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On Call

Living Each Stage of Life to the Full

It has been a blessing to practice medicine for 30 years. I have viewed it as more than a job. I see it as a vocation, with gifts and talents granted to me by God that I need to share with others. Imagine what an honor it is to journey with individuals at all stages of life: childhood, adolescence, adulthood and the senior years. 

I have been there for many patients who were experiencing the gift of health, and were just checking in for their yearly exam. I have been there for patients during their aches, pains and battles with the flu. I have provided care for individuals facing chronic illness, whether diabetes, congestive heart failure or chronic obstructive pulmonary disease (COPD), just to name a few. Lastly, I have provided care for those who were in the process of dying. Those moments required my medical training and experience, as well as a compassionate and attentive ear to help them through the challenges they faced. 

One of the great advances I’ve seen in my over 30 years in medicine have been developments made in the field of palliative care. Advances in pain and disease management provide individuals who suffer from chronic illnesses with life-changing relief – and hope. Good palliative care takes into account a patient's life goals and provides the care he or she needs so that they can live life to the fullest, regardless of health challenges. Despite the advances in palliative care, many still operate under the misconception that palliative care equates to hospice, which is only one aspect of palliative care. 

Good palliative care means good stewardship of life which avoids opposite extremes — the deliberate hastening of death on one hand, or the overzealous use of treatment on the other. Proper and strong palliative care guards against physician-assisted suicide. Seven states, including Vermont and the District of Columbia, have legalized physician-assisted suicide and New Hampshire legislators recently considered following suit. We must make clear what our citizens need is good palliative care (including proper pain management), and not physician-assisted suicide.

Throughout the Ethical and Religious Directives for Catholic Healthcare Services (or ERDs), we see the important teachings of palliative care. According to the ERDs, “…medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person’s life so long as the intent is not to hasten death.” This is in sharp contrast to physician-assisted suicide, which provides medication not to suppress pain but to cause death. In physician-assisted suicide, the nature of the act is lethal by design, whereas in palliative care the nature of the act is therapeutic by design. Thus, CMC promotes good palliative care by creating a space to protect life from being intentionally taken away.

But palliative care isn’t always about discussions over life or death. It’s about enhancing the quality of life for people suffering from chronic conditions. Individuals with chronic illnesses can live for many years, and palliative care can help patients make the most of those years. At Catholic Medical Center, our pain management and palliative care programs are rooted in our Catholic tradition and CMC’s motto to provide care with compassion and excellence. Our palliative care team includes a physician, nurse practitioner and licensed social worker. They work as a team to serve our patients with compassion, dignity and respect. 

Dr. Joseph Pepe is the president and CEO of CMC Healthcare System: Catholic Medical Center, New England Heart & Vascular Institute, and several subsidiaries. He and his wife reside in Manchester.