Illinois' assisted suicide law took effect this morning.

I have written elsewhere about how it passed and what twenty-seven years of data from Oregon actually show about why people use these laws. That piece is an argument, and it is written for anyone. This is not that.

This is for the people in my parish - people of good faith - and anybody else who wants it, and it is not an argument at all. It is the thing I would tell you if you called me or asked me after Mass.

The thing most Catholics misunderstand

In years of conversations with other faithful, the most common misunderstanding I encounter about end of life care is this one: that the Church requires you to stay alive by every means available, for as long as medicine can manage it.

That is not true, and I have watched that false belief do real harm, because a person who thinks the alternative to assisted suicide is being kept alive on machines indefinitely will understandably start looking for a third option.

There is no need for a third option. What the Church actually permits is broader than most people think.

You may refuse treatment that has become more burdensome than beneficial. This is ordinary Catholic moral theology, not a loophole. The Catechism calls it the refusal of over-zealous treatment, and it says plainly that in doing so "one does not will to cause death; one's inability to impede it is merely accepted."

You may decline the fourth round of chemotherapy that will buy you six weeks and cost you all six of them.

You may sign a do-not-resuscitate order.

You may choose hospice. Hospice is not giving up and it is not a Catholic problem. It is a decision to treat the person rather than the disease when the disease can no longer be treated.

You may accept pain medication sufficient to manage your suffering, even if it carries some risk of shortening your life, provided that death is not what you are seeking. The Catechism addresses this directly and calls the relief of suffering at the end of life "a special form of disinterested charity."

You are not obliged to be kept alive by every machine that exists for as long as it is technically possible. Nobody has ever been obliged to do that.

Here is the whole of it, as simply as I know how to say it.

You may allow nature to take its course. You may not accelerate it.

That distinction is the entire moral question, and everything above sits on the permitted side of it.

I should add that the hard cases are genuinely hard. Questions about feeding tubes and artificial nutrition are more complicated than a blog post can settle, and they deserve a real conversation with a priest or chaplain or a moral theologian who knows your situation. If you are facing one of those decisions, do not settle it from something you read online, including this. Call somebody.

What the bishops are asking

The Catholic Conference of Illinois has released a collection of resources at the request of our bishops, called Compassion + Care, Now and at the Hour of Our Death. It includes talking points, answers to the ordinary questions about hospice and palliative care, guidance on advance directives, a novena, and the Illinois bishops' pastoral letter on end-of-life care.

It is at ilcatholic.org, and it is free.

But the bishops are asking for one thing in particular, and it is concrete enough that you can do it this week.

Complete an advance health care directive, and name someone you trust to make decisions if you cannot.

Two practical notes on that:

Use the Catholic guidance rather than the generic form your hospital hands you. Standard advance directive forms sometimes contain blanket language about withdrawing care that a Catholic should not sign without understanding what it means. The CCI materials will walk you through it.

And think carefully about who you name. The instinct is to pick whoever loves you most. The better criterion is who can hold their nerve. You want the person who will be able to say what you wanted, clearly, in a corridor at three in the morning, to a doctor who is in a hurry and a family that is frightened. Sometimes that is your spouse. Sometimes it is not.

Then tell them what you want. Out loud, while nothing is wrong. That conversation is a gift you give the people who will otherwise have to guess.

If someone you love is dying

Call a priest. Call early rather than at the last hour, and call even if you are not sure it is time, and call even if the person has been away from the Church for forty years.

There has been some discussion this week about the difficult position a priest may be in if he is called to someone who has already decided to take these drugs. That difficulty is real, and it is his to navigate. It is not yours.

Do not let it stop you from calling. Do not let embarrassment stop you, or the fear that you will be judged, or the worry that you waited too long. No priest I have ever known has turned away from that call, and the ones I know would rather be woken at two in the morning than find out afterward that nobody rang.

This is the part I would highlight for you

Auxiliary Bishop Larry Sullivan of Chicago said something key and important in this conversation:

"One of the things we have to really remember is that we are not a burden to family and to friends. In many ways, we are a blessing. Unfortunately, our society, our culture, is telling people, 'You don't want to be a burden.'"

I spent time this week reading Oregon's data on these laws, and the single clearest finding in twenty-seven years of it is that the fear of being a burden weighs more heavily on people than pain does. Nearly half cited it. Fewer than a third mentioned pain at all.

A bishop got to his point from the pulpit and the bedside. The Oregon statistics got there from a state health department. They arrive at the same place.

If you are sick right now, or getting older, or watching your own capacities go one at a time and doing arithmetic about what you cost the people around you, I would ask you to hear both of them at once. You are not a burden. You are not the sum of what you can still do. That was never where your worth came from and it is not leaving now.

And if you are the one caring for somebody, tell them. Not once. Regularly, out loud, in the ordinary way you would tell them anything else. They are almost certainly wondering.

One more thing

Pray for our state. Pray for the legislators, the physicians who now have a decision in front of them they did not ask for, and most of all for the person somewhere in Illinois who is holding a prognosis this morning and considering their options.

And then go see somebody. Somebody who has been sick a while and whose visitors have thinned out. You do not need a reason and you do not need to bring anything.

Nobody has ever been argued out of feeling like a burden. They get talked out of it by somebody who shows up and stays with them a while and does not check the clock.

I have written a longer piece on how this law passed and what the evidence shows, at Another Voice: The Sanitary Food Preparation Act.

Catholic Conference of Illinois resources: Compassion + Care, Now and at the Hour of Our Death

If you are struggling, the 988 Suicide and Crisis Lifeline is available by call or text, any hour.