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Ask a Franciscan: Must I Take All Medications Prescribed?

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Q. My wife and I are in our early 70s and each of us has quite a few medical problems. If we stopped taking all our medications and stopped going to our many doctors, we would shorten our lives. Would the Catholic Church consider this suicide? Would it keep us out of God’s Kingdom?

A. Your letter does not indicate that any of these medical problems is currently life-threatening. The virtue of prudence indicates that you should take care of your body, using good medical care.

At a certain point, you may judge that the negative side effects of a particular medication or medical treatment outweigh the good it is intended to accomplish. You are obliged neither to take every medication recommended nor to submit to every surgical procedure proposed by your doctor.

The key here is a frank and honest exchange about the pros and cons of various options. You and your wife need to explore those options and make careful decisions about them.

Over the years, the Catholic Church has chosen to speak of “ordinary” and “extraordinary” means of preserving life. Catholic theology has understood “ordinary” means as those that are required and “extraordinary” means as those that are optional.

Some medicines and surgical procedures may eventually offer little hope of addressing a particular patient’s main medical problem. The virtue of prudence means that there may come a time to say, “Enough is enough.” That same virtue, however, argues against a decision by someone in relatively good health who says, “No prescriptions of any kind, no surgeries.”

You and your wife need to talk very seriously about your wishes in this matter, in case either of you should be unable to communicate directly. You need to give your wishes legal standing through Advance Medical Directives (one for each of you). Even if you do not go into a hospital for scheduled treatment, you could find yourself there because of an accident.

Making your wishes known now to the person whom you designate to make medical decisions if you cannot do so is an expression of your love and care for your spouse. You should probably indicate a second person in case the first person is unavailable at the time such a decision needs to be made.

God, the Lord of all life, expects that we take sensible care of our bodies but not that we try to cling to life by increasingly extraordinary means. There comes a time to surrender our lives back to God. That is not suicide.

Can Second Cousins Marry?

Q. A niece of my husband has become very close to one of her second cousins. They and some family members are questioning if they are too closely related to marry one another. Are they?

A. The Catholic Church’s current laws permit a marriage between second cousins, that is, between a man and woman who have a common great-grandparent.

The canonical term for family relationships too close to permit a marriage is called consanguinity. This is subdivided into direct (grandfather-son-granddaughter) and collateral (uncle-niece-great-niece). Marriages within the direct line are always invalid. Those in the fourth degree of the collateral line are invalid (Canon 1091), but a local bishop can give a dispensation for the marriage of first cousins (Canon 1078).

Under the 1917 Code of Canon Law, the marriage of second cousins was not permitted. Under the 1983 Code of Canon Law, it is. Second cousins are related in the sixth degree of the collateral line, as the New Commentary on the Code of Canon Law explains. The new Code prohibits marriage up to and including the fourth degree.

These are the Catholic Church’s requirements. Civil law can make other provisions. I am not aware of any U.S. state that prohibits the marriage of second cousins.

Absolving an Unconscious Person

Q. A dear friend recently died. Her parish priest came to the hospital ICU room and administered the Sacrament of the Sick—she was unconscious. He said, “I absolve you from all your sins.” Did she go right into heaven?

Also, after she died many perpetual Mass cards were given. If she went to purgatory, would all the prayers said on her behalf help her get to heaven?

A. That absolution presumes that she is truly sorry for her sins and would want to receive forgiveness for them had she been conscious. God knows the truth about such things and judges accordingly. The Church’s practice reflects its belief in God’s love and mercy.

Regarding prayers offered for people who have died and enrollment in more than one perpetual Mass group, God sorts that all out. We are never wasting our time or energy in praying for someone who has died. That’s part of what belonging to the Communion of Saints means. Our prayer also prepares us to comfort bereaved family members and other friends by appropriate words and actions—not simply at the time of the funeral but in the weeks and months ahead.

What if the deceased person for whom you pray is already in heaven? Even then, the prayer is not wasted. You are a better follower of Jesus for having prayed for that person.

How to Count Tithing

Q. Our parish provides weekly contribution envelopes that ask us to give five percent of our pre-tax income to the parish and another five percent to charities of our choice.

If we assist relatives or friends who need help, can this be considered part of our tithing? Is it O.K. not to meet financial duties such as rent to meet the 10-percent tithing goal?

A Protestant relative says that we must always give 10 percent even if that means not paying certain bills. I do not agree. Also, he says that helping others besides the Church is a love offering and is not part of tithing. What can I respond?

A. Let’s begin with the biblical description of tithing, giving one tenth of some product to God. According to John L. McKenzie’s excellent Dictionary of the Bible, this practice was already in use before Abraham, who paid a tithe to Melchizedek (Genesis 14:20).

Tithes on grain, wine, oil and firstborn animals are required in Deuteronomy 14:22-29. Every third year they are to benefit Levites, aliens, orphans and widows. Tithes are also mentioned in the Books of Leviticus, Numbers, Nehemiah, Malachi and 1 Maccabees.

In Matthew 23:23, Jesus refers to how zealously Pharisees pay tithes. In Luke 18:12, he describes a Pharisee boasting to God about paying tithes. Hebrews 7:1-10 also mentions tithes. Without using this exact term, Acts of the Apostles describes the common fund that meant that no follower of Jesus was in financial need (4:34).

Although most followers of Jesus do not understand tithing as required, many Christian groups encourage it. Must 10 percent go to the local parish or congregation? No. Can private gifts or donations to charitable organizations be considered as part of a tithe? I would say yes to that and to assisting financially one’s friends and relatives.

In biblical times, there was no social “safety net” that most Western societies now provide by means of taxes. Even so, there are many genuine needs addressed by charitable organizations, some of which advertise in this publication.

Give what you can, after you have paid your bills (including your rent) and made reasonable provision for your future. All we have comes from God and should be used in a way that reflects that fact.

Are They Saints?

Q. I have visited a Web site that has lists of saints. However, I see saints listed there whom I have never seen listed elsewhere—for example, Saints Adam, Eve and Seth (all biblical figures). Where can I find a comprehensive and current list of Catholic saints?

A. I have read that the Bibliotheca Sanctorum series lists over 10,000 saints! The 2001 revision of the Martryologium Romanum identifies over 7,000 saints but includes few biblical men and women who lived before Jesus. That does not mean they are not saints, however. We know that Jesus led the righteous into heaven between his burial and his resurrection.