♪ hello, and about half of the archdiocese of san francisco , we have some guests. you won't think it is a joke, i hope, if i say that none of us can live without dying. it was a joke in the old jackie gleason routine when the straight may asked him, have you live your e lifein that our we're not there yet, but we will be.

100% of nyf us, will accompany our loved ones to and through death. and some of us will be amongst the professionals. how to any of us in any of these categories approach these tasks. how to discharge these responsibilities? what do we need to know and understand and do. important questions. after this brief break, please join us for a catholic conversation on death and dying.

hello and welcome to mosaic. we're talking about death and dying. a serious subject with some live really -- lively people as guests. introduce them really. this is vickie evans. vicki, the title i wrote cpa and stl the name. you work as a cpa, but i know that you are also a writer and you give workshops on bioethics and end-of-life issues. nader said of an advanced degree, which is as tl. you are a licentiate of theology.

you work with archdiocese of san francisco. >> i'm with the department of human life and dignity. been there for about several years. i received my degree from the pontifical university. i speak on the subject. >> mixture is doctor thomas cavanaugh. tom cavanaugh, graduate of thomas aquinas college. and the notre dame phd in philosophy. and your bio there says that you start to their 1994. i think it was 25 years? >> 25 delightful yea called what is wisdom? that would be interesting to take. and honors seminar and you

specialize, in medical ethics. you've written books on and have a new book on it, which i am reading right now. it is very interesting. it is placed at the origin of the western medical profession. so you are our experts. this will be a catholic conversation death and dying. it is not for catholics, it is for everyone. i tried to paint a picture of a pyramid with 100% of us on the bottom level going to die. many of us on the next level, helping others die. then professionals working in this business. i would like to ask you the question, what to the catholics have to tell us about death? what is the catholic teaching for this? >> there's a beautiful document promulgated by the vatican in 1980 call euia. not a great title, but it is more uplifting than the title makes it sound. the catholic church has an amazing body of knowledge

around death and dying. catholic social teachings form the principles of what we call end-of-life care. the declaration on euthanasia goes through very practical points, talking about death first of all. death is part of the human condition and it is either to be feared and avoided at all costs, nor is it to be actively procured. so, we know that is part of life. by looking at some of the principles of catholic teaching, we can see what the best way is to die and what principles are okay, howh oug shouldt doi how to help each other through death in a spiritual and physical and mental way. >> in your job, you do provide practical resources for people who need to know. >> your website at the

archdiocese, all of the resources there, people can study that they can also talk to personally to find out what there is to know. >> we have a hotline. a medical ethics hotline on her website. if anyone is having a problem, either with a relative or friend dying, or they have a question about an end-of-life issue, they're welcome to call. we can talk it through. it is very difficult to be at someone's bedside. say you have an elderly person or parent dying. is a doctor doing this right? are they withholding nutrition and hydration? of the given too much morphine? because you never know unless you are in the situation whether or not you're doing everything right. is d somes it is good to have backup. >> i would think so. being prepared with the knowledge you may need, as frustrating and confusing as it can be.story of a

higher order of philosophy or theology understanding what is it that the catholics survive -- supply there for us. >> the catholic church has a good message concerning death. it is paradoxical, but the gospel is in greek, a good message. and the good message is that death is not the end of our existence. so, in catholic theology, we distance between the first death and the second death. the first death is the separation of our bodies from our souls. our souls are the principal of our life. the vilify us. when the soul separates from the body, we suffer the first death. that is not the end of the story. that is the good news. the good message that the church has to share about death. it is not all over. there is an afterlife.

the soul continues to is after death. we are not that soul, we are the union of body and soul. the soul continues to exist after death and the great good message is that when jesus tells us, i am the resurrection and the life. he who believes in me, though he shall be dead, shall live. it is that we will rise from the dead as jesus did. that is the good message that the church has to share. the second death is the one that we want to stay away from. that death is the separation of the soul from god. our source of life. the church offers us ways and means and sacraments for avoiding the second death. we will all go through the first death. he says llenasleep.e sp. and they ridiculed him, because they said, he is dead.

but she said, she is not dead in the second death. her soul has separated from her body. she herself, her soul is not separated from god. at the end of our lives, the church offers us the last rights. so we have in the church, we have the anointing of the sick, which is actually a sacrament in the catholic illogical tradition where the sacrament anoints the sick. can be used when we are not only dying, but it can be certainly be used when we are dying. we have the anointing of the sick, we have confession, we have the eucharist, we have all of these means available to us so that we can die well. >> spiritual medicine. >> we will take a brief break now and be back in a couple of minutes to talk more about death.

hello and welcome back. we're talking about death and dying. end-of-life care is what we call it now. we're talking about the medical practice and the personal practice of this inevitable stage of life. i was reading the head of a catholic health care group the road this. he says, my parents deaths taught me about end-of-life care. when it died hard and one died easy. i've said many times, if we can improve the patient experience in the last 2 years of life, will go a long way toward improving healthcare for people at every stage of life. and i thought, that is strange, because the layman thinks that end-of-life medical care could be a big waste of resources. could be a waste of time.

it could be a money pit in the last years of life. and he is saying, it is a time practice and learn new things. things that can help us throughout the medical practice. does that sound right to you? >> i think that when you are talking about preparing for end- of-life, it is always a good idea to have an advance health care directive. we have a great catholic health care directive on her website. does not just for catholics. i think it is good for anyone. it takes up a few of the main questions that occur when people are dying. how much medication is too much. if you're given a lot of morphing, will that accelerate your death? the answer is that no one is expected to go through intractable pain when they are dying. giving pain medication like morphine, as long as the intent is not to cause death, here, the intent is always the most important word.

it is okay to give pain medication, even if theoretically, it could reduce the lifespan of the person. another issue that always comes up is nutrition and hydration. artificial nutrition and hydration is considered necessary healthcare. it is not a healthcare procedure because of your eating and drinking. but i get a lot of calls from family members saying that i'm afraid we were not feeding my mother or father. i'm afraid that we were not hydrating him enough. did we kill them? there is a point in which the body can no longer assimilate food and water. when you get very close to the dying process. cutting off food and water is okay. it is morally a valid thing to do. if you look at these advanced healthcare directives it goes through these points very briefly. it helps people think about, what do i want when i am dying? if these are the parameters, then you don't have to be as

strict with myself as a might otherwise be. >> surely not? >> it is getting to be more and more people who do have them. but they're still probably over 50% who do not. just because people do not like to talk about the issue. they do not like to think about it. and the fisherman was talking about a new way of patient interaction doctoring that involves more questioning of what the patient wants, needs, and who he is, is that you can prepare for this stage of life. as the man says, if we get this kind of behavior as a habit, which we need to do at end-of- life, achingly back into prior stages of medical care. does that sound correct? >> it strikes me as remarkably similar to the literature. >> theart of dying.

their treatises in the catholic intellectual tradition considering the art of dying. and remarkably, they say that if you can prepare adequately for death, it will transform the way you live. what this comment is, about the death of his parents, strikes me as very similar to the experience of the the aleutians that -- in the 1400s as they began to be written in that time around the time of chaucer. we are mortal creatures. we are going to die k abt this how we want to do it, it is understandable that, given that we are mortal creatures, that will transform our way of living.

it makes perfect sense. the doctrine, if the doctor and patient relationship adequately addresses the issue of dying, it will understandably, thereby address medical issues associated with living. it makes perfect sense to me. >> that does make sense to me. notice that a catholic priest published a journal for someone who is terminally ill to confront the questions and to record things. but i thought, i am pretty healthy these days. i can open the book and do this now and it would help me in thinking about what kind of death i want. i would get a better idea of what kind of life i want. >> you have to remember that people do not have to be hooked up to machines at hospitals. if there is no requirement in the catholic church or anywhere for you to be hooked up to machines at the end of your life. you can refuse that are extraordinary. >> it does seem that the doctors have a care is such

that we have great tools that you can aggressively give more treatments at the end of life, or we now have the capability of ending life voluntarily. this is in the law these days. the medical practice can divide along these things. it is hard to know what exactly is the best thing to do. >> if we draw a boundary and in the hippocratic oath, we have a i will not give a deadly drug if i am asked, nor will i counsel this plan. in hippocrates, that is a boundary. within the confines of the boundary, he practices at the art of medicine. the art of medicine, you can excel in a practice when one has a boundary. you cannot become excellent at something without boundaries

within two conduct the practice. he lays this out. >> we are going to take another break and come back for the last segment, in which we will talk about how we can learn more about these things. thank you. thank you . we will be right back.

thank you for being with us. we're talking about death and dying. to learn more, vicki, you are putting on a conference in november in san francisco. you and some associated catholic groups. i notice that it is for professionals. you get continuing education units in your medical specialty. it is also for lead the -- the layman. it is a full day gaining knowledge of these very things we're talking about. we will run a slide here with the flyer for the program. there it is. it is at st. mary's cathedral. it is all day on november 17. to know more about that come you can go to our website know the information is there. the title of the conference is interesting. both titles, >> converging roads is where the medical practice and ethics converge because they do, certainly.

the title of the conference is the heart of end-of-life care and so -- catholic social teaching. the catholics have a great body of social teaching underlying end-of-life care. if our viewers would like to learn more about it, we're having a conference that john was just mentioning on november 17. we have speakers from all over the country. dr. tom cavanaugh is one of them. it is for doctors and nurses because the continued education credits. but it's also for the general public because the principles will be very helpful for yourselves, your loved ones, for everybody towards the end of life. we are looking forward to a good conference. >> i do want to come. you advises that we need to get prepared. it is a serious business to get prepared for ourselves and for our families. let me ask you this question.

what do you think we should all be doing to get prepared for end-of-life? vicki has a very practical side of things. what about you. what is the main thing we should take away? >> i think what we should do is a model for what we should do is -- which is talking about dying. dying in our families. what good deaths have we seen ? what bad deaths things have we been part of? what can we do looking forward to our own deaths and the deaths of our friends and family to make sure the bad things do not happen. sharing the stories with one another, i think is herschel. >> you have a lot of experience. do people not talk about this? >> one way to get them to start talking about is when you're filling out the advance healthcare directive. the most important thing on the form is appointing a healthcare proxy.

a power of attorney for healthcare, who knows your wishes and knows your values, knows what you want. that is the most important thing that you can do. as your pick at your powers of attorney for healthcare, that is when the conversation can start. i think that is what thomas talking about. >> we are also coming on halloween. the day of the dead. so october 31, november 1, >> we speak of those who are dead and those who are saints. we can think about our loved ones, remember them, and talk about the fact that we are mortal and associated with that national holiday that we have, halloween, it originally comes from the irish and the church has a lot to say about it as well. >> november in the catholic church is called month of the dead. it is a time when you particularly remember the dead and play -- pray for the dead and re-involve the dead in your life so that they are not

forgotten. that is important. i'm going to make your suggestion concrete. everybody in the month of december, talk about halloween. >> even this detail, as we recently had two funerals in our family, sadhana what you want for your funeral service, what you want to happen. otherwise, the grieving people are wondering and blowing in the wind trying to figure what to do. it is time to get ready. >> let's talk about your book also, if i may. you're going to be at the conference on november 17? you have your book there? >> i will have my book there. >> we will be having a white mass which is a mass dedicated to medical professionals. there is a 5:30 white mass and then tom's signing and reception afterwards. >> tom, i am reading your book. there is some latin and greek

in there, but it is really interesting. give me in 30 seconds, the gist of your book. >> the gist is that hippocrates found medicine as a profession by having an oath in which the physician makes promises to patients about how he or she will care for the patient and what norms the physician will honor and abide by. that is a profession of standing in front of other people to tell them what you stand for and how you will conduct yourself before them and in your interactions with them. hippocrates really founds medicine as a profession. we think of it as a professional , but we have forgotten where the initial conception began. it began with hippocrates about 2500 years ago. >> you're taking on an art which will stand up and profess your attention and your goals and do so in public. want to thank you both for being here we will be back in a

few seconds. vicki evans, tom cavanaugh, it has been great having you here. you very much for joining us on mosaic. ♪

headquarters.. live from the cvs bay area studios. >> i was in shock. i was in fight or flight. >> a uber driver violently slammed to the ground outside of the headquarters says he may sue. but first -- >> we need to treat it like it is a hurricane or tornado coming. >> that -- that -- it is 6 am on the sunday, october 14. >> a red flag warning went into effect last night. pg&e says they could cut power in extreme fire risk areas as a result. that includes portions of nampa, alameda and