When God Calls: Discerning End-of-Life Decisions Through Catholic Eyes
A geriatric nurse faces the profound question: When does medical intervention become an obstacle to God’s call home?
The question haunted Nancy even with her five decades of experience as a geriatric nurse: When does fighting to keep someone alive become an act of preventing God from calling them home? This fundamental tension between preserving life and accepting God’s will became intensely personal when her 93-year-old mother faced declining health and repeated hospitalizations—six hospitalizations and four rehab stays within seven months.
“Even being a geriatric nurse, this really hit me,” Nancy reflects. “We think of swallowing difficulties as something where we have to put in a feeding tube. Our Catholic faith tells us we should not be withholding food and fluid. But there does come a time medically when that may change, depending on the individual situation.”
The Sacred Tension: Life Preservation vs. Divine Will
Catholic teaching holds life as sacred from conception to natural death, but it also recognizes that death is part of God’s plan. Nancy found herself at the crossroads of this teaching when medical teams repeatedly suggested hospice and palliative care for her mother, who suffered from dysphagia (difficulty swallowing) that led to recurring aspiration pneumonia at each hospitalization.
“Are we ready to put her on hospice?” medical professionals would ask. Nancy’s response was always rooted in prayer and discernment: “Not yet, though there may come a time. But I don’t think this is it.”
The Catholic distinction between ordinary and extraordinary care became crucial in Nancy’s decision-making process. Years prior, she had asked her mother about her wishes. Her mother had clearly expressed: no NG tube (nasogastric tube through the nose), no PEG or G-tube (surgical feeding tube into the stomach). Even with the intervention of an NG tube, doctors explained that risk of aspiration pneumonia would remain due to reflux issues.
“The systems were failing,” Nancy explains. “We’re not going to keep a person alive forever.”
Her family worked closely with medical professionals to ensure every appropriate option was considered. Nancy’s mother participated in multiple rounds of therapy and trials of nutrition support, and all feeding approaches were guided by her mother’s wishes and were closely monitored. In the end, their decisions were made in full alignment with Catholic ethics and Church teaching, as it became clear she was entering the natural process of dying.
Finding Guidance in Faith-Based Care
A year prior, through MyCatholicDoctor, Nancy connected with Matthew Estrade— in hopes of finding support for navigating family dynamics and aging and the cognitive changes it brings. Nancy struggled to find a counselor willing to work with her family, and Matt’s expertise in elder care and Catholic teaching offered a potentially wonderful solution.
“Matt from MyCatholicDoctor was such a great help,” Nancy shares. “His help from a Catholic perspective really was helpful for mom and I in those end months and years.”
Although her mother did not yet have an official dementia diagnosis, a cognitive decline was suspected, which later led to dysphagia. Matt’s guidance, rooted in faith and elder care experience, helped Nancy approach these challenges with both medical understanding and spiritual clarity.
Matthew’s approach wasn’t just medical – it was deeply spiritual and practical. He helped Nancy understand that fighting for life and accepting God’s call aren’t necessarily opposing forces but require careful discernment guided by prayer, Catholic teaching and medical reality. When her mother shared with Matt the frustration she had that she could no longer prostrate herself on the floor in prayer as she had done in her younger years, Matt suggested the use of a chapel veil to provide another sign of humility. He helped by providing her mother with resources related to financial power of attorney, and he suggested websites where she could research questions on her own.
Still, Nancy recalls how hard it was to find Catholic resources to guide these decisions. “If only more people knew where to look ahead of time,” she reflects. “When you’re in the moment, it’s overwhelming—we need Church teaching on this to be more visible, more accessible.”
The Moment of Recognition
Nancy’s breakthrough came during one hospitalization when a pulmonologist advocated for her mother while others pushed for hospice. At this time, mom was still trying, still accepting pureed foods being fed to her spoonful by spoonful. “You must really love me,” her mother would say as Nancy patiently fed her.
Nancy also recognized the signs her nursing training had taught her to see: the recurring pneumonia, cardiac issues, edema, and failing systems. The question became not whether her
mother was dying—she was—but whether continued aggressive intervention was helping or hindering her natural transition.
“We only get to be here for so long, we can’t stay here forever,” Nancy would remind her mother.
Her mother’s response revealed her quiet defiance: “I don’t think I’m ever going to die.” She imagined herself waiting for her own version of the “Rapture”—struggling to fully grasp death as a necessary step in her sacred journey.
“Mom, we all have our own rapture, in our own time,” Nancy would gently reply. The Catholic Framework for End-of-Life Discernment The Catholic approach to these decisions centers on several key principles:
- Ordinary vs. Extraordinary Care: Catholics are obligated to provide ordinary care (food, water, basic medical treatment) but not extraordinary care that offers little hope of benefit or imposes excessive burden.
- Quality vs. Quantity: The focus shifts from merely prolonging life to ensuring dignity, comfort, and spiritual preparation for the transition to eternal life.
- Divine Providence: Recognizing that God’s timing may be different from our own, and that accepting death can be an act of faith rather than surrender.
- Proportionate Care: Weighing the benefits of treatment against its burdens, considering the person’s overall condition and prognosis.
When the Call Becomes Clear
Nancy’s final decision came when her mother experienced another aspiration event after briefly returning to her Catholic assisted living facility. Her mother wanted to be there—surrounded by familiar faith practices and friends—but Nancy recognized the signs more clearly.
“At that point, I’m like, no, you know this. You’ve given it your all,” she recalls.
The transition to hospice wasn’t giving up—it was recognizing that God was calling her mother home and that she had fulfilled all this medical and spiritual work.
In her mother’s final days, their shared faith practices took on new meaning. They prayed the rosary together, recited the Divine Mercy chaplet, and maintained their nightly prayer routine for family members—a practice inspired by a prayer Matt had shared: “May the light of Christ be on
this person, that they see themselves the way God our Father sees them, and that we see them the way God our Father sees them.”
“We’d pray for family and friends wherever there was difficulty,” Nancy recalls. “Then we’d add other intentions, plus the St. Michael prayer, the Magnificat, and the Memorare.”
The Role of Faith, Family, and Struggle
Nancy’s journey was complicated by family disagreements over care and spiritual decisions. As the designated healthcare agent—a responsibility her mother entrusted to her—Nancy carried the weight of making difficult decisions, allowing the activation of the Health Care POA in the hospital, balancing her professional knowledge with love, faith, and the realities of family dynamics.
Sacred Heart Devotion and Spiritual Comfort
Nancy’s mother had a lifelong devotion to the Sacred Heart of Jesus. She saved every image she received, filled shoeboxes with them, and had her room enthroned to the Sacred Heart in her final months.
“She wouldn’t throw away a single Sacred Heart image,” Nancy shares. “Her faith stayed at the center of her life, even when her body was failing.” Her pastor came to the hospital to give her the Sacrament of the Sick and the Apostolic Pardon.
Finding Peace in the Decision
When her mother took her last breath, Nancy felt profound confirmation they had made the right choices.
“I felt God’s hands on my shoulders,” she remembers. “I know we were doing the right thing, but I’m still battling in my nurse brain.”
This tension—between professional training to preserve life and faith-based acceptance of God’s will—is one many Catholic healthcare workers face. Nancy’s experience, guided by the Catholic principles reinforced through MyCatholicDoctor, demonstrates that the question isn’t simply when to stop fighting, but when to recognize that the fight has become an interference with God’s call.
The Ongoing Journey
Even after her mother’s peaceful death, Nancy continues to wrestle with these questions—not from doubt, but from the depth of Catholic teaching that honors both life and death as part of God’s plan.
“I know she’s at peace now,” Nancy says of her mother. “And I know she’s still praying for everyone.”
Through her journey, Nancy learned that the most profound act of love isn’t fighting to keep someone here—it’s helping them prepare, body and soul, for their journey home to God.
She hopes that others who find themselves in similar situations can take comfort in knowing that faithful, ethically sound care is possible—and deeply supported by Catholic teaching. She encourages readers to explore resources from Matt Estrade and MyCatholicDoctor, and to seek additional clarity and confidence through the faithful moral guidance provided by Father Tad Pacholczyk and the National Catholic Bioethics Center.
