huebscher, WCC executive director, the first two editions of the letter “have proven to be our most frequently requested document. In the seven years since the second edition, we have seen even greater interest in the moral questions surrounding death and dying. The bishops are resolved to keep responding to that interest. Reissuing the document is an effective way to do that.”

The pastoral letter opens by acknowledging that advances in medical technology create opportunities and moral challenges. As medicine continues to strive to preserve human life, scientific progress poses new ethical questions regarding the meaning of life and death.

The letter offers guidance to those who face a serious illness and to those who are seeking to prepare in advance for their medical care. It addresses the challenges faced by society today, noting the mounting threat of assisted suicide and euthanasia. The document also provides guidance on the church’s teaching regarding various treatment measures, such as life support, nutrition and hydration, pain management, and overly aggressive medical treatment.

The bishops emphasize that medical decisions one faces have moral dimensions.  

“Choices regarding medical treatments must be viewed through a moral lens that guides us away from choices that deny human dignity and toward choices that affirm our respect for all life and our belief in eternal life,” Huebscher noted in the release.