Charter for Health Care Workers by xuyuzhu


									The Perspective of the Theology of
in the Vatican’s “Charter for Health Care Workers”

 on Suffering


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.”
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
• “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.”                              5
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
• “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….                              6
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
  does not know it is in despair’….                                        7
Suffering from a Hindu Perspective

  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.”
Suffering from a Buddhist Perspective

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.”                     11
Suffering from the Perspectiveof

     Suffering from the Perspectiveof
• “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.“                                                 13
Suffering from an Islamic Perspective

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
• “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 self-
       injuries, 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!”
Suffering from a Jewish Perspective?

“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.”
     "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. “              19
Not Very Satisfying!

      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.

      Reasons to Believe:
     Argument from Design
• Monkeys could have banged out
  the greatest musical
  masterpieces. Common sense
  instead points us to great
• The existence of the universe
  points to a creator.
       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
        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
• 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
  sceptic?                                           28
     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?
             President of
John Haas,   the National
Ph.D., STL     Catholic

 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?
What is this “Natural Law” (aka,
    “Natural Moral Law”?

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                           "LAWS OF NATURE"
      (prescriptive)                                                              (descriptive)
    the road map to true human happiness
  ("...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"
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                                                        Life,
         l           We always choose "goods;"                    Knowledge,
         l           we are concerned with how                    Skillful performance/
         l                   we choose.                           aesthetic appreciation
         l                                                        Integrity
         l           Arguments about how                          Authenticity,
         l                  to choose BHGs                        Friendship,
         l                  get confused.                         Religion, &
         l                                                        Marriage.                        33
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
                    hope, and
                 love (Rm 13)....   34
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
      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.
      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.

      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
      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.
       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
    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                 v.               Material Cooperation
(always wrong)                              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.
      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.              43
• 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, &
• Principle of Participation (aka,
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.
• 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”

•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.
•Principle of Inner Freedom
Obsessions we experience are
 not simply crosses to bear
 passively. We have moral
 responsibility to seek treatment
 for an obsession.
•Principle of Personalized
 Sexuality (aka, Family-
 Oriented Sexuality)
Sexual acts have "unitive" & "procreative"
Reserved for marriage, they unite a couple.
Each act is to be open to the transmission of
 new life.                                49
•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.

        Encyclical letter of Pope John Paul II

"'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.....

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 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
  good.....                                                                        54
  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

“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
  Passion of Christ....                                   55
                  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

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.....
                  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.                                    57
                 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
   "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
  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

“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'
  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 that extent he in his own way
  completes the suffering through which Christ accomplished the Redemption
  of the world.
  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

“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....

           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 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....
           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….
          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.....
        The Gospel of Suffering
“Saint Paul speaks of such joy in the Letter to the
  Colossians: 'I rejoice in my sufferings for your
“It is suffering, more than anything else, which clears
  the way for the grace which transforms human
“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.....
               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....
“ 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.....

                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
   of suffering.                                                                 67
"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,

“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'
         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

Charter for Health Care Workers     71
                      Fertility Control
• In conceiving & giving birth, spouses "cooperate" with God's work of
• 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 pro-
  abortion culture is especially strong, where this teaching on
  contraception has been rejected.
Charter for Health Care Workers                                        72
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
                  to try to divorce
                  sexual pleasure
               from marriage and

Hugh Heffner
The so-called Sexual Revolution
    & Some of Its Generals

 Hugh Heffner
 Margaret Sanger
 Wilhelm Reich

               Hugh Heffner
 Hugh Heffner, founded Playboy Magazine in 1953:
“In the first issue, Playboy identified its philosophy as anti-
“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”
On Sept 21,
1957, Mike
(of “60 Minutes” fame)



          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
 ….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
 According to Planned Parenthood, the “pill” is now the most widely
  used of various contraceptive methods
  < 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
• While contraceptives are supposedly a panacea for "unwanted
  pregnancies," the CDC reports that one of every three pregnancies
  ends in an induced abortion <>. 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
Currently, “The CDC estimates that 19 million
 new [STD] infections occur each year, almost
 half of them among young people ages 15 to
 24” <>.
 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)
The FBI now reports 92,455 annual forcible
  rapes of women (30.9 per 100,000 people)
 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
  r_21/sr21_010acc.pdf> and a divorce rate of 2.2 per
  1000 people
Currently, there is a marriage rate of 7.4 per 1000 people
  and a divorce rate of 3.6 per 1000 people
"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
                Heart”<>.                82
"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
                Heart”<>.                83
"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
•“One out of three visitors to all adult web sites are
•“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
                Heart”<>.                84
 Somehow, the Idea that Pornography is
“Victimless” Seems to Remain Popular….
“Annually, according to U.S. Government-
sponsored 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”
Has there been a benefit to marriage
           itself from the
 “Sexual Revolution”’s divorce of
          sexual pleasure
     marriage and procreation?

Was Wilhelm Reich correct, in that people had
 been made sick by the imposition of such an
        unnatural sexual morality?
  What is Marriage? (Harvard
Journal of Law & Public Policy)

  What is Marriage? (Harvard
Journal of Law & Public Policy)

    “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
•   <>
•                                                                                                                                       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
                <>                                                                 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
                <>                                                                 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
•   <>
•                                                                                                                                       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
    “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
•   <>
•                                                                                                                                       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
    “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
•   <>
•                                                                                                                                       96

 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!
•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 <>.

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.

   NFPSurvey.html>)                                    99
               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

• 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
the Vatican
released an
 focused on
 human life
       at its
   origins –
  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
   • 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.”
  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

  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
  "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."

                  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 &

• 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

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

The Vatican’s 10/31/000 “STATEMENT
           AFTER 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
• “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.”
      Pope Benedict
      XVI’s 10/29/07
      address to the
        Congress of

112             112
 Pope Benedict XVI’s 10/29/07 address to the
    International Congress of Catholic
• “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. ”
    it was on
12/12/08 that
 the Vatican
 released an
  focused on
  human life
at its origins
 – Dignitas
    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.
            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
  lines.                                 117
   Dignitas Personae is NOT to be
    dismissed as a laundry list of
•“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
  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.
 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.
    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)“
• "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 <
  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
   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”
  ml >.                                                           123
   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”
   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”
• 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” < >.             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,
• 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
• Health care workers can play a role in society's
  addressing special problems of groups, such as
                people with disabilities,
                older people, etc.,
  as well as with health risks tied to modern

• Prevention involves rediscovering & applying
  forgotten values.
Charter for Health Care Workers               129
• "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
• "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
Charter for Health Care Workers                 132
            Therapy & Rehabilitation
• "Therapy is a medical action" & " amalgam of medical,
  physiotherapeutic, psychological measures & functional exercises."
• A patient has a right to any treatment from which he can receive curative or salutary
• 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
• 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
• 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
• "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
• 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
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 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 Care Workers
Charter for Health to brain death criteria.].”            140
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" .

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“;
  <>). 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
• "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)."
           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' <>)

• "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
  at least 15 minutes’….                                       143
          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' < NHBD-VatMar2004.html>)

• [As per “Withdrawal of Mechanical Ventilation in Anticipation of Death in the
  Intensive Care Unit”, New England Journal of Medicine
  <>; 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 so-
  called ‘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.”
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."
         “‘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….
         “‘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.'
         “‘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.    ‘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.
5.    ‘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....
6.    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.
         “‘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.    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.
8.    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.
9.    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.

         “‘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.   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.
11.   A diagnosis of death by neurological criteria alone is theory, not scientific
      fact. It is not sufficient to overcome the presumption of life.
12.   No law whatsoever ought to attempt to make licit an act that is
      intrinsically evil....
13.   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"
 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”
  <>.    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"

 Donation & Transplanting of Organs

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
• "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

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

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
• 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

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

Charter for Health Care Workers                    158

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
      “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….
      “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….
        “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,

“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:….
          “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.”
          “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.”
• "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 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 "
 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
              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
• "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
 “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
 “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
         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
• 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
• "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

• "In this <faith>, filled with <charity> the powerlessness 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
• "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
• (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
Charter for Health Care Workers                                185
                  Terri Schiavo

Videos are available at
<>.   186
• 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....
Charter for Health Care Workers
• "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

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