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The Rev. Paul Schenck asked the room of St. Joseph Parish members an odd question.

"Has anyone in the room died?" he asked on Sunday. No one raised their hands, and a few chuckled.

Although the Catholic faith does give a sense of certainty about what happens after death, no one truly knows what death will be like for them, Schenck said.

That's why it's necessary to talk about death before it happens, said Dr. Chris Echterling, who organized the end-of-life forum — the fourth in a series at the Springettsbury Township church.

Talk about it: After a screening of "Consider the Conversation," a documentary on the subject, about 30 people discussed the taboo subject of death and how to honor the health care wishes of patients with life-limiting illnesses.

Advance directives are legal documents that outline these wishes. Pennsylvania recognizes two types: living wills and durable powers of attorney for health care.

A living will describes a patient's desired treatment if he or she cannot communicate it, and the latter involves appointing another person to make treatment decisions in the same case.

End-of-life wishes should be part of an ongoing conversation, and documents should change along with one's life situation, said Michael Scheib, an attorney who practices in Springettsbury Township.

"You probably have to have (the talk) more than one time," he said.

Patient involvement: The goal is to actually have the conversation — not to simply fill out a form, which is just the record of having the conversation, said Echterling, a WellSpan Health doctor who practices family medicine.

He said he hopes to inspire other churches to hold similar forums and continue to spur these conversations in the community.

It's difficult, though, to get patients and their families to discuss end-of-life options, said Dr. Nick Spagnola of Stewartstown Family Practice.

"They don't understand that every one of us is going away," he said. "We're all gonna die."

Spagnola, 61, of Windsor Township said he's been through the death process with eight family members.

"It is a very difficult discussion to have," he said.

Doctors are taught to fight illness, but many don't get their patients involved in the process, said Dr. Dominic Glorioso of York Palliative Care Specialists.

"We're treating the disease and not the patient, and that has to change," he said.

Human value: Richard Weber, a retired attorney, said he came to the forum to brush up on church teaching — in the late '90s, it was a little more liberal.

Families could never cover all of the possible scenarios of death, so it's important to appoint a good agent — just one — who shares the same values, he said.

"I don't care if you have 10 kids — you pick one," said Weber, 61, of Dallastown.

Catholic teaching is to value all human life and never intend, hasten or introduce death, said Schenck, a certified Catholic health care ethicist.

As a chaplain at York Hospital for 10 years, the Rev. Fred Nkwasibwe said he too often sees families deem a life not worth keeping because of economic reasons.

This influence can often push doctors to the wall as they're challenged by different values and world views, he said.

Even in a state of suffering or missing parts of our physical selves, "We are full, total human beings," Nkwasibwe said.

Visit fivewishes.org and seniors.sharpaccess.com for end-of-life resources.

— Reach Mollie Durkin at mdurkin@yorkdispatch.com.

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