Transcript The Vatican’s “Charter for Health Care Workers”

The Perspective of the Theology of
Suffering
in the Vatican’s “Charter for Health Care Workers”
<www.ewtn.com/library/CURIA/PCPAHEAL.HTM>
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Varying
Perspectives
on Suffering
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<http://jppr.psychiatryonline.org/cgi/reprint/10/3/187>
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Putting Suffering Into Perspective
• “The meaning of pain defines suffering. An athlete may expect and
even embrace pain during a game but may suffer if his injury
disables him or causes his team to lose. A person who is injured
intentionally and ignored is likely to suffer more than one who is
hurt accidentally and treated with care….
• “The task of putting profound suffering into perspective can
require grappling with larger questions. For example, serious
physical illness often prompts individuals to reassess what gives
their lives significance. Survivors of childhood sexual abuse may
need to rebuild their shattered assumptive worlds so as to achieve
a new take on themselves, on their hopes, and on reality….
• “in recent years mental health professionals have increasingly
recognized the clinical relevance of spirituality…. However,
relatively little attention has been directed to the implications of
different belief systems embraced by patients for accomplishing
basic psychotherapeutic tasks such as integrating suffering.”
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Putting Suffering Into Perspective
The Relationship Between Suffering & World View
• “A person’s world view helps to shape the meaning of her
painful experience.
• “An individual who trusts in God as a protector of good
people may feel cheated, if not punished, by a dx of cancer.
• “A believer with a different understanding of God may
wonder if the same illness is intended to discipline him or
bring him closer.
• “Cancer may remind a Buddhist of the need to transcend
desire & attachment,
• “an atheist of his most important accomplishments or
values.
• “suffering can also influence one’s world view….In a survey
of 350 members of the American Association for the
Advancement of Atheism, they found that ½ of the younger
atheists had lost one or both parents before the age of 20. A
large # of this group also described themselves as unhappy
in childhood & adolescence.”
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Putting Suffering Into Perspective
The Therapist’s Role
• “Jews can find in the Psalms & in the story of Job precedent for the
sufferer to call out to and question God.
• “Christians can also see in Christ’s suffering evidence that God cares
about their suffering because he has taken it on himself—thus
dignifying suffering on behalf of others.
• “Buddhists find in the dharma support for detaching from the desire
that leads to suffering.
• “Atheists faced with suffering may instead take pride in their own
integrity, intellectual honesty, or stoicism….
• “Individuals with a spiritual or theistic world view often feel that
someone cares about their pain and that they are not ultimately
alone. However,
• they may also be struggling with the concept that a God who is
powerful enough to have spared them illness did not choose to do
so….
• “Clinicians will usually find that believing patients (like nonbelievers)
…most often want a chance to be heard & to talk about their
concerns….They may also need to reflect on, & to think through, their
own beliefs & doubts. The account by the Christian apologist C. S.
Lewis of his experience of his wife’s death, A Grief Observed, is a
compelling description of this process….
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Putting Suffering Into Perspective
The Therapist’s Role
• “Individuals with a naturalistic or atheistic world view consciously reject a
purposeful explanation for the universe….they may feel ultimately alone
and anxious in bearing pain….they see illness as no one’s fault, except
perhaps their own through mistakes they made in bringing it on or failing
to detect it in its early forms. Instead, they often struggle to achieve a
kind of Eriksonian integrity, or ability to live and die consistent with who
they are….
• “Suffering makes many patients realize that they are uncertain or
ambivalent about their philosophy of life. They may consider themselves
as ‘lapsed’ churchgoers or skeptics who have rejected organized religion
but retained a strong sense of personal spirituality.
• A number of challenges face clinicians in attempting to help agnostic
patients clarify their beliefs about what matters most, think through their
questions, and consolidate their values so as to live in accord with their
deepest commitments….
• “Perhaps the most difficult challenge is presented by those agnostic
patients (often character-disordered, with narcissistic traits or substance
abuse) who lack both a framework of meaning and the insight that they
need direction. The psychologist and philosopher Søren Kierkegaard would
have diagnosed them with ‘the sickness unto death,’ or ‘the despair that
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does not know it is in despair’….
Suffering from a Hindu Perspective
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Suffering from a Hindu Perspective
• Hinduism encourages “ a resigned attitude based
upon the belief that there is nothing much one can do
about what happened in the past or what is
happening now & what is going to happen in the
immediate future….
• [It] “provides an opportunity to every individual to
shape his future & he is inclined spiritually, to liberate
himself from the world of births & deaths….
• “True liberation comes when one achieves self
realization and becomes free from the cycle of births
and deaths.”
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Suffering from a Buddhist Perspective
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Suffering from a Buddhist Perspective
“’….The essence of life is suffering, said the Buddha. At first glance this seems exceedingly morbid
and pessimistic….Take any moment when you feel really fulfilled and examine it closely. Down
under the joy, you will find that subtle, all-pervasive undercurrent of tension, that no matter how
great this moment is, it is going to end. No matter how much you just gained, you are either
going to lose some of it or spend the rest of your days guarding what you have got and scheming
how to get more. And in the end, you are going to die. In the end, you lose everything. It is all
transitory.’ Henepola Gunaratana, from 'Mindfulness in Plain English'.
“The reason that we experience suffering comes ultimately from our mind. According to
Buddhism, our main mental problems or root delusions are: attachment, anger and
ignorance. Because of these delusions, we engage in actions that cause problems to
ourselves and others. With every negative action (karma) we do, we create a
potential for negative experiences….If we can control our body and mind in a way
that we help others instead of doing them harm, and generating wisdom in our own
mind, we can end our suffering and problems.
“The Buddha summarised the correct attitude and actions in the Eight-fold Noble Path:
(The first 3 are avoiding the 10 non-virtues of mind, speech and body:)
Correct thought: avoiding covetousness, the wish to harm others and wrong views (like thinking: actions
have no consequences, I never have any problems, there are no ways to end suffering etc.)
Correct speech: avoid lying, divisive and harsh speech and idle gossip.
Correct actions: avoid killing, stealing and sexual misconduct
Correct livelihood: try to make a living with the above attitude of thought, speech and actions.
Correct understanding: developing genuine wisdom.
(The last three aspects refer mainly to the practice of meditation:)
Correct effort: after the first real step we need joyful perseverance to continue.
Correct mindfulness: try to be aware of the ‘here and now’, instead of dreaming in the ‘there and then’.
Correct concentration: to keep a steady, calm and attentive state of mind.”
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Suffering from the Perspectiveof
Confucianism
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Suffering from the Perspectiveof
Confucianism
• “In all the greatest cultures of the world, there have been prominent
teachers, leaders and reformers who are still honoured and revered to
this day. From amongst those of the Chinese tradition, one man stands
foremost, and that is Confucius, the great sage, teacher & reformer….
• “In his teaching he emphasised righteousness - correct behaviour
based on duty, which in turn is based on one's situation in
society….Confucius was the rare combination of an idealist and
practical business man….
• “earthly minded, [He] never acknowledged a personal God. Confucius
was neither interested in where man came from or where his soul
departed to after death.
• “Of himself he said, ‘I have striven to become a man of perfect virtue
and to teach others without weariness,’ His ideal was ‘the superior
man carrying out in his conduct what he professes’….
• “Since the death of Confucius, a whole school of philosophy has
developed from his teachings, and his fame and reputation have
spread throughout the world. To some he was a God, to others a
remarkable administrator, a great reformer, the first teacher or the
supreme teacher.“
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Suffering from an Islamic Perspective
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Suffering from an Islamic Perspective
• “our present life, with all its joys and sufferings, is merely transitory & illusionary….
Death may be the ultimate human suffering in this world, but it is certainly not the
end of life….the 2nd phase of human life is reflective of how we conduct ourselves in
the first phase of life. The joys as well as the sufferings shall continue in the life
Hereafter….
• “Islam acknowledges that life is full of suffering, starting as early as the very process
of human conception in a mother's womb and during the process of childbirth…..
• ….the disasters that are caused by natural laws are no reflection of the Creator's cruelty
over humans. According to the Holy Quran, the study of natural phenomenon makes us
understand that, despite the devastation suffered by some humans, God's Mercy (rahmah)
is the most overwhelming attribute in Nature that creates, maintains and evolves all forms
of life including human life.
• “there are the man-made infliction that cause other humans to suffer….causing suffering,
pain and death to others through the misuse and abuse of one's free will, humans remain
responsible to God, & not God to humans….to establish, a JUST society is one of the most
important obligations taught by Islam. Those who may escape the corporal punishment in
this world, for them God's punishment shall be waiting in the life to come…..
• “there are acts of ‘self-inflicted suffering’:….The Holy Quran prohibits inflicting selfinjuries, specifically committing of suicide….
•
“it does not matter how much a person suffers in this world, as long as he or
she is engaged, according to his or her capacity, in repelling the evil and doing the
good works. The joys and comforts of the life yet to come are far greater,
unparalleled and everlasting as compared with human sufferings of this life!….for
us Muslims and all others, the important thing should be is to learn how to handle
human sufferings retaining full faith in a loving God!”
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Suffering from a Jewish Perspective?
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“I believe in God. But I do not believe
the same things about Him that I did
years ago, when I was growing up or
when I was a theological student.”
“I recognize His limitations. He is limited in
what He can do by laws of nature and by
the evolution of human nature and
human moral freedom.”
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"We could bear nearly any pain or
disappointment if we thought there was a
reason behind it, a purpose, to it. But even
a lesser burden becomes too much for us if
we feel it makes no sense….
“Let me suggest that the bad things that happen to us in
our lives do not have a meaning when they happen to
us. They do not happen for any good reason which
would cause us to accept them willingly. But we can
give them a meaning. “
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Not Very Satisfying!
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(from
Peter
Kreeft’s
web
site)
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Reasons to Believe:
First Cause Argument
Four of Aquinas' 5 proofs are
variations. Whether it be
• motion,
• the beginning of existence;
• present existence or
• goodness/value,
everything needs an explanation.
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Reasons to Believe:
Argument from Design
• Monkeys could have banged out
the greatest musical
masterpieces. Common sense
instead points us to great
composers.
• The existence of the universe
points to a creator.
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Reasons to Believe:
Argument from Desire
"Creatures are not born with
desires unless satisfaction for
these desires exists.... If I find
in myself a desire which no
experience in this world can
satisfy, the most probable
explanation is that I was made
for another world" (C.S. Lewis)26
Reasons to Believe:
Pascal’s Wager
• If you've got everything
to gain and nothing to
lose, why not believe?
• If there is a God, don't
we want to give Him His
due?
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Reasons to Believe:
Arguments from History
Similar to the argument from design, we could argue
• 1st, that humanity's story is meaningful.
• 2nd, that God's justice is revealed in this story.
• 3rd, that various "coincidences" testify to
Providence,
• as do miracles (which is 4th).
• 5th, that honest examination of evidence forces
the question of Christ's identity:
• Lord, lunatic, or liar?
• 6th , that if not God, what causes martyrs' joy?
• 7th, that if not for God, how would Christianity
have been so successful at winning converts?
• 8th, what happens when you pray the prayer of the
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sceptic?
Reasons to Believe:
Argument from Conscience
Some basic beliefs about
right & wrong enjoy
universal agreement. Who
but God gives the inner
"still, small voice" telling us
to do good?
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John Haas,
Ph.D., STL
President of
the National
Catholic
Bioethics
Center
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Some Very, Very Basic Beliefs about Right &
Wrong Enjoy Universal Agreement
Dr. John haas notes that
"the ancient Babylonian code,
the Code of Hammurabi, [and] ....
other ancient pagan religions,...
have rules against adultery, murder, theft, & bearing false witness."
Because there truly are objective moral standards, Dr. Haas says we can
"dialog with other peoples who may not share our...religious beliefs....
basic moral teachings ...apply to everybody....
we all share the same human nature."
Traditionally, this has been called the “Natural Law” or “Natural Moral Law.”
In his letter to the Romans, the Apostle Paul said the "demands of the law are
written in their hearts."
The "Natural Law" or "Natural Moral Law" is concerned with universal &
unchanging principles of morality. Who but God gives the inner "still, small voice"
telling us to do good?
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So,
What is this “Natural Law” (aka,
“Natural Moral Law”?
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Norms of Christian Decision Making in Bioethics are consistent with the "Natural Law," that applies to all:
"NATURAL LAW"
is not the same as the
(prescriptive)
the road map to true human happiness
"LAWS OF NATURE"
(descriptive)
("...demands of the law are written in their hearts..." (Romans 2: 15))
"Natural Law“ (prescriptive) is also not the same as the
"Might is Right"
nor "Morals Are Mores"
nor "Right Is What Brings Pleasure"
nor "Right is the Greatest Good
for the Greatest Number"
(Utilitarianism)
First Principle of Morality:
Choose the goods which will promote the true good of humanity
(Do not impede, damage, or destroy a "Basic Human Good.")
("God looked at everything he had made, & He found it very good." (Genesis 1:31))
l
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l
l
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l
l
We always choose "goods;"
we are concerned with how
we choose.
Arguments about how
to choose BHGs
get confused.
Life,
Knowledge,
Skillful performance/
aesthetic appreciation
Integrity
Authenticity,
Friendship,
Religion, &
Marriage.
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According to authors/Dominican priests
Benedict Ashley & Kevin O'Rourke,
"Christian ethics might be
specified by the priority it gives
to certain values....St. Paul,
summarized these Christian
priorities as
faith,
hope, and
love (Rm 13)....
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Norms of Christian Decision-Making
in Bioethics
Norms of Christian Faith & Prudence
Principle of Well-Formed Conscience
Principle of Free and Informed Consent
Principle of Moral Discrimination
Principle of Double Effect
Principle of Legitimate Cooperation
Principle of Professional Communication
Norms of Christian Love
Principle of Human Dignity in Community
Principle of Participation (aka, subsidiarity)
Principle of Totality & Integrity
Norms of Christian Hope
Principle of Stewardship and Creativity
Principle of Inner Freedom
Principle of Personalized Sexuality
(aka, The Principle of Family-Oriented Sexuality)
Principle of Growth through Suffering
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NORMS OF CHRISTIAN FAITH &
PRUDENCE (6)
• Principle of Well-Formed Conscience
Good, decent, well intentioned people
can “follow their conscience” and
still be objectively wrong. In any
ethical decision-making, I have the
responsibility to “step to the plate”
equipped with facts, as well as a
conscience well-formed by the
relevant ethical principles.
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NORMS OF CHRISTIAN FAITH &
PRUDENCE (6)
•Principle of Free & Informed Consent
This principle is sometimes
misinterpreted as meaning that
my health care provider is morally
free to perform any procedure
which is agreed-to by the patient.
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NORMS OF CHRISTIAN FAITH &
PRUDENCE (6)
• Principle of Moral Discrimination
According to the Natural Law’s “First Principal of Morality,”
I should always make my moral choices in a manner
which will promote “Integral Human Fulfillment,” the
true good of humanity (This should NOT be confused with
other types of moral decision-making, such as the notions of
"Might is Right," "Morals are Cultural Mores," "Right Is
What Brings Pleasure" or "Right is the Greatest Good for the
Greatest Number" (aka, Utilitarianism)). In making
choices, I should NEVER impede, damage or destroy a
“basic human good” (i.e., Human Life, Knowledge, Skillful
performance/aesthetic appreciation, Integrity, Authenticity,
Friendship, Religion, & Marriage.). Along the lines of this
principle, provision of nutrition/hydration (even if via an
“artificial” means) would ordinarily constitute obligatory
“care,” rather than “treatment” (which MAY not always be
obligatory).
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NORMS OF CHRISTIAN FAITH &
PRUDENCE (6)
• Principle of Double Effect
In a situation where I am choosing a good action,
but in which my action will have both good &
bad effects, my intention must be the good
effects and the avoidance of the bad effects.
The anticipated good effects must outweigh
or at least equal the bad effects; the
anticipated good effects must NOT be
products of the bad effects. My action must
produce those good effects at least as
immediately as the bad. This principle would
absolutely NOT justify doing an inherently
bad action, so that good may come of it.
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NORMS OF CHRISTIAN FAITH &
PRUDENCE (6)
• Principle of Legitimate Cooperation
This principle concerns “cooperation” with the immoral act of another person.
It is really an extension of Double Effect.
To “formally cooperate” in an immoral act means to assist without moral
reservation; formal cooperation is always wrong.
Any other type of cooperation with the immoral act of another is called “material
cooperation.” If my material cooperation with the immoral act is “immediate”
(i.e., if I am “an instrumental agent of the principal agent”), it is also always
wrong.
When my my material cooperation is not immediate, it is called “mediate.” If my
mediate, material cooperation with the immoral act is “remote” (rather than
“proximate”), it may be acceptable – “depending on the degree of the good to be
achieved or evil avoided by the cooperation" (Ashley & O’Rourke, pp.193 - 199).
Even with remote, mediate material cooperation, I should consider the d danger
of scandal that my cooperation may entail.
Formal Cooperation
(always wrong)
v.
Material Cooperation
immediate
v.
mediate
(always wrong)
proximate v. remote
Making a referral for a morally excluded service would be an example of formal
cooperation or immediate, material cooperation in the immoral act of another.
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NORMS OF CHRISTIAN FAITH &
PRUDENCE (6)
• Principle of Professional Communication
This principle entails trust, and honest/
appropriate sharing of information:
“For the Christian ...confidentiality is not
only professional; it expresses respect for
the dignity of the human person, whom
only God has a right to judge (Mt 7:1-5)"
(Ashley & O’Rourke, pp. 199, 200). This
principle would NOT necessarily
exclude sharing information with the
Center for Disease Control.
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NORMS OF CHRISTIAN LOVE (3)
• Principle of Human Dignity in Community
According to the Natural Law’s “First
Principal of Morality,” I should always
make my moral choices in a manner
which will promote “Integral Human
Fulfillment,” the true good of humanity In
making choices, I should NEVER impede,
damage or destroy a “basic human good”
(i.e., Human Life, Knowledge, Skillful
performance/aesthetic appreciation, Integrity,
Authenticity, Friendship, Religion, &
Marriage.).
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NORMS OF CHRISTIAN LOVE (3)
• Principle of Participation (aka,
subsidiarity)
This principle seems best understood with
an illustrative example: The family is the
basic unit of society. The government
would be wrong to interfere in a parent's
relationship with her/his child, other
than for very serious reasons, such as the
abuse of the child.
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NORMS OF CHRISTIAN LOVE (3)
• Principle of Totality & Integrity
“Everyday clinical practice generally accepts a limited form of disposing of the body
and certain mental functions in order to preserve life, as for example in the case of
the amputation of limbs or the removal of organs. Such practice is permitted by
the principle of totality and integrity (also known as the therapeutic principle).
The meaning of this principle is that the human person develops, cares for, and
preserves all his physical and mental functions in such a way that
(1) lower functions are never sacrificed except for the better functioning of the total
person, & even then with an effort to compensate for what is being sacrificed; &
(2) the fundamental faculties which essentially belong to being human are never
sacrificed, except when necessary to save life….
“For the application of the principle of totality & integrity, the following conditions
must be met:
(1) there must be a question of an intervention in the part of the body that is either
affected or is the direct cause of the life-threatening situation;
(2) there can be no other alternatives for preserving life;
(3) there is a proportionate chance of success in comparison with drawbacks; &
(4) the patient must give assent to the intervention”
<www.vatican.va/roman_curia/congregations/cfaith/cti_documents/rc_con_cfa
ith_doc_20040723_communion-stewardship_en.html>
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NORMS OF CHRISTIAN HOPE (4)
•Principle of Stewardship & Creativity
While Genesis teaches that humans
were given dominion over God's
creation, we are to have the
mentality of a creative steward.
We are NOT free to thoughtlessly
use worldly resources.
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NORMS OF CHRISTIAN HOPE (4)
•Principle of Inner Freedom
Obsessions we experience are
not simply crosses to bear
passively. We have moral
responsibility to seek treatment
for an obsession.
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NORMS OF CHRISTIAN HOPE (4)
•Principle of Personalized
Sexuality (aka, FamilyOriented Sexuality)
Sexual acts have "unitive" & "procreative"
dimensions.
Reserved for marriage, they unite a couple.
Each act is to be open to the transmission of
new life.
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NORMS OF CHRISTIAN HOPE (4)
•Principle of Growth through Suffering
For the Christian, pain is a sharing in
Christ's own suffering and a uniting
with Him in His redemptive sacrifice,
offered in obedience to His father.
This does NOT mean that all
suffering/pain must be accepted, &
that all efforts to alleviate
suffering/pain should be foregone.
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and
www.youtube.com/watch?v=rrHIS9gi1UQ
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SALVIFICI DOLORIS
- ON THE CHRISTIAN MEANING
OF HUMAN SUFFERING
Encyclical letter of Pope John Paul II
INTRODUCTION
"'In my flesh I complete what is lacking in Christ's afflictions
for the sake of his body, that is, the Church'....
"Now I rejoice in my sufferings for your sake"
....the Redemption was accomplished through the Cross of Christ, that
is, through his suffering.....
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The World of Human Suffering….
“Sacred Scripture is a great book about suffering....above all moral suffering:
danger of death...
death of one's own children...especially...the firstborn & only son...
the lack of offspring...
nostalgia for the homeland...
Persecution & hostility of the environment...
mockery & scorn of the one who suffers...
loneliness and abandonment...
the remorse of conscience...
difficulty of understanding why the wicked prosper & the just suffer...
unfaithfulness and ingratitude...
misfortunes of one's own nation.....
“the reality of suffering prompts the question about the essence of evil:
what is evil?....
“The Christian response...is different...[from] traditions which hold that existence is
an evil from which one needs to be liberated. Christianity proclaims the essential
good of existence & the good of that which exists, acknowledges the goodness of
the Creator & proclaims the good of creatures.
“Man suffers on account of evil, which is a certain lack, limitation or distortion of
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good.....
The Quest for an Answer to the
Question of the Meaning of Suffering
"pain, especially physical pain, is widespread in the animal
world....But only the suffering human being knows that
he is suffering & wonders why….
“whereas the existence of the world opens...the eyes of the
human soul to the existence of God, to his wisdom,
power & greatness, evil & suffering seem to obscure
this….
“it is not true that all suffering is a consequence of a fault
and has the nature of a punishment. The figure of the just
man Job is a special proof of this....
“The Book of Job is not the last word on this subject in
Revelation. In a certain way it is a foretelling of the
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Passion of Christ....
Jesus Christ
Suffering Conquered by Love
"For God so loved the world that he gave his only Son, that whoever believes in
him should not perish but have eternal life"
....the very essence of Christian soteriology, that is, of the theology of
salvation.....When one says that Christ by his mission strikes at evil at its
very roots, we have in mind not only evil & definitive, eschatological
suffering ..., but also - at least indirectly toil and suffering in their temporal and
historical dimension....
Though it is not licit to apply here the narrow criterion of direct dependance (as
Job's three friends did), it is equally true that one cannot reject the criterion
that, at the basis of human suffering, there is a complex involvement with
sin.....
As a result of Christ's salvific work, man exists on earth with the hope of eternal
life and holiness. And even though the victory over sin and death achieved
by Christ in his Cross and Resurrection does not abolish temporal suffering
from human life, nor free from suffering the whole historical dimension of
human existence, it nevertheless throws a new light upon this dimension and
upon every suffering: the light of salvation.....
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Jesus Christ
Suffering Conquered by Love
In his messianic activity in the midst of Israel, Christ drew increasingly closer to the
world of human suffering. "He went about doing good” (32), & his actions
concerned primarily those who were suffering and seeking help.
He healed the sick,
consoled the afflicted,
fed the hungry,
freed people from deafness,
from blindness,
from leprosy,
from the devil &
from various physical disabilities,
three times he restored the dead to life.....
at the heart of his teaching there are the eight beatitudes....
Christ severely reproves Peter when the latter wants to make him abandon the
thoughts of suffering & of death on the Cross...The Scriptures had to be fulfilled
.....Among all these, particularly touching is the.... Fourth Song of the Suffering
Servant, in the Book of Isaiah.....
....Christ suffers voluntarily and suffers innocently. With his suffering he accepts that
question which - posed by people many times - has been expressed, in a certain
sense, in a radical way by the Book of Job.
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Jesus Christ
Suffering Conquered by Love
Christ, however, not only carries with himself the same question..., but he
also carries the greatest possible answer.... And this is the final, definitive
word of this teaching: "the word of the Cross", as Saint Paul one day will
say....the prayer in Gethsemane becomes a definitive point here. The
words:
"My Father, if it be possible, let this cup pass from me; nevertheless, not
as I will, but as thou wilt",
and later:
"My Father, if this cannot pass unless I drink it, thy will be done"....
But precisely through this suffering he accomplishes the Redemption,
and can say as he breathes his last:
"It is finished"....
Human suffering has reached its culmination in the Passion of Christ.....
it has entered into a completely new dimension and a new order: it has been
linked to love....
The Cross of Christ has become a source from which flow rivers of living
water....
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Sharers in the Suffering of Christ
“....In the Cross of Christ not only is the Redemption accomplished through
suffering, but also human suffering itself has been redeemed.....each man, in his
suffering, can also become a sharer in the redemptive suffering of Christ....
“In the eyes of the just God, before his judgment, those who share in the
suffering of Christ become worthy of this Kingdom....Those who share in the
sufferings of Christ are also called, through their own sufferings, to share in
glory....
“Suffering is also an invitation to manifest the moral greatness of man, his
spiritual maturity.....not only in the martyrs for the faith but in many others
also who, at times, even without belief in Christ, suffer & give their lives for
the truth and for a just cause....The gospel paradox of weakness & strength
often speaks to us....In such a concept, to suffer means to become particularly
susceptible, particularly open to the working of the salvific powers of God, offered
to humanity in Christ.....
“'More than that, we rejoice in our sufferings, knowing that suffering produces
endurance, & endurance produces character, & character produces hope, &
hope does not disappoint us, because God's love has been poured into our
hearts through the Holy Spirit which has been given to us'
59
Sharers in the Suffering of Christ
“....Suffering as it were contains a special call to the virtue...of perseverance....
a dignity linked to awareness of the meaning of life. And indeed this
meaning makes itself known together with the working of God's love, which is
the supreme gift of the Holy Spirit.
“The more he shares in this love, man rediscovers himself more & more fully in
suffering: he rediscovers the 'soul' which he thought he had 'lost'...because
of suffering....
'Now I rejoice in my sufferings for your sake, & in my flesh I complete what is lacking
in Christ's afflictions for the sake of his body, that is, the Church‘….
“In this Body, Christ wishes to be united with every individual, and in a special
way he is united with those who suffer.....
“The sufferings of Christ created the good of the world's redemption. This good
in itself is inexhaustible &infinite. No man can add anything to it. But at the
same time, in the mystery of the Church as his Body, Christ has in a sense
opened his own redemptive suffering to all human suffering. In so far as
man becomes a sharer in Christ's sufferings....to that extent he in his own way
completes the suffering through which Christ accomplished the Redemption
of the world.
60
Sharers in the Suffering of Christ
“Does this mean that the Redemption achieved by Christ is not
complete? No. It only means that the Redemption,
accomplished through satisfactory love, remains always open to
all love expressed in human suffering. In this dimension - the
dimension of love - the Redemption which has already been
completely accomplished is, in a certain sense, constantly being
accomplished....
“this Redemption, even though it was completely achieved by
Christ's suffering, lives on and in its own special way develops
in the history of man. It lives and develops as the body of
Christ, the Church, and in this dimension every human
suffering, by reason of the loving union with Christ, completes
the suffering of Christ. It completes that suffering just as the
Church completes the redemptive work of Christ....
61
The Gospel of Suffering
“The witnesses of the Cross & Resurrection of Christ have handed
on to the Church & to mankind a specific Gospel of suffering
.....at the side of Christ, in the first and most exalted place, there
is always his Mother through the exemplary testimony that she
bears by her whole life to this particular Gospel of suffering.....
“Christ did not conceal from his listeners the need for suffering....
The way that leads to the Kingdom of heaven is 'hard &
narrow', and Christ contrasts it to the 'wide and easy' way that
'leads to destruction'....
“The Master does not conceal the prospect of suffering from his
disciples & followers….he reveals it with all frankness,
indicating…the supernatural assistance that will accompany
them in the midst of persecutions & tribulations 'for his name's
sake'. These persecutions & tribulations will also be, as it were,
a particular proof of likeness to Christ and union with him....
62
The Gospel of Suffering
“This first chapter of the Gospel of suffering, which speaks of
persecutions, namely of tribulations experienced because of
Christ, contains in itself a special call to courage & fortitude,
sustained by the eloquence of the Resurrection....
“Down through the centuries & generation it has been seen that
in suffering there is concealed a particular power that draws a person
interiorly close to Christ, a special grace....
“When this body is gravely ill, totally incapacitated, & the person
is almost incapable of living and acting, all the more do interior
maturity and spiritual greatness become evident, constituting a
touching lesson to those who are healthy and normal.
“This interior maturity & spiritual greatness in suffering are
certainly the result of a particular conversion and cooperation
with the grace of the Crucified Redeemer….
63
The Gospel of Suffering
“This is not all: the Divine Redeemer wishes to penetrate the soul
of every sufferer through the heart of his holy Mother, the first
and the most exalted of all the redeemed..... so that every form
of suffering, given fresh life by the power of this Cross, should
become no longer the weakness of man but the power of God....
“in general it can be said that almost always the individual enters
suffering with a typically human protest & with the question "why“
....he cannot help noticing that the one to whom he puts the
question is himself suffering and wishes to answer him from the
Cross, from the heart of his own suffering. Nevertheless,
it often takes time, even a long time, for this answer to begin to
be interiorly perceived.....
“Man hears Christ's saving answer as he himself gradually
becomes a sharer in the sufferings of Christ. The answer which
comes through this sharing…is in itself something more than the
mere abstract answer to the question about the meaning of
suffering. For it is above all a call. It is a vocation.....
64
The Gospel of Suffering
“Saint Paul speaks of such joy in the Letter to the
Colossians: 'I rejoice in my sufferings for your
sake'....
“It is suffering, more than anything else, which clears
the way for the grace which transforms human
souls....
“the Church sees in all Christ's suffering brothers &
sisters…a multiple subject of his supernatural power.
How often is it precisely to them that the pastors of
the Church appeal, and precisely from them that
they seek help and support! The Gospel of suffering
is being written unceasingly, &it speaks unceasingly
with the words of this strange paradox: the springs
of divine power gush forth precisely in the midst of
human weakness.....
65
The Good Samaritan
"The name 'Good Samaritan' fits every individual who is sensitive to the
sufferings of others, who "is moved" by the misfortune of another....
“the Good Samaritan of Christ's parable does not stop at sympathy and
compassion alone. They become for him an incentive to actions aimed at
bringing help to the injured man....
“a Good Samaritan is one who brings help in suffering, whatever its nature
may be. Help which is, as far as possible, effective. He puts his whole
heart into it, nor does he spare material means. We can say that he gives
himself, his very 'I', opening this 'I' to the other person. Here we touch
upon one of the key-points of all Christian anthropology. Man cannot
"fully find himself except through a sincere gift of himself"....A Good
Samaritan is the person capable of exactly such a gift of self....
“suffering...is also present in order to unleash love in the human person,
that unselfish gift of one's "I" on behalf of other people, especially those
who suffer.
“The world of human suffering unceasingly calls for, so to speak, another
world: the world of human love; and in a certain sense man owes to
suffering that unselfish love which stirs in his heart and actions.....
66
The Good Samaritan
"How much there is of "the Good Samaritan" in the profession of the doctor, or the
nurse, or others similar! Considering its "evangelical" content, we are inclined to
think here of a vocation rather than simply a profession….
”The family, the school &other education institutions must, if only for humanitarian
reasons, work perseveringly for the reawakening and refining of that sensitivity
towards one's neighbour and his suffering of which the figure of the Good
Samaritan in the Gospel has become a symbol. Obviously the Church must do
the same....
“The eloquence of the parable of the Good Samaritan, and of the whole Gospel, is
especially this: every individual must feel as if called personally to bear witness
to love in suffering....
“Christ's revelation of the salvific meaning of suffering is in no way identified with
an attitude of passivity. Completely the reverse is true.....
“this parable...will enter into those disturbing words of the Final Judgment, noted
by Matthew in his Gospel.... Christ said: 'You did it to me'. He himself is the one
who in each individual experiences love; he himself is the one who receives
help, when this is given to every suffering person without exception....At one &
the same time Christ has taught man to do good by his suffering & to do good to
those who suffer. In this double aspect he has completely revealed the meaning
67
of suffering.
Conclusion
"This is the meaning of suffering, which is truly
supernatural and at the same time human.
“It is supernatural because it is rooted in the
divine mystery of the Redemption of the world,
and
“it is likewise deeply human, because in it the
person discovers himself, his own humanity, his
own dignity, his own mission.
'Through Christ and in Christ, the riddles of
sorrow and death grow meaningful'
68
The Vatican’s
“Charter for Health
Care Workers”
Charter for Health Care Workers
69
Ministers of Life
• Scientific & professional expertise is not enough; personal empathy with the
concrete situations of each patient is required.
Health care is a type of Christian witness.
• The health care worker is a "good Samaritan."
• The health care worker is "a collaborator with God in restoring health to the sick body.
• Health care is a therapeutic ministry, sharing the Church's pastoral & evangelizing work.
• All health care workers should be taught morality and bioethics.
The Charter supports establishment of ethical committees in principal medical centers.
• Catholic or not, health care workers are absolutely obliged to be faithful to the
natural moral law which recognizes human dignity.
The Church provides specialized teaching, the bioethical magisterium, to provide guidance.
• The Charter is organized around the stages of human existence:
procreation, living, dying.
• The Bible indicates that only humans are made in God's image and likeness.
We are unique in the animal world.
Human procreation itself is rich with religious meaning.
Charter for Health Care Workers
70
Procreation
Charter for Health Care Workers
71
Fertility Control
• In conceiving & giving birth, spouses "cooperate" with God's work of
creation!
• There is an "indissoluble bond" between the "unitive" & "procreative"
meanings of sexual acts in marriage (Yet, few American Catholics seem
to accept this.).
• In terms of moral judgment, intentions and motives are insufficient.
People are encouraged to delve into a deeper understanding of human
persons & human acts.
• For serious reasons, spouses may utilize NFP (Natural Family Planning)
to gain knowledge of the woman's fertility & forego marital relations in
fertile times.
• Unlike with contraceptives, the use of NFP does not aim to close the
marital act off to the possibility of procreation. Health care workers are
encouraged provide information on natural family planning. The proabortion culture is especially strong, where this teaching on
contraception has been rejected.
72
Charter for Health Care Workers
Once upon a time, it went without saying that
childbearing went with sexual relations and
sexual relations went with marriage….
In the 20th Century,
it became popular
Wilhelm
to
try to divorce
Reich
sexual pleasure
from marriage and
procreation.
.
Hugh Heffner
.
73
The so-called Sexual Revolution
& Some of Its Generals
Hugh Heffner
Margaret Sanger
Wilhelm Reich
74
Hugh Heffner
 Hugh Heffner, founded Playboy Magazine in 1953:
“In the first issue, Playboy identified its philosophy as antimarriage….
“Playboy attacked women as gold-diggers who bartered sex
for a marriage license….
“When the Pill gave women the freedom to join men in their
sexual rebellion, cultural attitudes shifted radically. Junk
sex was no better than junk food, but millions of men
and women greedily devoured the empty calories….
“[Playboy] vulgarized what most men and women in their
deepest sentiments hold dear ….It turned courtship
away from the patient pleasures of a gourmet meal with
many courses and replaced it with a cheesy burger”
<www.jewishworldreview.com/cols/fields121503.asp>.
75
On Sept 21,
1957, Mike
Wallace
(of “60 Minutes” fame)
interviewed
Margaret
Sanger….
<www.hrc.utexas
.edu/multimedia
/video/2008/
wallace/sanger_
margaret.html>
76
Wilhelm Reich
 “At the end of the Second World War, Wilhelm Reich
introduced American readers to some of his earlier
writings under the title The Sexual Revolution
(1945)
 ….The truth, according to Reich, was that Western
civilization had made people sick by imposing on
them an unnatural, destructive sexual morality….
 even if we assume that in actual fact our ancestors
behaved very much as we do, one very important
difference remains: When they violated traditional
sexual standards, they usually suffered from guilt….
 we now decide for ourselves what sexual activity is
proper….there is nothing eternal or sacred about our
sexual morality” (Haeberle, The Sex Atlas, New
York: Continuum, 1983).
77
Incredible changes in a 1/2 century…
 In 1957, Time Magazine seemed to gush with the excitement of a
junior high student: “Some of the most hush-hush medical research has
been pursued in dozens of laboratories in the effort to find a contraceptive
pill”<www.time.com/time/magazine/article/0,9171,
809446,00.html?promoid=googlep>
 According to Planned Parenthood, the “pill” is now the most widely
used of various contraceptive methods
<www.guttmacher.org/pubs/fb_ contr_use.html> (Note: The “pill”
is known to work in an abortifacient manner.). In an age of increased
awareness about the foods we consume, people seem to be relatively
unconcerned about ingesting chemicals and placing foreign objects
on or in their bodies to "protect" themselves against their natural
fertility.
• While contraceptives are supposedly a panacea for "unwanted
pregnancies," the CDC reports that one of every three pregnancies
ends in an induced abortion <www.cdc.gov/nchs/releases>. 78
Incredible changes in a 1/2 century…
• There are now 56 times more new STD infections each
year, than there were overall STD infections in 1957:
As per the Centers for Disease Control, 340,687
cases of STDs were reported by state health
departments in 1957
<http://wonder.cdc.gov/wonder/STD/OSTD
3202/Table_1.html>.
Currently, “The CDC estimates that 19 million
new [STD] infections occur each year, almost
half of them among young people ages 15 to
24” <www.cdcnpin.org/scripts/std/std.asp>.
79
Incredible changes in a 1/2 century…
• In the past half century, the rate of forcible rape
of women has tripled:
In 1960, there were 17,190 forcible rapes of
women (9.6 per 100,000 people)
<www.disastercenter.com/crime/uscrim
e.htm>.
The FBI now reports 92,455 annual forcible
rapes of women (30.9 per 100,000 people)
<www.fbi.gov/ucr/cius2006/data/table_
01.html>.
80
Incredible changes in a 1/2 century…
• Over the past half century, Americans have become
less likely to marry. Of those fewer who do marry,
they are more likely to divorce:
In 1957, there was a marriage rate of 8.9 per 1000 people
<http://thecommunityguide.org/nchs/data/series/s
r_21/sr21_010acc.pdf> and a divorce rate of 2.2 per
1000 people
<www.divorcereform.org/03statab.html>.
Currently, there is a marriage rate of 7.4 per 1000 people
and a divorce rate of 3.6 per 1000 people
<www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_01.p
df>.
81
Pornography
"Son, you shouldn't watch that other channel. It's only for mommies & daddies who
love each other very much“ (Homer J. Simpson)
“U.S. porn revenue exceeds the combined revenues of ABC, CBS,
and NBC (6.2 billion). Porn revenue is larger than all combined
revenues of all professional football, baseball and basketball
franchises. The pornography industry, according to conservative
estimates, brings in $57 billion per year, of which the United States
is responsible for $12 billion.”
 “The Internet accounted for US $2.5 billion of

the adult industry’s revenues.”
 “Cable pay per view amounted to $2.5 billion.”
 “Magazines accounted for $7.5 billion.”
As reported in Bishop Robert Finn’s February 2007 pastoral letter, “Blessed Are The Pure In
82
Heart”<www.diocese-kcsj.org/Bishop-Finn/pastoral-07.htm>.
Pornography
"Son, you shouldn't watch that other channel. It's only for mommies & daddies who
love each other very much“ (Homer J. Simpson)
•“
•There are 100 thousand websites
offering illegal child pornography
(U.S. Customs Service estimate).”
•“Child Pornography generates $3
billion annually.”
As reported in Bishop Robert Finn’s February 2007 pastoral letter, “Blessed Are The Pure In
83
Heart”<www.diocese-kcsj.org/Bishop-Finn/pastoral-07.htm>.
Pornography
"Son, you shouldn't watch that other channel. It's only for mommies & daddies who
love each other very much“ (Homer J. Simpson)
•“70% of 18 to 24 year old men visit pornographic
sites in a typical month. 66% of men in their 20s
and 30s also report being regular users of
pornography.”
•“One out of three visitors to all adult web sites are
women.”
•“Eleven years old is the average age of first
Internet exposure to pornography.”
As reported in Bishop Robert Finn’s February 2007 pastoral letter, “Blessed Are The Pure In
84
Heart”<www.diocese-kcsj.org/Bishop-Finn/pastoral-07.htm>.
Somehow, the Idea that Pornography is
“Victimless” Seems to Remain Popular….
“Annually, according to U.S. Governmentsponsored research completed in 2006,
approximately 800,000 people are trafficked across
national borders, which does not include millions
trafficked within their own countries. Approximately
80 percent of transnational victims are women and
girls and up to 50 percent are minors. The majority
of transnational victims are females trafficked into
commercial sexual exploitation.”
from the U.S. State Department’s “Trafficking in Persons Report 2007”
<http://usinfo.state.gov/gi/global_issues/human_trafficking/traffick_report.html>.85
Has there been a benefit to marriage
itself from the
“Sexual Revolution”’s divorce of
sexual pleasure
from
marriage and procreation?
Was Wilhelm Reich correct, in that people had
been made sick by the imposition of such an
unnatural sexual morality?
86
What is Marriage? (Harvard
Journal of Law & Public Policy)
87
What is Marriage? (Harvard
Journal of Law & Public Policy)
88
“The State of Our Unions 2010”
•
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
•
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
•
89
“The State of Our Unions 2010”
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
90
“The State of Our Unions 2010”
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
91
“The State of Our Unions 2010”
•
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
•
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
•
92
“The State of Our Unions 2010”
•
The University of Virgina’s National
Marriage Project &
the Center for Marriage and
Families at the Institute for
American Values
•
<http://www.stateofourunions
.org/2010/SOOU2010.pdf>
•
93
“The State of Our Unions 2010”
•
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
•
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
•
94
“The State of Our Unions 2010”
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
95
“The State of Our Unions 2010”
•
The University of Virgina’s National Marriage Project & the Center for Marriage and Families at the Institute for American Values
•
<http://www.stateofourunions.org/2010/SOOU2010.pdf>
•
96
Review
Except for the marrying at 25+ part, isn’t this what
your great grandparents would have told – or
expected from - your grandparents?
•Be prepared & ready to properly support
your family!
•Check that your intended has a good
example of solid marriage from
her/his own family!
•Honor God always!
•Sexual intimacy is only for marriage!
97
•Couples who reject contraceptives
and adhere to methods of "Natural
Family Planning" enjoy phenomenal
success. In an era of an almost 50%
divorce rate, estimates are that only 0
- 4% of couples using NFP end up
divorced <www.ccl.org>.
98
In 2002, Mercedes Arzú Wilson presented fascinating sociological
evidence, concerning women who utilize NFP.
She found them to have…
“lower rates of…divorce (0.2%)….
“a high level of success in family life…,
as well as strong religious faith.
(“LINKAGE OF ARTIFICIAL BIRTH CONTROL TO SEXUAL PROMISCUITY,
ABORTION & DIVORCE”, <www.familyplanning.net/indexNFPSurvey.html>)
99
100
Genetic Manipulation
• Genetic therapy is not outright condemned. Certain
genetic therapies truly aim to cure illness, while
respecting human dignity. Genetic manipulations that
do not aim to directly cure illness are illicit.
• Moral evaluations must be enlightened by proper
perspective on the dignity of the beginning of human
life.
• Sexual acts are reserved for marriage & each sexual act
must be open to human life. Each new human being
has the absolute right to life, to this type of origin, and
to be born into a family with a mother and a father.
Charter for Health Care Workers
101
On
12/12/08,
the Vatican
released an
instruction,
focused on
human life
at its
origins –
“Dignitas
Personae.”
102
Dignitas Personae further discusses
gene therapy…
• "25....In theory, it is possible to use gene therapy on two
levels: somatic cell gene therapy and germ line cell
therapy.
• Somatic cell gene therapy seeks to eliminate or reduce
genetic defects on the level of somatic cells, that is, cells
other than the reproductive cells, but which make up
the tissue and organs of the body. It involves
procedures aimed at certain individual cells with effects
that are limited to a single person.
• Germ line cell therapy aims instead at correcting
genetic defects present in germ line cells with the
purpose of transmitting the therapeutic effects to the
offspring of the individual. Such methods of gene
therapy, whether somatic or germ line cell therapy, can
be undertaken on a fetus before his or her birth as gene
therapy in the uterus or after birth on a child or adult.”
103
Dignitas Personae further discusses
gene therapy…
• "26....Procedures used on somatic cells for strictly
therapeutic purposes are in principle morally licit....
• "Because the risks connected to any genetic manipulation
are considerable and as yet not fully controllable, in the
present state of research, it is not morally permissible to
act in a way that may cause possible harm to the resulting
progeny. In the hypothesis of gene therapy on the embryo,
it needs to be added that this only takes place in the
context of in vitro fertilization and thus runs up against all
the ethical objections to such procedures. For these
reasons, therefore, it must be stated that, in its current
state, germ line cell therapy in all its forms is morally
illicit.
104
Dignitas Personae further discusses
gene therapy…
• "27. The question of using genetic engineering for
purposes other than medical treatment also calls for
consideration....the prospect of such an intervention would
end sooner or later by harming the common good, by
favouring the will of some over the freedom of others.
Finally it must also be noted that in the attempt to create a
new type of human being one can recognize an ideological
element in which man tries to take the place of his
Creator....
"the Church also recalls the need to return to an attitude of
care for people and of education in accepting human life in
its concrete historical finite nature."
105
Artificial Procreation
• "Nature itself dictates that the transmission of human life be a personal & conscious act
and, as such, subject to the most holy laws of God: immutable & inviolable laws which
must be acknowledged & observed." "The dignity of the human person demands that it
come into being as a gift of God & as the fruit of the conjugal act."
• While there may be "sincere and intense" desire for children, this "does not legitimize
recourse to techniques which are contrary to the truth of human procreation & to the
dignity of the new human being.....the child has the right to be conceived only with full
respect for its personhood."
• While some artificial means can be used to aid the marital act, those which replace the
marital act must be rejected. Any artificial means to help unmarried people achieve
pregnancy are unacceptable.
• “Homologous artificial insemination" is not necessarily forbidden. The aim must be to aid
the marital act or help it reach its proper end. The husband's semen must be obtained
through a normal act of sexual intercourse.
• In homologous FIVET (Fertilization in vitro with embryo transfer), fertilization takes
place outside the wife's body. FIVET "is illicit because conception is not the result of a
conjugal act....the child is not born as a 'gift' of love, but as a laboratory 'product.'"
• There are further aggravating factors with FIVET:
• "numerous embryonal losses, which are procured abortions....[&
• possible] congealment, which means suspension of life, of the so-called 'spare'
embryos, & often even their destruction.
• Unacceptable is 'post mortem' insemination"
Charter for Health Care Workers
106
Artificial Procreation (continued)
• "Heterologous techniques" involve conception outside of marriage. Recourse to
gametes of people other than the spouses is contrary to the unity of marriage & the
fidelity of the spouses, & it harms the right of the child to be conceived & born in &
from a marriage....
• "A further reason for unlawfulness is the commercialization & eugenic selection of
the gametes."
• "Surrogate" motherhood is "contrary to the dignity of the woman, to the unity of
marriage & to the dignity of the procreation of a human"
• A child who has been conceived by illicit means is still made in God's image &
likeness.
• Down the road, we may see illicit efforts, such as
•
•
•
•
"fertilization between human & animal gametes...
gestation of human embryos in animal or artificial wombs...
sexless reproduction of human beings through twinning fission, cloning, parthenogenesis."
"Medicine directed to the integral good of the person cannot prescind from the ethical
principles governing human procreation"
Charter for Health Care Workers
107
Life
Charter for Health Care Workers
108
Beginning of Life & Birth
• There is new life at the moment that the ovum is
fertilized, even before implantation. With respect to
prenatal life, "health care workers owe it the same
respect, the same protection and the same care as that
given to a human person."
• "If, despite every effort, the life of the child is at
serious risk, health care workers should see to the
child's baptism....If an ordinary minister of the
sacrament is unavailable - a priest or a deacon - the
health care worker has the faculty to confer it."
Charter for Health Care Workers
109
The Vatican’s
10/31/000
“STATEMENT
ON THE SOCALLED
"MORNINGAFTER PILL"
110
The Vatican’s 10/31/000 “STATEMENT
ON THE SO-CALLED ’MORNINGAFTER PILL’"
• “a predominantly ‘anti-implantation’ function”
• “it can never be legitimate to decide arbitrarily that the human
individual has greater or lesser value…according to its stage of
development….
• “the proven ‘anti-implantation’ action of the morning-after pill is really
nothing other than a chemically induced abortion….
• “All who, whether sharing the intention or not, directly co-operate
with this procedure are also morally responsible for it.
• “we strongly urge everyone who works in this sector to make a firm
objection of moral conscience, which will bear courageous and
practical witness to the inalienable value of human life, especially in
view of the new hidden forms of aggression against the weakest and
most defenceless individuals, as is the case with a human embryo.”
111
Pope Benedict
XVI’s 10/29/07
address to the
International
Congress of
Catholic
Pharmacists
112
112
Pope Benedict XVI’s 10/29/07 address to the
International Congress of Catholic
Pharmacists
• “it is not possible to anaesthetize consciences, for example, concerning the
effects of particles whose purpose is to prevent an embryo's implantation or
to shorten a person's life. ”
• “In the moral domain, your Federation is invited to address the issue of
conscientious objection, which is a right your profession must recognize,
permitting you not to collaborate either directly or indirectly by supplying
products for the purpose of decisions that are clearly immoral such as, for
example, abortion or euthanasia.”
• “it is important that all Catholic health-care professionals and people of
good will join forces….
• “The biomedical sciences are at the service of the human being; if this were
not the case, they would have a cold and inhuman character. All scientific
knowledge in the health sector and every therapeutic procedure is at the
service of the sick person, viewed in his integral being, who must be an
active partner in his treatment and whose autonomy must be respected. ”
113
As
mentioned,
it was on
12/12/08 that
the Vatican
released an
instruction,
focused on
human life
at its origins
– Dignitas
Personae.
114
Dignitas Personae proclaims…
• human dignity from the first moment of
fertilization until natural death &
• the right of everyone to originate in the
loving embrace of a mom and dad, who are
wife and husband.
• each human being is owed uncompromising
respect, no matter how she came to be
• we must stand with the weak and powerless
against exploitation.
115
Dignitas Personae.
• Recent years have seen a vast increase in reports of
infertility and interest in reproductive technology.
• When employed by a husband and wife, Dignitas
Personae says assistance to AID the “marital act”
toward procreation can be moral.
• However, even when used by a husband and wife,
Dignitas Personae says that methods REPLACING
the marital act - such as IVF - are immoral.
• Exacerbating IVF’s immorality is the discarding or
freezing of “extra”, unwanted embryos.
• Dignitas Personae forbids using these new
humans as research material or implanting one in
the womb of a woman other than her mom. 116
Also recognized as immoral by
Dignitas Personae are…
• human cloning,
• the mixing of human with animal
genetic material (Yup, some “scientists”
are doing that!),
• germ line cell therapy,
• “genetic engineering for purposes other
than medical treatment” (# 27),
• research using illicitly obtained cell
117
lines.
Dignitas Personae is NOT to be
dismissed as a laundry list of
prohibitions.
•“Behind every ‘no’ in the difficult
task of discerning between good
and evil, there shines a great ‘yes’
to the recognition of the dignity
and inalienable value of every
single and unique human being
called into existence [# 37].
118
My own examples of “a great ‘yes’ to
the recognition of the dignity and
inalienable value of every single and
unique human being”:
• NaProTechnology
<www.fertilitycarefriends.org/>
strikes me as a “great yes” – a fabulous
alternative to the immorality of IVF, as
well as IVF’s incredible expense and
low "success" rate.
119
My own examples of “a great ‘yes’ to
the recognition of the dignity and
inalienable value of every single and
unique human being”:
• Another “great yes” is that stem cells can be
obtained in manners, which are not morally
objectionable! Obtaining stem cells from embryos
results in the death of the embryo. Despite the
research “science” presented to us by celebrities,
this is NEITHER the only way NOR the most
promising way to obtain stem cells. Stem cells
can be morally obtained from adults and
umbilical cord blood.
120
Dignitas Personae, Section 23
• This appears to require change at Catholic hospitals, regarding
treatment of women identified as victims of sexual assault.
• After trying to rule out pregnancy (&/or ovulation), so-called
"emergency contraception" (aka, "morning after pills") HAS
been allowed (Note: Some say it’s IMPOSSIBLE to ensure
"emergency contraception" is NOT abortifacient. In fact, the
FDA says that "If fertilization does occur, Plan B may prevent a
fertilized egg from attaching to the womb (implantation)“
<www.fda.gov/CDER/drug/infopage/planB/planBQandA.htm>).
• "Such methods are interceptive if they interfere with the
embryo before implantation & contragestative if they cause the
elimination of the embryo once implanted....the use of means of
interception & contragestation fall within the sin of abortion
and are gravely immoral."
• NO guidelines are offered for supposed "moral" use of a
potential interceptive or contragestative.
Treatment of an Ectopic Pregnancy
• Citing the principle of “double effect,” Catholic health care has
allowed the removal of a fallopian tube to save a mother’s life,
in the case of an ectopic pregnancy. This unintentionally
results in the death of the preborn child.
• In the July/August 1998 issue of Health Progress (i.e., the
official journal of the Catholic Health Association of the United
States), Father Kevin O’Rourke seemed to indicate that a
Salpingostomy (i.e., removal of the child from the fallopian
tube) and use of the chemical Methotrexate might also be
acceptable <www.chausa.org/Pub/MainNav/News/HP/
Archive/1998/07JulyAug/Articles/Features>. It appears that
Catholic thinking is moving decidedly away from the position
of Father O’Rourke.
• To the best of my knowledge, however, there has been no
definitive Catholic teaching on the use of a Salpingostomy and
Methotrexate. In the meantime, Catholic hospitals are
apparently employing Salpingostomies and the chemical
Methotrexate
122
Treatment of an Ectopic Pregnancy
• Writing in the February 1999 Linacre Quarterly (i.e., the official
journal of the Catholic Medical Association), Dr. John E. Foran
bemoans “toleration of salpinotomy(ostomy) & pharmacologic
(methotrexate) treatment of ectopic pregnancy in Catholic
health facilities….since the immediate effect of methotrexate
and saplingotomy(ostomy) is the death of the fetus, the
principle of double effect is not applicable because the act is
evil. In The Management of Ectopic Pregnancies: A Moral
Analysis, William E. May points out that ‘it is morally
imperative today to make every effort possible to discover and
transplant into the uterus those unborn babies who have,
unfortunately, implanted in the fallopian tube or other ectopic
site’…. no matter how good the intention, salpingotomy/
ostomy and the use of methotrexate or similar pharmacologic
agents result in the death of the infant as a direct effect of the
action and culminates in the good effect. The death is the
means chosen to the end. To willfully choose to terminate
innocent human life, no matter how good the intent, is
anywhere and everywhere morally wrong”
<www.cathmed.org/publications/linacrequarterly/1999_03.ht
123
ml >.
Treatment of an Ectopic Pregnancy
• In the July 1999 Homiletic & Pastoral Review, Msgr. William
Smith explains that “All Catholic authors agree that
salpingectomy is a licit application of the principle of double
effect. That is, full salpingectomy—the entire fallopian tube
(together with the ectopic pregnancy) is surgically removed; or,
partial salpingectomy—only the damaged segment of the tube
enveloping the ectopic pregnancy is removed, and then the
severed ends of the tube are brought together and
sutured….[By contrast] salpingostomy and this administration
of MTX are direct abortions ….Since the procedures are not
necessary to protect the mother’s life (salpingectomy can
preserve that) but allegedly to preserve future fertility, I would
judge that the final condition of double effect, proportion, is
also not verified here and thus is not a legitimate application of
double effect and is a direct abortion”
<www.catholic.net/rcc/Periodicals/Homiletic/July99/questio
ns.html>.
124
Treatment of an Ectopic Pregnancy
• As per # 48 of the 2001 Ethical and Religious Directives for
Catholic Health Care Services, Fourth Edition, “In case of
extrauterine pregnancy, no intervention is morally licit which
constitutes a direct abortion”
<www.nccbuscc.org/bishops/directives.shtml>.
• As per the March 2006 issue of Ethics and Medics (the official
journal of the National Catholic Bioethics Center), Dr. Eugene
Diamond writes: “The consensus among Catholic theologians
and practicing obstetricians is that the use of methotrexate in
ectopic pregnancy is a direct abortion of a developing embryo
or fetus….[However] The proscription against the use of
methotrexate and against surgical procedures such as
salpingostomy (the opening of the fallopian tube) with
evacuation of the tubal contents (in favor of the use of
salpingectomy, the removal of the fallopian tube, instead), do
not apply if the ectopic pregnancy has terminated with fetal
demise” <http://mm.dio.org/apr_06/item23.pdf >.
125
The Value of Life:
Unity of Body & Soul
• The Bible indicates that humans are made in
God's own image & likeness. We are unique in
the animal world. "Human life is irreducibly
both corporeal & spiritual." It is our souls &
bodies which God wants in Heaven.
• At a time when medical science is moving
towards greater specialization, we cannot
isolate particular treatments from care "to the
person of the patient in all his dimensions."
Charter for Health Care Workers
126
Indisposability & Inviolability of Life
• "The body cannot be....dealt with as a thing or
an object of which one is the owner & arbiter.
Every abusive intervention on the body is an
insult to the dignity of the person & thus to
God who is its only and absolute Lord"
• Life belongs to God & not the human being,
giving life a "sacred character." Right reason
can recognize this sacredness, even without
religious faith.
• Just because an action is technically possible, it
need not be "morally admissible."
127
Charter for Health Care Workers
Right to Life
• From conception to natural death, whether healthy or
sick, able bodied or disabled, rich or poor, every
human being has the right to life - "the right to live
with human dignity."
• Neither the health care worker nor the patient himself
has the right to power over the life which is receiving
care. No person has the right to "arbitrarily choose
whether to live or die." That decision is for God,
alone.
• The employment rights claims of health workers - just
though they may be - must be subordinated to the care
of the patient.
Charter for Health Care Workers
128
Prevention
• Health care workers can play a role in society's
addressing special problems of groups, such as
adolescents,
people with disabilities,
older people, etc.,
as well as with health risks tied to modern
living.
• Prevention involves rediscovering & applying
forgotten values.
Charter for Health Care Workers
129
Sickness
• "Sickness and suffering are not experiences which affect only
the physical substance of the human being, but they affect him
in his entirety and in his somatic-spiritual unity."
• The Charter presents counter-cultural notions about suffering:
• "The Christian knows by faith that sickness and suffering share in the
salvific efficacy of the Redeemer's cross.... the sick person can say with
the Apostle: 'I fill up in my body what is wanting to the sufferings of
Christ, for the sake of his body which is the Church' (Col 1:24). From
this new Christian meaning, the sick person can be helped to develop
a triple salutary attitude to the illness:
an'<awareness>' of its reality 'without minimizing it or exaggerating it';
'<acceptance>,' 'not with a more or less blind resignation' but in the serene
knowledge that 'the Lord can & wishes to draw good from evil';
'<the oblation>,' 'made out of love for the Lord and one's brothers and sisters.'"
• "Helping the relatives, and their cooperation with health care
workers are a valuable component of health care."
Charter for Health Care Workers
130
Diagnosis
• "the health care worker should seek, first & foremost, to find the illness &
analyze it in the patient: this is the <diagnosis> & related <prognosis>."
Both "hopeless" & "tenacious" diagnosis should be avoided:
• "In the first case the patient is forced to go from one specialist or health care
service to another, without finding the doctor or diagnostic center capable &
willing to treat his illness. Overspecialization & fragmentation of clinical
competencies & divisions, while ensuring professional expertise, is damaging to
the patient when health services in the place prevent a caring and global
approach to his illness.
• "In the second case, instead, one persists until some illness is found at any
cost....[and] treated as medical when, in fact, they are not medical-health in
nature.... the person is not helped to perceive the exact nature of their problem,
thus misleading them about themselves & their responsibilities."
When diagnosis avoids these pitfalls & is conducted with "full respect for the
dignity & integrity of the person, particularly with regard to the use of
instrumentally invasive techniques," it does not generally pose ethical problems
• "However, particular problems are posed by predictive diagnosis, because
of the possible repercussions at a psychological level & the discriminations it
could lead to and to prenatal diagnosis."
Charter for Health Care Workers
131
Prenatal Diagnosis
• Prenatal diagnosis is licit, when its aim is to
benefit the baby and the baby's mother - "if the
methods used, with the consent of the parents
who have been adequately instructed,
safeguard the life & integrity of the embryo &
its mother & does not subject them to
disproportionate risks."
• Prenatal diagnosis is absolutely illicit, when it
is carried out with the possibility of opting for
abortion.
Charter for Health Care Workers
132
Therapy & Rehabilitation
• "Therapy is a medical action" & "Rehabilitation...an amalgam of medical,
physiotherapeutic, psychological measures & functional exercises."
• A patient has a right to any treatment from which he can receive curative or salutary
benefit.
• All "proportionate" treatments must be applied, while it is acceptable to forego
"disproportionate" treatments.
• A principle of "appropriate medical treatment in the remedies": As a last resort &
with the patient's consent, it is acceptable to use methods from advanced medicine
that are still experimental stage and not without some risk. It can be acceptable to
interrupt the use of such experimental, risky methods when the results are
disappointing & these methods show themselves to be disproportionate.
• It is not suicidal for a patient to forego disproportionate treatment.
• "Therapeutic manipulation of the organism," involving "modification, mutilation or
removal of organs" is justified by the "principle of totality" or the "principle of
therapeuticity."
• While physical or "corporeal" life is a fundamental good, "there are higher values for
which it could be legitimate or even necessary to expose oneself to the danger of
losing it."
Charter for Health Care Workers
133
Analgesia & Anasthesia
• Pain has a therapeutic function:
"it eases the confluence of the physical and psychic reaction of the person to
a bout of illness," &...
it appeals to medicine for an alleviating and healing therapy.
• While not calling it by this name, the Charter discusses the "Theology of
Suffering": For the Christian, pain is a sharing in Christ's own suffering & a
uniting with Christ in His redemptive sacrifice, offered in obedience to His
father. Some Christians may opt to forego some painkiller medication,
trying to consciously associate with Christ's sufferings. This does not mean
that all suffering/pain must be accepted & that efforts to alleviate
suffering/pain should be foregone.
• "beyond certain limits of endurance it is...a duty for the health care worker
to prevent, alleviate and eliminate pain."
• "analgesic & anaesthesic techniques & medicines" can sometimes suppress
or diminish "consciousness & the use of the higher faculties." Where "loss of
consciousness & freedom" is merely an unintended side effect of efforts "at
dulling sensitivity to pain, & are limited to the clinical need alone," they can
"be considered ethically legitimate."
Charter for Health Care Workers
134
The Informed Consent of the Patient
• The "express or tacit consent of the patient" is a necessity for medical
intervention. A patient should receive "a precise idea of his illness &
the therapeutic possibilities, with the risks, the problems & the
consequences that they entail."
• Consent cannot be presumed for a "patient who is in a condition to
know.“ For a patient who is not "in a condition to know," "the health
care worker can, & in extreme situations must, presume the consent
to therapeutic interventions, which from his knowledge & in
conscience he thinks should be made.
• "If there is a temporary loss of knowing and willing, the health care
worker can act in virtue of <the principle of therapeutic trust>....
• "Should there be a permanent loss of knowing and willing, the health
care worker can act in virtue of <the principle of responsibility for
health care>, which obliges the health care worker to assume
responsibility for the patient's health."
• The "relatives...should be informed about ordinary interventions, &
involved in the decision making when there is question of
extraordinary & optional interventions."
135
Charter for Health Care Workers
Research & Experimentation
• Human dignity restricts biomedical sciences from the same investigative
freedom which they have with mere things. "Any research contrary to the true
good of the person is immoral."
• When a patient is unable to expressly provide it, consent can be presumed for
truly therapeutic experimentation. While experimental danger & risk cannot be
completely avoided, consent cannot be presumed - or even explicitly given - for
certain procedures. A patient is forbidden "to endanger his life, his equilibrium.
his health, or to aggravate his illness.“
• It can be proper to first test new pharmaceutical products/ techniques on
animals.
• A sick person's condition & the foreseeable effects of experimental treatment
must be compared, to assess whether a treatment is proportionate:
In desperate cases, when the patient will die if there is no intervention, if there is a
medication available, or a method or an operation which, though not excluding all
danger, still has some possibility of success, any right-thinking person would concede
that the doctor could certainly, with the explicit or tacit consent of the patient,
proceed with the application of the treatment."
• There are circumstances, for humanitarian reasons, under which a healthy
person could legitimately volunteer for an experiment, when his "own
substantial integrity is safeguarded" & the experiment would be interrupted
upon disappointing results.
Charter for Health Care Workers
136
Research & Experimentation
(continued)
• "Research on human embryos & fetuses can only be
allowed only when
"there is moral certainty that there will be no harm either to
the life or the integrity of the expected child & the mother, &
on condition that the parents have given their consent."
(NOTE: Embryonic Stem Cell Research (ESCR) is more explicitly condemned
in the later Dignitas Personae. ESCR necessitates destruction of the embryo.)
• Experimentation is only licit "for clearly therapeutic
purposes, when no other possible remedy is
available.“ Otherwise, this "is a crime against their
dignity as human beings"; parents cannot consent to
such. To keep "human embryos alive, actually or in
vitro, for experimental or commercial reasons,' is
especially & 'altogether contrary to human dignity.'"
Charter for Health Care Workers
137
Donation & Transplanting of Organs
While donation & transplant of organs can be an
incredible "service to life," there are concerns.
Charter for Health Care Workers
138
Donation & Transplanting of Organs
(continued)
• In "Autoplastic transplants," the donor of the
explant & the recipient of the implant are the
same person. The "principle of totality" can
justify disposing "a part for the integral good of
the organism." Removal of organs should "not
constitute a serious & irreparable impairment
for the donor."
Charter for Health Care Workers
139
Donation & Transplanting of Organs
(continued)
In "Homoplastic transplants," the donor of the explant
& the recipient of the implant are of the same species both human beings. The donor may or may not be
still alive. These can be justified by the principle of
solidarity and by charity. Where there is removal of
an organ from a corpse, there must be certainty the
corpse really is a corpse! There must be safeguards
that "the removal of organs does not cause or even
hasten death.“ As per the the Charter (1995), "When
total cerebral death is verified with certainty...it is licit
to remove organs & also to surrogate organic
functions artificially in order to keep the organs alive
with a view to a transplant“ [Note: In William May's
more recent (i.e., 2000) "Catholic Bioethics & the Gift of
Human Life," he discusses D. Allan Shewmon's
challenge
death criteria.].”
140
Charter
for Health to
Carebrain
Workers
What Pope John Paul II said about “brain death
criteria” in his 8/29/00 address to the
International Congress on Transplants...
• "With regard to the parameters used today for ascertaining death -- whether
the 'encephalic' signs or the more traditional cardio-respiratory signs -- the
Church does not make technical decisions. She limits herself to the Gospel
duty of comparing the data offered by medical science with the Christian
understanding of the unity of the person, bringing out the similarities and
the possible conflicts capable of endangering respect for human dignity....
• "the criterion adopted in more recent times for ascertaining the fact of death,
namely the complete and irreversible cessation of all brain activity, if
rigorously applied, does not seem to conflict....
• "Only where such certainty exists, & where informed consent has already
been given by the donor or the donor's legitimate representatives, is it
morally right to initiate the technical procedures...for the removal of organs
for transplant" .
141
Is John Paul II’s 8/29/00 Guidance Implemented?
A large number of physicians & others - including Fr. David
Albert Jones of the Linacre Centre for Healthcare Ethics &
Bishops Fabian Bruskewitz & Robert F. Vasa - comment on the
Pope's address in a 2000 Statement Opposing Brain Death
Criteria ("'Brain Death' - Enemy of Life and Truth“;
<www.lifestudies.org/jp/noshihantai.htm>). They maintain
• “None of the shifting sets of 'so-called neurological criterion' for
determining death fulfills the Pope's requirement that they be 'rigorously
applied' to ascertain 'the complete & irreversible cessation of all brain
activity'....
• "For vital organs to be suitable... they must be living organs removed from
living human beings....persons condemned to death as 'brain dead' are not
'certainly dead' but, to the contrary, are certainly alive....
• "adherence to the restrictions stipulated by the Pope & the prohibitions
imposed by God Himself in the Natural Moral Law precludes the
transplantation of unpaired vital organs, an act which causes the death of
the 'donor' & violates the fifth commandment of the divine Decalogue,
'Thou shalt not kill' (Deut. 5:17)."
142
Non-Heart Beating Donation (NHBD)
(As per George Isajiw, MD’s & Nancy Guilfoy Valko, RN’s March 2004 address at the Vatican:
'Non-heart beating organ donation' & the 'vegetative state' <www.wf-f.org/NHBD-VatMar2004.html>)
• "a new procedure called ‘non-heart-beating organ donation’ has
been quietly added to brain death organ donation in more and
more hospitals….the potential NHBD patient does not meet the
brain death criteria but is termed ‘hopeless’ or ‘vegetative’ soon
after suffering a devastating condition such as a severe stroke
or trauma, and while still needing a ventilator to breathe….
• “In NHBD, the ventilator is usually stopped in an operating
room while a doctor watches for up to one hour until the
heartbeat and breathing stops. After an interval of usually just 2
to 5 minutes, the patient is declared dead and the transplant
team takes over to remove the organs. A determination of brain
death is considered unnecessary even though one of the
inventors of the NHBD protocol, Dr. Michael DeVita has
admitted, ‘the possibility of [brain function] recovery exists for
143
at least 15 minutes’….
Non-Heart Beating Donation (NHBD)
(As per George Isajiw, MD’s and Nancy Guilfoy Valko, RN’s March 2004 address at the Vatican:
'Non-heart beating organ donation' & the 'vegetative state' <ww.wf-f.org/ NHBD-VatMar2004.html>)
• [As per “Withdrawal of Mechanical Ventilation in Anticipation of Death in the
Intensive Care Unit”, New England Journal of Medicine
<http://content.nejm.org/cgi/content/short/349/12/1123>; 9/18/03] “no study
was done to ‘validate physicians' predictions of patients, future functional status &
cognitive function’, & the researchers did not ask doctors to 'justify their predictions
of the likelihood of death or future function’. With such subjective standards being
used for withdrawal of ventilators, it should not be surprising that the potential
NHBD patient will unexpectedly continue to breathe for longer than the usual one
hour time limit required for the organ transplant to be successful. In these cases of
failed NHBD, the transplant is then cancelled but, rather than resuming care, the
patient is just returned to his or her room to eventually die without any treatment or
further life support….The rush…can thus deprive at least some patients of the
chance of survival or even recovery….
• Even more pressure to increase the use of NHBD is apparently coming in the US….
Ironically, at the same time, new information is coming forward about these socalled ‘hopeless’ patients who are considered potential NHBD candidates….While
organ donation can be a gift of life and a worthy goal, we must not allow the deaths
of some people to be manipulated to obtain organs for others.”
144
What Pope John Paul II said about “brain death
criteria” in his 2/2/05 message to the Pontifical
Academy of Sciences...
•
•
•
•
"you have chosen to explore once again, in a serious interdisciplinary study, the particular
question of the 'signs of death,' on the basis of which a person's clinical death can be established
with moral certainty, in order to proceed with the removal of organs for transplant....
"the moment of death for each person consists in the definitive loss of the constitutive unity of
body and spirit. Each human being, in fact, is alive precisely insofar as he or she is 'corpore et
anima unus' ('Gaudium et Spes,' 14), and he or she remains so for as long as this substantial
unity-in-totality subsists. In the light of this anthropological truth, it is clear, as I have already
had occasion to observe, that 'the death of the person, understood in this primary sense, is an
event which no scientific technique or empirical method can identify directly' (Address of 29
August 2000, 4, in: AAS 92 [2000], 824).
"From the clinical point of view, however, the only correct way -- and also the only possible
way -- to address the problem of ascertaining the death of a human being is by devoting
attention and research to the individuation of adequate 'signs of death,' known through their
physical manifestation in the individual subject....
"I wish to assure you that your efforts are laudable and will certainly be of assistance to the
competent Dicasteries of the Apostolic See -- especially the Congregation for the Doctrine of the
Faith -- which will not fail to ponder the results of your reflection, and then to offer the
necessary clarifications for the good of the community, in particular that of the patients and the
specialists who are called to dedicate their professional expertise to the service of life."
145
“‘Brain Death’ is Not Death!”
(Subsequent to the Pontifical Academy of Sciences’ 2/05 meeting, a statement was released by Paul
A. Byrne, Cicero G. Coimbra, Robert Spaemann, and Mercedes Arzú Wilson:)
• “In 1968 the ‘Harvard criteria’ for determining brain death were published
in the Journal of the American Medical Association….without substantiating
data, either from scientific research or from case studies of individual
patients. For this reason, a majority of the presenters at the conference in
Rome stated that the ‘Harvard criteria’ were scientifically invalid.
• "In 2002 the results of a worldwide survey were published in Neurology,
concluding that the use of the term ‘brain death’ worldwide is ‘an accepted
fact but there was no global consensus on the diagnostic criteria’ and there
are still ‘unresolved issues worldwide’….
• “Many physicians, who feel that the Hippocratic Oath is being violated by
acceptance of such disparate sets of criteria, feel the need to expose the
fallacy of ‘brain death,’ because the noble reputation of the medical
profession is at stake….
146
“‘Brain Death’ is Not Death!”
(Subsequent to the Pontifical Academy of Sciences’ 2/05 meeting, a statement was released by Paul
A. Byrne, Cicero G. Coimbra, Robert Spaemann, and Mercedes Arzú Wilson:)
"Conclusions reached after examination of Brain-Related Criteria for death, at
the Pontifical Academy of Sciences meeting
1.
On the one hand the Church recognizes, consistent with her tradition, that
the sanctity of all human life from conception to natural end must
absolutely be respected and upheld. On the other hand, a secular society
tends to place greater emphasis on the quality of living.
2.
The Catholic Church has always opposed the destruction of human life
before being born through abortion and she equally condemns the
premature ending of the life of an innocent donor in order to extend the
life of another through unpaired vital organ transplantation....
3.
'Nor can we remain silent in the face of other more furtive, but no less
serious and real forms of euthanasia. These could occur for example
when, in order to increase the availability of organs for transplants,
organs are removed without respecting objective and adequate criteria
which verify the death of the donor.'
147
“‘Brain Death’ is Not Death!”
(Subsequent to the Pontifical Academy of Sciences’ 2/05 meeting, a statement was released by Paul
A. Byrne, Cicero G. Coimbra, Robert Spaemann, and Mercedes Arzú Wilson:)
4.
5.
6.
‘The death of the person is a single event, consisting in the total
disintegration of that unitary and integrated whole that is the personal
self. It results from the separation of the life-principle (or soul) from the
corporal reality of the person.' Pope Pius XII declared this same truth
when he stated that human life continues when its vital functions
manifest themselves even with the help of artificial processes.
‘Acknowledgement of the unique dignity of the human person has a
further underlying consequence: vital organs which occur singly in the
body can be removed only after death--that is, from the body of someone
who is certainly dead....
Many in the medical and scientific community maintain that brain-related
criteria for death are sufficient to generate moral certitude of death itself.
Ongoing medical and scientific evidence contradicts this assumption.
Neurological criteria alone are not sufficient to generate moral certitude of
death itself, and are absolutely incapable of generating physical certainty
that death has occurred.
148
“‘Brain Death’ is Not Death!”
(Subsequent to the Pontifical Academy of Sciences’ 2/05 meeting, a statement was released by Paul
A. Byrne, Cicero G. Coimbra, Robert Spaemann, and Mercedes Arzú Wilson:)
7.
8.
9.
It is now patently evident that there is no single so-called neurological
criterion commonly held by the international scientific community to
determine certain death. Rather, many different sets of neurological
criteria are used without global consensus.
Neurological criteria are not sufficient for declaration of death when an
intact cardio-respiratory system is functioning. These neurological criteria
test for the absence of some specific brain reflexes. Functions of the brain
not considered are temperature control, blood pressure, cardiac rate and
salt and water balance. When a patient on a ventilation machine is
declared 'brain dead,' these functions not only are present but also are
frequently active.
The apnea test--the removal of respiratory support--is mandated as a part
of the neurological diagnosis and it is paradoxically applied to ensure
irreversibility. This significantly impairs outcome, or even causes death,
in patients with severe brain injury.
149
“‘Brain Death’ is Not Death!”
(Subsequent to the Pontifical Academy of Sciences’ 2/05 meeting, a statement was released by Paul
A. Byrne, Cicero G. Coimbra, Robert Spaemann, and Mercedes Arzú Wilson:)
10.
11.
12.
13.
There is overwhelming medical and scientific evidence that the complete
and irreversible cessation of all brain activity (in the cerebrum, cerebellum
and brain stem) is not proof of death. The complete cessation of brain
activity cannot be adequately assessed. Irreversibility is a prognosis, not a
medically observable fact. We now successfully treat many patients who
in the recent past were considered hopeless.
A diagnosis of death by neurological criteria alone is theory, not scientific
fact. It is not sufficient to overcome the presumption of life.
No law whatsoever ought to attempt to make licit an act that is
intrinsically evil....
The termination of one innocent life in pursuit of saving another, as in the
case of the transplantation of unpaired vital organs, does not mitigate the
evil of taking an innocent human life. Evil may not be done that good
might come of it"
<www.chninternational.com/brain_death_is_not_death_byrne_paul_md.
html>.
150
February 2006 Comments from John Shea, MD
• “It is not ethical to harvest organs from living persons if it
will result in their deaths. That is true even if we don't
know for sure that the person is living or dead, as in the
case of some people in coma & on life support….The
typical scenario for such organ harvesting is a young
person between the age of 5-55 who is in good health, is in
intensive care due to an automobile accident & is on a
ventilator. The doctor makes an arbitrary decision that
treatment is futile. They take the patient off the ventilator
and if the heart stops beating they sometimes wait a
couple of minutes & then remove the organs. They do not
know how long a heart will stop beating & might recover
again….we have no agreement on determination of death
soon enough to harvest the heart before its deterioration”
<http://www.lifesite.net/ldn/2006/feb/06021709.html>.
151
September 2006 Catholic News Service report
• “"The Vatican academy invited some 20
neurology experts from all over the world
to take part in a Sept. 11-12 working
group on "The Signs of Death" to go over
the latest evidence"
<http://www.catholicnews.com/data/st
ories/cns/0605285.htm>.
152
Donation & Transplanting of Organs
(continued)
The brain and gonads can never be legitimately
transplanted, as these organs "ensure the
personal & procreative identity."
Charter for Health Care Workers
153
Donation & Transplanting of Organs
(continued)
• "Heterogeneous transplants" involve an
explant from another species or the implant of
an artificial organ. The "transplant of animal
sexual glands to humans must be rejected as
immoral; but the transplant of the cornea of a
non-human organism to a human organism
would not create any problem if it were
biologically possible & advisable."
• The lawfulness of the implant of artificial
organs "is conditioned by the beneficial effect
for the person and respect for his dignity."
Charter for Health Care Workers
154
Donation & Transplanting of Organs
(continued)
The Charter encourages people to donate parts of
their body, after death. In transplanting (even
blood transfusions), the health care worker
mediates "the gift of self by a person - even
after death - so that another might live."
Charter for Health Care Workers
155
Dependency
The Charter notes a rise in dependency which it
attributes to "the crisis of values & meaning," as
well as stress, frustration, activism, high
competitiveness & social anonymity.
Charter for Health Care Workers
156
Drugs
• Many deaths from drug overdose are
"voluntary suicides.“ "The way to recovery
cannot be that of ethical culpability or
repressive law, but it must be by way of
rehabilitation which, without condoning the
possible fault of the person on drugs, promotes
liberation from his condition & reintegration.“
In detoxification, there should be an attempt to
help the person discover or rediscover his
dignity and personal resources.
• A person does not have a right to do as he
pleases with his body.
Charter for Health Care Workers
157
Alcoholism
While "alcohol is not in itself illicit," its abuse is
"reprehensible.“ A "program of integrally
human rehabilitation" is needed with Medical
assistance , human assistance, and
psychotherapy.
Charter for Health Care Workers
158
Smoking
Similar to alcohol, it is the abuse of tobacco which
is problematic. "Smoking poses the problem of
dissuasion and prevention, which should be
done especially through health education and
information, even by way of advertisements."
Charter for Health Care Workers
159
160
“The Catholic Contribution
to the 12-Step Movement”
“A Catholic non-alcoholic who profoundly
influenced AA in its early days was Fr.
Edward Dowling of the Society of Jesus
….he was favorably impressed and saw
parallels between the 12 steps and aspects
of Ignatian spirituality-perhaps especially
the Ignatian admonition to pray as if
everything depends on God and to work as
if everything depends on oneself….
161
“The Catholic Contribution
to the 12-Step Movement”
“Having surrendered to God & received back
his sobriety, Wilson [Bill W.]could not retract
his surrender by demanding an accounting
from God when life did not unfold according
to preconceived expectations. Even the sense
of dissatisfaction could be an occasion of
spiritual growth….
“Wilson was deeply attracted to the Catholic
Church and even received instruction from
Fulton Sheen in 1947….
162
“The Catholic Contribution
to the 12-Step Movement”
“Another important, though somewhat later, Catholic
influence on AA was Fr. John C. Ford, S.J., one of
Catholicism's most eminent moral theologians. In the
early forties, Ford himself recovered from alcoholism
with AA's help. He became one of the earliest Catholic
proponents of addressing alcoholism as a problem
having spiritual, physiological, and psychological,
dimensions.
“Ford said that alcohol addiction is a pathology which is
not consciously chosen, but he rejected the deterministic
idea that alcoholism is solely a disease without any
moral component:….
163
“The Catholic Contribution
to the 12-Step Movement”
“’To answer the question: Is alcoholism a moral problem or is it a
sickness, I think the answer is that it is both. I don't think it is true
to say that alcoholism is just a sickness, in the sense that cancer or
tuberculosis are sicknesses….On the other hand, I don't think it is
true either to say that alcoholism is just a moral problem….
“’When you look at the agony that the alcoholic inflicts upon
himself over the course of the years, it seems to me to be very
difficult to say he wants to be that way or he does it on purpose. . .
. I think it is fair to speak of alcoholism as a triple sickness-a
sickness of the body, a sickness of the mind, and also a sickness of
the soul.’ John C. Ford, ‘The Sickness of Alcoholism: Still More
Clergy Education?’, Homiletic and Pastoral Review, Nov. 1986: pp.
10, 12.”
164
“The Catholic Contribution
to the 12-Step Movement”
“Wilson, impressed by Ford's insight, asked him to edit Twelve
Steps and Twelve Traditions (with the Big Book, this is the basic text
of 12-step recovery) and Alcoholics Anonymous Comes of Age….
“Ford's contribution to AA was therefore twofold: He drew on
both religion and psychology to show alcoholism as a synthetic
problem requiring a synthetic remedy, and he took seriously the
quasi- compulsive nature of addiction while rejecting both
absolute determinism and the attendant pitfalls of a purely
therapeutic approach….
“In so many ways, Ford's approach to addiction and recovery
remains a model of spiritual discernment for our own time.”
165
Psycho-pharmaceuticals
• "Psycho-pharmaceuticals are a special category of medicines
used to counter agitation, delirium & hallucinations and to
overcome anxiety and depression."
• The Charter supports psycho-pharmaceuticals being under
medical control.
• Psycho-pharmaceuticals are legitimate, when "Administered
for therapeutic purposes & with due respect for the person.“
• Further, "the informed consent of the patient is required & his
right to refuse the therapy must be respected, taking into
account the ability of the mental patient to make decisions.
• "Also to be respected is the principle of therapeutic
proportionality in the choice & administration of these
medicines, on the basis of an accurate etiology of the symptoms
& the motives for the subject's requesting this medicine.“
• "Non-therapeutic use & abuse of psycho-pharmaceuticals is
morally illicit if the purpose is to improve normal performance
or to procure an artificial & euphoric serenity.“
166
Charter for Health Care Workers
Psychology & Psychotherapy
• Psychotherapy aims to liberate a person from past problems &
enable him to "assume his identity, role and responsibilities."
Psychotherapy is morally acceptable, but it must be practiced
with proper respect for the patient:
His privacy cannot be violated without his consent.
His will cannot be unduly influenced or forced.
All types of psychotherapy are "acceptable, provided that they
are practiced by psychotherapists who are guided by a
profound ethical sense."
• Psychiatrist Viktor Frankl survived a Nazi concentration camp
& wrote, "Man's Search for Meaning." He noted that a person
who had a reason to live could put up with lifes' most horrific
circum-stances. Based on the human need for meaning, he
developed "logo-therapy." "From the moral standpoint," the
Charter says, "logo-therapy & <counseling> are privileged
forms of psychotherapy."
Charter for Health Care Workers
167
Pastoral Care & the Sacrament of the
Annointing of the Sick
• Pastoral care of the sick is a fundamental right of the patient & a Church
duty. It is the primary role of the health care pastoral worker, but all health
care workers are bound to facilitate it.
• Health care structure must facilitate religious assistance.
• When such assistance cannot be given by a pastoral worker, the health care
worker should (within certain limits) provide it directly, while respecting
the patient's freedom and affiliation & not detracting from the patient's other
rights for health care assistance.
• "Pastoral care of the sick...is a matter
of <evangelizing> illness, helping a person to uncover the redemptive meaning of
suffering borne in communion with Christ;
of <celebrating> the sacraments as efficacious signs of the recreative & vitalizing
grace of God;
of <witnessing> by means of the "diakonia" (service) & the "koinonia" (communion)
to the therapeutic power of charity."
Charter for Health Care Workers
168
Pastoral Care & the Sacrament of the
Annointing of the Sick (continued)
The "Anointing of the Sick" is for "any Christian
who is in a life-threatening condition" & not
just those at death's door. It "is a remedy for
body & spirit, relief & strength for the patient
in his corporeal-spiritual integrity casting light
on the mystery of suffering & death and
bringing a hope which opens the human
present to the future of God....It "should...be
preceded by a suitable catechesis“ The proper
minister of the Anointing of the Sick is a priest.
It cannot be conferred on someone who is
already dead.
Charter for Health Care Workers
169
Pastoral Care & the Sacrament of the
Annointing of the Sick (continued)
Viaticum is Communion in a special form. "'The
one who eats my flesh & drinks my blood has
eternal life, & I will raise him up on the last
day' (Jn 6:54)“ "it is the duty of a Christian to
request & receive Viaticum, and the Church has
a pastoral responsibility to administer it."
Charter for Health Care Workers
170
Death
It is up to God alone to decide a
person's final moment.
Charter for Health Care Workers
171
Terminal Illnesses
• Assistance in dying constitutes helping
someone to live intensely the end of their life.
The Charter supports allowing a patient to
spend his last days at home, with appropriate
medical help. While a terminally ill patient
needs palliative care and symptomatic
treatment, the "most important assistance is
'loving presence' at the bedside of the dying
person.“ At the approach of death, a health
care worker's faith & Christian hope is a
powerful witness.
172
Charter for Health Care Workers
Death with Dignity
• Responsibility for life "does not always & in all cases involve
recourse to every means." There is a "so-called 'therapeutic
tyranny,' of 'the use of methods which are particularly
exhausting & painful for the patient, condemning him in fact to
an artificially prolonged agony.' This is contrary to the dignity
of the dying person & to the moral obligation of accepting
death & allowing it at last to take its course." There is a
"principle of appropriate medical treatment":
'When inevitable death is imminent, despite the means used, it is lawful
in conscience to decide to refuse treatment that would only secure a
precarious & painful prolongation of life, but without interrupting the
normal treatment due to the patient in similar cases. Hence the doctor
need have no concern; it is not as if he had failed to assist the person in
danger.'"
• "The administration of food & liquids, even artificially, is part
of the normal treatment always due to the patient when this is
not burdensome for him: their undue suspension could be real &
properly so-called euthanasia."
Charter for Health Care Workers
173
174
“The administration of food and
water even by artificial means is,
in principle, an ordinary and
proportionate means of preserving
life. It is therefore obligatory to
the extent to which, and for as
long as, it is shown to accomplish
its proper finality, which is the
hydration and nourishment of the
patient. In this way suffering and
death by starvation and
dehydration are prevented.” 175
176
“A patient in a ‘permanent
vegetative state’ is a person
with fundamental human
dignity and must, therefore,
receive ordinary and
proportionate care which
includes, in principle, the
administration of water and
food even by artificial
means.”
177
The Use of Painkillers for the
Terminally Ill
• "Human & Christian prudence suggests the use for most
patients of medicines which alleviate or suppress pain, even if
this causes torpor or reduced lucidity."
The Use of Painkillers with the
Dying, However, Is Not Without Its
Problems
• Painkiller use can be judged licit, even with a possibility of
hastening death, as an unitended side effect. Painkillers can
cause unconsciousness: "Without serious reasons, the dying
person must not be deprived of consciousness."
Charter for Health Care Workers
178
Telling the Truth to a Dying Person
• "The person cannot be abandoned to
unconsciousness in the decisive 'hour' of his
life, taking him away from himself & from his
final & most important decisions.“
• "The truth must not remain unspoken, but
neither must it be given in all its bare, crude
reality.“
• "It is not simply a matter of giving clinical facts,
but of meaningful communication"
Charter for Health Care Workers
179
The Moment of Death
• "To ascertain & interpret these signs [of death] is not a matter
for faith or morals but...medical science:.... 'Scientists, analysts
& scholars must continue their research &... studies to
determine in the most precise way possible the exact moment
&...irrefutable sign of death'" "the Pontifical Academy of
Sciences has made an authoritative contribution
"First with regard to the <biomedical definition of death>: 'a person is
dead when he has irreversibly lost all ability to integrate & coordinate
the physical & mental functions of the body.'
Second, with regard to the precise moment of death: 'death comes when:
a) the spontaneous functions of the heart & breathing have definitively ceased, or
b) the irreversible arrest of all brain activity.'"
In reality 'brain death is the true criterion..., although the
definitive arrest of cardio-respiratory activity very quickly
leads to brain death.'"
Charter for Health Care Workers
180
Religious Assistance for the Dying
• There is a "crisis" with the dying process, prompting "the
Christian & the Church to be a bearer of the light of truth."
"Death...must be evangelized." Through charity, prayer & the
sacraments, the Gospel is announced to the dying in "especially
expressive & effective forms." While the hospital chaplain has a
special obligation in this regard, "It is a pastoral duty of the
ecclesial community in each one of its members, according to
the responsibilities of each."
• The Charter defines "Charity" as "that giving & receptive
presence which establishes with the dying person a
communion born of attention, comprehension, concern,
patience, sharing and selflessness." Through Charity, the
relationship with the dying person can "expand in prayer, that
is, in communion with God."
Charter for Health Care Workers
181
Religious Assistance for the Dying
• "A privileged moment of prayer with the dying person is the
celebration of the <sacraments>:....Foremost is the...
• <Anointing of the Sick> through which the Holy Spirit,
completing in the Christian his assimilation to Christ begun
in baptism, makes him participate definitively in the paschal
triumph over sickness & death.
• <Viaticum> is eucharistic nourishment, the bread of
communion with Christ which gives the dying person the
strength to face the final & decisive stage of life's journey.
• <Penance> is the sacrament of reconciliation: at peace with
God, the dying person is at peace with himself and with his
neighbor"
• "In this <faith>, filled with <charity> the powerlessness
experienced...is not agonizing & paralyzing. The Christian finds
<hope> & in it the possibility... to live & not suffer death."
Charter for Health Care Workers
182
The Suppression of Life
Health care workers are called "to safeguard life";
conditions call for particular attention to
abortion & euthanasia.
Charter for Health Care Workers
183
Abortion
• "broad sectors...[try to] justify certain crimes against
life in the name of the rights of individual
freedom...they claim not only exemption from
punishment but...authorization by the state, so that
these things can be done with total freedom & indeed
with the free assistance of health care systems."
• "The Church....calls all health care workers to
<professional loyalty>, which does not tolerate any
action which suppresses life." "Fidelity to <medical
health> delegitimizes every intervention, surgical or
pharmaceutical, intended to interrupt the pregnancy
at any stage."
• While some may have compelling reasons for seeking
an abortion, no reason "can objectively give the right
to dispose of another's life, even in the initial phase.“
Charter for Health Care Workers
184
Abortion
• (The "pill" can be abortifacient.) "The use of substances or
means which impede the implantation of the fertilized embryo
or which cause its premature detachment is also...abortion."
• We can never obey intrinsically immoral laws. Hence, doctors
& nurses are obliged to be "conscientious objectors“
• Those who procure abortions automatically excommunicate
themselves from the Church, whether or not anyone else knows
of their action: "It is a forceful call from the Church, meant to
arouse insensitive consciences, to dissuade people from an act
which is absolutely incompatible with Gospel demands, & to
awaken unreserved fidelity to life.“
• "Health care workers have special obligations with regard to
aborted fetuses. An aborted fetus, if it is still alive, should be
baptized if at all possible. A dead aborted fetus must be given
the same respect as a human corpse ....If at all possible it should
be appropriately interred....the fetus cannot be used for
experimentation or transplant if the abortion was caused
voluntarily."
Charter for Health Care Workers
185
Terri Schiavo
Videos are available at
<www.terrisfight.org/quicklinks.php?id=50.>.
186
Euthanasia
• Euthanasia is homicide.
• Euthanasia is "an action or omission which of its nature or by
intention causes death, in order that all suffering may be
eliminated." However, "This is not a question of helping a sick
person, but rather the intentional killing of a person."
• The Charter does not distinguish between formal v. material,
immediate v. mediate, proximate v. remote, in saying that
health care workers must absolutely not "cooperate" in
euthanasia, even if requested by the patient & "much less at the
request of the relatives....
• "the individual does not have the right to euthanasia, because
he does not have a right to dispose arbitrarily of his own life....
187
Charter for Health Care Workers
Euthanasia
• "There is a radical difference between 'death dealing'
and 'consent to dying':
• "the former is an act suppressing life,
• "the latter means accepting life until death."
• "The pleas of gravely ill persons who sometimes ask
for death are...almost always a case of an anguished
plea for help & love"
• Doctor-patient relationships are "life-trusting";
euthanasia disrupts this.
Charter for Health Care Workers
188