Dolentium Hominum N

DH n.63 ing 1-80 16-01-2006 17:14 Pagina 1

DOLENTIUM HOMINUM N. 63 – Year XXI – No. 3, 2006

JOURNAL OF THE PONTIFICAL COUNCIL FOR HEALTH PASTORAL CARE

CARDINAL JAVIER LOZANO BARRAGÁN, Editor-in-Chief BISHOP JOSÉ L. REDRADO, O.H., Executive Editor CORRESPONDENTS REV. FELICE RUFFINI, M.I., Associate Editor REV. MATEO BAUTISTA, Bolivia MONSIGNOR J. JAMES CASSIDY, U.S.A. REV. RUDE DELGADO, Spain REV. RAMON FERRERO, Spain REV. BENOIT GOUDOTE, Ivory Coast EDITORIAL BOARD PROFESSOR SALVINO LEONE, Italy REV. JORGE PALENCIA, Mexico REV. CIRO BENEDETTINI REV. GEORGE PEREIRA, India DR. LILIANA BOLIS MRS. AN VERLINDE, Belgium SR. AURELIA CUADRON PROFESSOR ROBERT WALLEY, Canada REV. GIOVANNI D’ERCOLE, F.D.P. DR. MAYA EL-HACHEM REV. GIANFRANCO GRIECO REV. BONIFACIO HONINGS MONSIGNOR JESÚS IRIGOYEN EDITORIAL STAFF REV. JOSEPH JOBLIN REV. VITO MAGNO, R.C.I. DR. COLETTE CHALON DR. DINA NEROZZI-FRAJESE MRS. STEFANIA CASABIANCA DR. FRANCO PLACIDI DR. ANTONELLA FARINA REV. LUCIANO SANDRIN DR. MATTHEW FFORDE MONSIGNOR ITALO TADDEI DR. GUILLERMO QWISTGAARD

Editorial and Business Offices: PONTIFICAL COUNCIL FOR HEALTH PASTORAL CARE VATICAN CITY; Tel. 06-6988-3138, 06-6988-4720, 06-6988-4799, Fax: 06-6988-3139 www.healthpastoral.org - e-mail: [email protected]

Published three times a year. Subscription rate: 32 postage included €

Printed by Editrice VELAR, Gorle (BG)

Cover: Glass window Rev. Costantino Ruggeri

Poste Italiane s.p.a. Spedizione in Abbonamento Postale - D.L. 353/2003 (conv. In L. 27/02/2004 nº 46) art. 1, comma 2, DCB Roma DH n.63 ing 1-80 16-01-2006 17:14 Pagina 2

Contents

4 Message of His Holiness Benedict XVI 40 The Figure of the for the Fifteenth World Day of the Sick Ecclesiastical Assistant Benedict XVI Rev. Armando Aufiero Felice Di Giandomenico 7 In the Face of the Actual Suppression of the Human Being there can be no Compromises or Prevarication TESTIMONIES Benedict XVI 44 Witnesses to Love in Pain H.E. Msgr. José L. Redrado, O.H. TOPICS 57 Health Care and Utopia. 10 The Rights of the Mentally Ill Is the Humanisation Rev. Pierluigi Marchesi, O.H. of Health Care a Utopia? Prof. Pietro Quattrocchi 2 13 The Catholic Church and Conjugal Sexuality 66 Gynaecologists and Obstetricians Rev. Bonifacio Honings, O.C.D. Called to Service to Life Msgr. Jean-Marie Mpendawatu 17 Pain and Suffering: a New Approach? 68 The Anchor of Life Rev. Jesús Conde Herranz Volunteers of Suffering Center

35 The Anthropological Dimension 70 The Journey of the Office of the Right to Health for Pastoral Care in Health Prof. Francesco D’Agostino of the Archdiocese of Bari-Bitonto Under the Banner of Creativity 37 Pastoral Actions Rev. Leonardo Nunzio Di Taranto to Defend and Promote the Right to Health 77 Pastoral Care in Health in Poland Rev. Mariano Steffan H.E. Msgr. Władysław Ziołek

The illustrations in this edition are taken from the book: The High Tatras by Jerzy Choinacki published by Wydawnictwo Secesja

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 3 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 4

Message of His Holiness Benedict XVI for the Fifteenth World Day of the Sick Seoul, Korea – 11 February 2007

Dear Brothers and Sisters, On 11 February 2007, when the Church keeps the liturgical memorial of Our Lady of Lourdes, the Fifteenth World Day of the Sick will be celebrated in 4 Seoul, Korea. A number of meetings, conferences, pastoral gatherings and liturgical celebrations will take place with representatives of the Church in Ko- rea, health care personnel, the sick and their families. Once again the Church turns her eyes to those who suffer and calls attention to the incurably ill, many of whom are dying from terminal diseases. They are found on every continent, particularly in places where poverty and hardship cause immense misery and grief. Conscious of these sufferings, I will be spiritually present at the World Day of the Sick, united with those meeting to discuss the plight of the incurably ill in our world and encouraging the efforts of Christian communities in their witness to the Lord’s tenderness and mercy.

Sickness inevitably brings with it a moment of crisis and sober confrontation with one’s own personal situation. Advances in the health sciences often provide the means necessary to meet this challenge, at least with regard to its physical aspects. Human life, however, has intrinsic limitations, and sooner or later it ends in death. This is an experience to which each human being is called, and one for which he or she must be prepared. Despite the advances of science, a cure cannot be found for every illness, and thus, in hospitals, hospices and homes throughout the world we encounter the sufferings of our many brothers and sisters who are incurably and often terminally ill. In addition, many mil- lions of people in our world still experience insanitary living conditions and

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 5

lack access to much-needed medical resources, often of the most basic kind, with the result that the number of human beings considered “incurable” is greatly increased.

The Church wishes to support the incurably and terminally ill by calling for just social policies which can help to eliminate the causes of many diseases and by urging improved care for the dying and those for whom no medical remedy is available. There is a need to promote policies which create conditions where human beings can bear even incurable illnesses and death in a dignified manner. Here it is necessary to stress once again the need for more palliative care centres which provide integral care, offering the sick the human assistance and 5 spiritual accompaniment they need.

This is a right belonging to every human being, one which we must all be committed to defend.

Here I would like to encourage the efforts of those who work daily to ensure that the incurably and terminally ill, together with their families, receive adequate and loving care.

The Church, following the example of the Good Samaritan, has always shown particular concern for the infirm. Through her individual members and institutions, she continues to stand alongside the suffering and to attend the dying, striving to preserve their dignity at these significant moments of human existence. Many such individuals – health care professionals, pastoral agents and volunteers – and institutions throughout the world are tirelessly serving the sick, in hospitals and in palliative care units, on city streets, in housing projects and parishes.

I now turn to you, my dear brothers and sisters suffering from incurable and terminal diseases. I encourage you to contemplate the sufferings of Christ cru-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 6

cified, and, in union with him, to turn to the Father with complete trust that all life, and your lives in particular, are in his hands. Trust that your sufferings, united to those of Christ, will prove fruitful for the needs of the Church and the world. I ask the Lord to strengthen your faith in his love, especially during these trials that you are experiencing. It is my hope that, wherever you are, you will always find the spiritual encouragement and strength needed to nourish your faith and bring you closer to the Father of Life. Through her priests and pastoral workers, the Church wishes to assist you and stand at your side, helping you in your hour of need, and thus making present Christ’s own loving mercy towards those who suffer. 6 In conclusion, I ask ecclesial communities throughout the world, and particularly those dedicated to the service of the infirm, to continue, with the help of Mary, Salus Infirmorum, to bear effective witness to the loving concern of God our Father. May the Blessed Virgin, our Mother, comfort those who are ill and sustain all who have devoted their lives, as Good Samaritans, to healing the physical and spiritual wounds of those who suffer! United to each of you in thought and prayer, I cordially impart my Apostolic Blessing as a pledge of strength and peace in the Lord.

From the Vatican, 8 December 2006

BENEDICTUS PP. XVI

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 7

In the Face of the Actual Suppression of the Human Being there can be no Compromises or Prevarications ADDRESS OF HIS HOLINESS BENEDICT XVI TO THE PARTICIPANTS IN THE SYMPOSIUM ON THE THEME: “STEM CELLS: WHAT FUTURE FOR THERAPY?” ORGANIZED BY THE PONTIFICAL ACADEMY FOR LIFE, HALL OF THE SWISS, CASTEL GANDOLFO, SATURDAY, 16 SEPTEMBER 2006

Venerable Brothers in the Episcopate and The prospects opened by this new chapter in the Priesthood, in research are fascinating in themselves, for Distinguished Ladies and Gentlemen, they give a glimpse of the possible cure of de- I address a cordial greeting to you all. This generative tissue diseases that subsequently meeting with you, scientists and scholars ded- threaten those affected with disability and icated to specialized research in the treatment death. of diseases that are a serious affliction to hu- How is it possible not to feel the duty to manity, is a special comfort to me. praise all those who apply themselves to this I am grateful to the organizers who have research and all who support the organization 7 promoted this Congress on a topic that has be- and cover its expenses? come more and more important in recent I would like in particular to urge scientific years. The specific theme of the Symposium structures that draw their inspiration and orga- is appropriately formulated with a question nization from the Catholic Church to increase open to hope: “Stem cells: what future for this type of research and to establish the clos- therapy?”. est possible contact with one another and with I thank Bishop Elio Sgreccia, President of those who seek to relieve human suffering in the Pontifical Academy for Life, for his kind the proper ways. words, also on behalf of the International Fed- May I also point out, in the face of the fre- eration of Catholic Medical Associations (FI- quently unjust accusations of insensitivity ad- AMC), an association that has cooperated in dressed to the Church, her constant support organizing the Congress and is represented for research dedicated to the cure of diseases here by Prof. Gianluigi Gigli, outgoing Presi- and to the good of humanity throughout her dent, and Prof. Simon de Castellvi, President- 2,000-year-old history. elect. When science is applied to the alleviation of suffering and when it discovers on its way new resources, it shows two faces rich in humanity: through the sustained ingenuity in- vested in research, and through the benefit an- nounced to all who are afflicted by sickness. Those who provide financial means and encourage the necessary structures for study share in the merit of this progress on the path of civilization. On this occasion, I would like to repeat what I said at a recent Audience: “Progress becomes true progress only if it serves the human person and if the human person grows: not only in terms of his or her technical power, but also in his or her moral awareness” (cf. General Audience, 16 August 2006). In this light, somatic stem-cell research also deserves approval and encouragement when it felicitously combines scientific knowledge, the most advanced technology in the biological field and ethics that postulate respect for the human being at every stage of his or her existence.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 8

If there has been resistance – and if there Church, addressed to all people of good will, still is – it was and is to those forms of re- on the human value of the newly conceived search that provide for the planned suppres- child, also when considered prior to implanta- sion of human beings who already exist, even tion in the uterus. if they have not yet been born. Research, in The fact that you at this Congress have ex- such cases, irrespective of efficacious thera- pressed your commitment and hope to peutic results, is not truly at the service of hu- achieve new therapeutic results from the use manity. of cells of the adult body without recourse to In fact, this research advances through the the suppression of newly conceived human suppression of human lives that are equal in beings, and the fact that your work is being re- dignity to the lives of other human individu- warded by results, are confirmation of the va- als and the lives of the researchers them- lidity of the Church’s constant invitation to selves. full respect for the human being from concep- History itself has condemned such a science tion. The good of human beings should not in the past and will condemn it in the future, only be sought in universally valid goals, but not only because it lacks the light of God but also in the methods used to achieve them. also because it lacks humanity. A good result can never justify intrinsically I would like to repeat here what I already unlawful means. It is not only a matter of a wrote some time ago: Here there is a problem healthy criterion for the use of limited finan- that we cannot get around; no one can dispose cial resources, but also, and above all, of re- 8 of human life. An insurmountable limit to our spect for the fundamental human rights in the possibilities of doing and of experimenting area of scientific research itself. must be established. The human being is not a I hope that God will grant your efforts disposable object, but every single individual – which are certainly sustained by God who represents God’s presence in the world (cf. J. acts in every person of good will and for the Ratzinger, God and the World, Ignatius Press, good of all – the joy of discovering the truth, 2002). wisdom in consideration and respect for every In the face of the actual suppression of the human being, and success in the search for ef- human being there can be no compromises or fective remedies to human suffering. prevarications. One cannot think that a society To seal this hope, I cordially impart an af- can effectively combat crime when society it- fectionate Blessing to all of you, to your col- self legalizes crime in the area of conceived laborators and to your relatives, as well as to life. the patients who will benefit from your inge- On the occasion of recent congresses of the nuity and resourcefulness and the results of Pontifical Academy for Life, I have had the your work, with the assurance of my special opportunity to reassert the teaching of the remembrance in prayer

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 9

Topics

The Rights of the Mentally Ill

The Catholic Church and Conjugal Sexuality

Pain and Suffering: a New Approach?

The Anthropological Dimension of the Right to Health

Pastoral Actions to Defend and Promote the Right to Health

The Figure of the Ecclesiastical Assistant DH n.63 ing 1-80 16-01-2006 17:14 Pagina 10

The Rights of the Mentally Ill

1. The Dignity of the loneliness that leads to social nulling the very value of law Mentally Ill Person exclusion. which tends to regulate the To this is added an excessive lives of all citizens in order to To be concerned about the medicalisation that with time achieve a peaceful life together rights of the mentally ill means tends to separate health treat- in society with respect for to take responsibility for a ment from psychological, so- everyone. large number of people who cial and emotional support, In the specific case of men- are often forgotten about by with deleterious consequences tally ill people, the World health care systems and state for the sick person who has to Health Organisation places the administrations. Given that the be rehabilitated and for his question of rights at the centre Church has the mission to family. Lastly, it is often the of its approach to the mentally come to the help of the poor, case that the very legislative ill. mentally ill people are a privi- instruments created to protect At the international confer- leged part of the family of the the mentally ill person have the ence that has already been re- needy who are the recipients of effect of making even more ferred to, Dr. Hiroshi Nakajima pastoral care in health. difficult his social integration stated: ‘whatever the mental In reality, mental distur- because his participation is not incapacities or disturbances bances now affect about a assured when decisions have to that afflict a person, that person 10 thousand million people in the be taken about him. has the right to receive care world and are responsible for The aim of the listing of the and medical treatment as well about 10% of health care ex- specific rights of the mentally as social, psychological and penditure in industrialised ill should be the same as the human support which allow countries, as was pointed out objectives of the whole of the him to have access to the high- 2 by the World Development Re- social organisation which est autonomy and wellbeing’. port in 2000. According to the should be directed towards the In order to make this right classification of the World common good, the protection effective, the World Health Or- Health Organisation, these and the promotion of the wel- ganisation advises against pathologies affect perhaps one fare of everybody without dis- shutting up mentally ill people thousand five hundred million tinctions of race, religion, sex in structures characterised by people and involve their family or social condition. custody, and proposes, instead, relatives in problems of care At the basis of life together that they should be placed in that at times are difficult to in society is the right to the de- places of care suited to their deal with. fence of the dignity of every condition. This represents an More specifically, in the human person as the founda- important shift in the defence light of the statistics presented tion of all the other individual of rights because it tends to see 1 in 1996 by the international and social rights. Without a the sick person as a being en- conference organised by the convinced adherence to the dowed with intellectual facul- Pontifical Council for Health value represented by the hu- ties and able to use them if he Pastoral Care on human mental man person at every stage of is in a ‘humanised’ context. disturbance, behaviour disor- his life and in every condition ders linked to cases of real of health, this right and other mental illness affect over a half rights run the risk of being re- 2. Rights and the Defence of the world’s population with duced to pure and simple of the Mentally Ill Person very grave consequences for proclamations of good intent the spiritual equilibrium of that do not have an effect on On the basis of the state- families and the sustainability the real organisation and work- ments at the level of principle of the health care economy. ing of institutions. of the World Health Organisa- In their action of assuring Side by side with the formu- tion, for at least twenty years the rights of all citizens, the lation of individual rights in the associations of psychiatry, various States of the world the various laws, reference families and at times ex-pa- have tried to formulate laws should always be made to the tients have formulated a series that aim at the protection of moral question of the dignity of declarations of rights: mentally ill people as subjects of the mentally ill person who 1. The right of a mentally of rights and members of soci- as a human person is the bearer sick person to enjoy the same ety who should be taken into of rights. fundamental rights as all other account in civil life. From this ethical belief aris- citizens, including the right to The fact remains that still to- es a culture of human rights lead a life that is as normal as day, albeit to varying extents which are seen as an expres- possible. according to different cultures sion of the needs for develop- 2. The right to treatment and civilisations, a mentally ill ment of every person translat- suited to the kind of pathology person and his family are treated into the idea of duties- that is present and treatment ed with detachment and often rights. Without the culture of which has exclusively thera- closed up in an unbearable ethics, the risk is run of an- peutic goals.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 11

3. The right to the protection have the aim of reducing the thority can find a justification of the patient who is subjected mental disturbance, belongs to and a foundation in obligatory to obligatory health care treat- such a definition. health care treatment. It is pre- ment against possible thera- The right to appropriate care cisely from a correct interpre- peutic abuses and an unjusti- and treatment concerns two tation of this form of treatment fied prolonging of coerced categories of questions and is- that one evinces the intention treatment. sues. The first concerns experi- of legislators who seek to de- 4. The right to be informed mentations on mentally ill peo- fend first and foremost the on the kind of treatment to ple which must have a preva- health of a person with a men- which he is subjected and the lent therapeutic purpose and tal disturbance and for this rea- consequent right to consent or not that of pure and simple sci- son temporarily reduce his dissent, albeit within the limits entific research in order to freedom during the period of imposed by the mental pathol- safeguard their possible reha- treatment that has to be admin- ogy of the individual con- bilitation. The second concerns istered in an emergency situa- cerned. a suitability of the treatment to tion. 5. The defence of these the type of mental disorder pre- The right to civil defence rights in the case of mentally sent in the individual rather and penal defence of the men- sick people admitted to legal than to another typology or a tally ill person is of the same 3 mental asylums. general mental illness. nature. Civil defence involves The fact emerges with clari- a series of measures that seek ty that rights aim at the defence to protect both the patient and of the person in his most inti- other people from the juridical mate constitution and not only consequences of civil acts car- the defence of society against ried out by the patient himself. 11 possible disorders produced by The juridical realities of inter- the presence of mentally ill diction and non-responsibility people within the social fabric. that have been introduced to As regards the capacity for protect the possessions and the consent, it is necessary to em- goods of the patient himself phasise that only in a limited belong under this heading. number of cases can we en- Penal defence, on the other counter a total incapacity on hand, fundamentally involves a the part of a sick person to pro- series of norms that take into vide consent to the best treat- consideration the person both ment proposed. as the author and as a victim of It is licit to state here that in a crime. the majority of cases it is the The first aspect fundamen- duty of medical doctors togeth- tally concerns the responsibili- The constitutional charters er with psychologists, educa- ty and the treatment of individ- on which are based the laws of tors, nurses and social workers uals that have been acquitted modern democracies are based to inform the person with a because of mental infirmity on these principles and see the mental disturbance in the most and for whom admission to a safeguarding of the common specific and accessible terms judicial hospital is necessary. good as an institutional pur- possible about the treatment The second aspect largely pose of the state. In particular, that is to be administered and concerns the incapacity of an the right to suitable care and his right to accept it or reject it. individual who is mentally ill treatment in the case of mental- Lastly, respect for the digni- to provide consent that is valid ly ill people must include the ty of the mentally ill person is in juridical terms. Thus there is right not to be distanced from expressed in the defence of the right upheld by adequate one’s habitual place of resi- professional secrecy: that the laws to be defended in cases of dence and one’s own family patient’s privacy is guaranteed carnal violence, in the doctor- relatives except in particular so as to avoid, as well, the per- patient relationship, and in and exceptional cases. petuation of the social stigma matters connected with con- Within the framework of attached to him and the group sent to therapeutic ends, abor- these rights should be included to which he belongs, is a pre- tion or any act that suppresses the right to active participation cise right of the patient and his the conscience of a person with in civil life and thus to rehabil- family. mental disturbance. itation at the level of work. These original rights that Reference should be made The reference made above to rightly put the mentally ill per- lastly to the right to defence at medical treatment directed ex- son on the same level as every the level of insurance of a men- clusively to therapeutic ends other citizen are followed by tally ill person which takes brings out the risk of prescrip- certain specific rights. form in the right to compensa- tions that we may define as be- First of all, the right not to be tion at the level of pension ing punitive or convenient. At seen as a dangerous individual rights in the case of illness times an excessive use of psy- in relation to himself and to caused or aggravated by work, chotropic drugs used in the other people, as was thought in addition to the right to enjoy place of old methods of con- for a long time, even though the social assistance envisaged tainment, which do not always the intervention of public au- for the rehabilitation and the

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 12

social integration of a person 4. The psychiatrist must in- al respect on the basis of which with a handicap who must not form the patient about the na- the patient can take free and in- be discriminated against. ture of his situation, the conse- formed decisions. The duty of From the question of rights quent diagnosis and the thera- the psychiatrist lies in provid- one moves to the broader issue pies envisaged and the progno- ing the patient with relevant of ethics. I thus reproduce here sis. and significant information certain articles of international 5. No treatment should be that allows him to take reason- documents designed to pro- applied against the will of the able decisions in line with his mote the welfare of mentally ill patient or independently of that own norms, values or prefer- people. In these the link be- will, unless the patient is inca- ences. tween rights and ethics and be- pable of expressing his own Only in this way can one tween deontology and morality will. Only in these cases and combat stigma and discrimina- clearly emerges. for grave reasons can recourse tion. From this point of view be made to forced health care the infinite particular situations treatment. relating to forced internment, 6. When these circumstances research and treatment should no longer exist the treatment be reconsidered. must be suspended to allow the If psychiatry and the neuro- patient to express his consent sciences in general are able to to the treatment. overcome the barriers against 7. The psychiatrist must nev- mental illness, to activate com- er use the powers of his profes- munication with the most sion to maltreat individuals and alienated of the alienated, to 12 groups and must be aware of look for the truth with those the fact that his personal wish- who are dominated by an autis- es, feelings and prejudices tic truth, then research will be must never interfere with the possible. treatment. If the opposite occurs, psy- 8. The psychiatrist is always chiatry will disappear as a dis- obliged to professional confi- cipline and as a practice and dentiality unless the patient the neurosciences will collapse himself or interests of a higher having lost the meaning of nature free him from this duty. their mission (The World Psy- 5 9. The development and the chiatric Association, 1996 ). 3. The Declaration of Hawaii dissemination of psychiatric knowledge requires the active Rev. PIERLUIGI MARCHESI With the intention of making participation of patients them- OH. clear the deontological nature selves. As a result it is neces- Father Pierluigi Marchesi OH left us of the profession and to act as a sary to obtain the informed and returned to the house of the Father in guide for every psychiatrist, consent of the person involved 2001. He was Prior General of the Hos- pital Order of St. John of God (Fatebene- certain written rules are indis- to present his case or publish fratelli) for twelve years, member of the pensable. At the time of the the results of an experimenta- Pontifical Council for Health Pastoral General Assembly of the tion. Whatever the case, Care from its foundation onwards, and President of the AISAC (International World Psychiatric Association anonymity must be assured Association of Catholic Health-Care In- the following ethical norms and the personal reputation of stitutes). were established for psychia- the person must be safeguard- He dedicated himself to the training of health-care professionals and his works trists throughout then world: ed. were published by Velar-elledici in 2006 1. The goal of psychiatry is 10. Every patient has the under the title ‘Umanizzazione storia e to contribute to the health, the right to withdraw from an ex- utopia’ (‘Humanisation: History and personal autonomy and the de- perimentation at any moment Utopia’) velopment of individuals. or for any reason, thereby also 2. Every patient must be of- ending voluntary treatment, re- fered the best treatment possi- search or a teaching pro- ble and must be treated with gramme underway. This deci- the care and the respect due to sion does not preclude his right the dignity to which all human to treatment (Honolulu 26 Au- 4 Note 1 beings have a right, in addition gust 1977 ). J. M. BERTOLETE, ‘Malattie mentali to respect for his capacity to nel mondo: dati epidemiologici’, Dolen-

decide about his own life and tium2 Hominum, 34, 1997, 40-43. H. NAKAJIMA, ‘Programmi ed attività health. 4. The Madrid Declaration. di salute mentale dell’OMS’, Dolentium 3. The therapeutic relation- Conclusion Hom3 inum, 34, 1997, 11-12. ship between the patient and AA.VV, The Protection of Persons the psychiatrist is based upon a The patient must be accepted Suffering from Mental Disorders (AIDO, Syr4acuse, 1981). reciprocal agreement. It re- in the therapeutic process with World Psychiatric Association, quires trust and respect for the right of equality. The rela- Hawaii Declaration (1977, 1983), Sela5 re, 82, March 2000, 42-45. confidentiality, openness, co- tionship between the therapist World Psychiatric Association, operation and mutual responsi- and the patient must be based Madrid Declaration (1996), cited in Do- bility. upon confidentiality and mutu- lentium Hominum, 34, 1997, 58.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 13

The Catholic Church and Conjugal Sexuality THE HUMAN BODY: THE SUMMIT OF CREATED MATTER

5 Shaken by admiration for its fourth point, I will clarify the and husband’. ‘By calling God discoveries and its power, two inseparable meanings of ‘Father’, the language of faith mankind often discusses anx- the conjugal act, the proper, indicates two main things: that ious questions about the con- specific and exclusive expres- God is the first origin of every- temporary development of the sion of conjugal love. thing and transcendent authori- world, about the place and task ty; and that he is at the same of man in the universe, about time goodness and loving care the meaning of its own individ- The Human Body for all his children. God’s ual and collective efforts, and in the Image of God parental tenderness can also be

also about the ultim1 ate purpose expressed by the image of of things and men. On the one ‘Then the Lord God formed motherhood, which emphasises hand, the pluralism of concep- man of dust from the ground, God’s immanence, the intima- tions of life and the world, his- and breathed into his nostrils cy between Creator and crea- toricism with its consequent the breath of life; and man be- ture. The language of faith thus relativism in relation to truth, came a living being’ (Gen 2:7). draws on the human experience and distrust in the capacity of These are the words of Genesis of parents, who are in a way the 13

man to reach absolute truth, with which God Himself re- first r6epresentatives of God for and, on the other, confidence in veals that the body of man man. But this experience also science and scientific-techno- shares in the dignity of being in tells us that human parents are logical progress, believed to the ‘image of God’ because he fallible and can disfigure the able to solve all the problems of is animated by a spiritual body. face of fatherhood and mother- man, have changed the certain- As regards sexuality in general, hood. We ought therefore to re- ty of religious culture and the and conjugal sexuality in par- call that God transcends the hu-

face of Christian civilisat2ion in ticular, it should be further em- man distinction between the the continent of Europe. In a phasised that this value of be- sexes. He is neither man nor specific way and in an increasing in the image of God applies woman: he is God. He also ingly worrying way, we per- both to the body of a man and transcends human fatherhood ceive a loss of the meaning and to the body of a woman. ‘So and motherhood, although he is

the significance of sexuality, in God created man in his own their origin and standard: no7 general, and of conjugal and fa- image, in the image of God he one is father as God is Father’. milial sexuality, in particular. made them; male and female The human body, and this is One need only think of free and he created them’ (Gen 1:27). what should be emphasised, ‘de facto’ cohabitations placed The Catechism of the Catholic thus expresses a ‘divine’ lan- on the same level as ‘de iure’ Church (CCC) states on this guage that is proper and specif- marriages, the increase in di- point: ‘‘Being man’ ‘being ic to the conjugal sexuality of a vorce, the civil legalisation of woman’ is a reality which is man, a husband and father, and gay marriages with the right to good and willed by God: man of a woman, a wife and mother. adopt children, and even more and woman possess an inalien- ‘God created man and woman topical, the discussion, so many able dignity which comes to together and willed each for the times in a way that does not them immediately from God other. The Word of God gives correspond to scientific truth their Creator. Man and woman us to understand this through and even less to ethical criteria, are both with one and the same various features of the sacred of assisted procreation, cloning dignity ‘in the image of God’. text. ‘It is not good that man and the use of frozen embryos In their ‘being-man’ and ‘be- should be alone. I will make for therapeutic purposes and so ing-woman’, they reflect the him a helper fit for him’ (Gen

forth. Faced with this situation, Creato4r’s wisdom and good- 2:18). None of the animals can and in the light of the final doc- ness’’. In order to avoid all be man’s partner. The woman

ument of the tenth congress of3 misunderstandings, and this God ‘fashions’ from the man’s the FEAMC held in Bratislava, point should be noted well, rib and brings to him elicits on it seemed to me to be useful to God is not in man’s ‘image’. the man’s part a cry of wonder, present certain key points of the God is neither man nor woman. an exclamation of love and teaching of the Catholic Church God is pure spirit and thus in communion: ‘This at last is on conjugal sexuality. First of him there is no place for the bone of my bones and flesh of all I will stress how the human difference between the sexes. my flesh’ (Gen 2:23). Man dis-

body is the summit of created Thus when we state that man covers woman as another 8‘I’, matter. Then I will clarify some and woman are in God’s image sharing the same humanity’. In characteristics of conjugal sex- we mean that ‘the perfections’ the divine plan, all of this is uality. From there I will go on of man and woman reflect first of all and above all true to the third point: an absolute something of the infinite per- and verifiable in the sexual re- ‘no’ to divorce and a relative fection of God: those of a lationship between the two ‘yes’ to annulment. Lastly, as a mother and those of a father spouses.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 14

Conjugal Sexuality and provident institution of No to Divorce God the Creator, whose pur- and Yes to Annulment It is very significant that pose was to establish in man his Holy Scripture not only opens loving design. As a conse- As a consequence, the legali- with the account of the creation quence, husband and wife, sation of divorce with the ex- of man and woman in the im- through that mutual gift of plicit right to a new marriage age of God but also closes with themselves, which is specific clearly contradicts this explicit the vision of the ‘marriage of and exclusive to them, seek to will of God. This is why the the Lamb’ (Rev 19:7-9). From develop that kind of personal Catholic Church, even though it the beginning to the end the union in which they comple- tries to understand more and in Word of God talks to us, in fact, ment one another in order to a better way the dramatic char- about marriage and its ‘mys- co-operate with God in the gen- acter of certain conjugal states

tery’, its establishment and the eration11 and education of new that are in crisis, can never en- meaning that God has given to lives’. With this ‘personalis- gage in compromises with the it. In Holy Scripture we find its tic’ conception of conjugal sex- contemporary pro-divorce cul- origins and its purpose, its vari- uality, Pope Montini unmasks ture. The only thing that the ous ‘historical-salvific’ expres- the falseness of every ‘biologis- Catholic Church can do, and it sions, as well as its difficulties tic’ criticism of the authentic has been doing this for some derived from original sin and Magisterium of the Catholic time, is to see if God has really personal sins, but also its sacra- Church and its official morali- joined certain conjugal ties. The mental renewal in the New ty. The approach of the Church possibility of declaring a conju-

Covenan9 t of Christ and the reveals, first and foremost, the gal union ‘void’, that is to say Church. Overall, God the Cre- interpersonal gift of the that it never existed, is the mas- 14 ator is the author of the intimate woman, wife, and of the man, ter road for solving certain con- communion of life and of con- husband, and only afterwards is jugal cohabitations that have jugal love, founded by God there a move to the generation become irreversibly compro- Himself and endowed with and education of children, em- mised. Indeed, aware that sexu- laws that are specific to a con- phasising that this is co-opera- ality exercises an influence on jugal pact. The vocation to mar- tion with God. In other terms, all aspects of the human person, riage was thus written into the the mutual personal giving of in the unity of his body and his very nature of man and woman the husband and wife is above soul, the Magisterium of the as they came from the hand of all directed towards mutual per- Church evaluates in particular the Creator. Despite the numer- fection. This demonstrates that the affectivity, the capacity to ous changes down the cen- all of those who accuse the love and to procreate and in a turies, in the various cultures, Church of ‘procreationism’ fal- more general way the aptitude

social structures and spiritual sify the teaching of the Church. for forming bond1s3 of commu- attitudes, there nonetheless ex- The morality of ‘conjugal sexu- nion with others. It is worth ists in all cultures a sense of the ality’ is perfectly and complete- noting that this evaluation cor- greatness of the conjugal union. ly in harmony with the account responds to the full to the digni- I would like to emphasise how of Genesis: ‘Therefore a man ty of each human being, specif- the Fathers of the Second Vati- leaves his father and his mother ically as a person. ‘Being in the can Council stressed these and cleaves to his wife, and image of God the human indi- common and permanent fea- they become one flesh’ (Gen vidual possesses the dignity of tures: ‘the well-being of the in- 2:24). Now, it is not difficult to a person, who is not just some- dividual person and of both hu- understand that marriage de- thing, but someone. He is capa- man and Christian society is notes, as an intrinsic property ble of self-knowledge, of self- strictly closely bound up with of its being, an unfailing unity possession and of freely giving

the healthy state10 of conjugal of two human existences, equal himself and entering into com- and family life’. It should be as persons but different sexual- munion with other persons. observed that the vocation to ly. For that matter, the Lord And he is called by grace to a marriage is written by the Cre- demonstrates this when he re- covenant with his Creator, to ator into the very nature of minded us of what was, at the offer him a response of faith

woman and man. Indeed, God, outset, the design of the Cre- and love that no other cr14eature who created man for love, also ator: ‘So they are no longer two can give in his stead’. This called him to love, the funda- but one’ (Mt 19:6). ‘In his dignity as a person is thus a di- mental and innate vocation of teaching Jesus unequivocally vine gift of equal measure to every human being. God, who taught the original meaning of man and to woman because is Love (cf. 1 Jn 4:8,16), after the union of man and woman as both of them, in fact, have been

creating man, male and female, the Creator willed it from the created15in the image of God a in His image, wanted, through beginning: permission given by person. their mutual love, to reveal His Moses to divorce one’s wife At this point, and here I re- absolute and unfailing love was a concession to the hard- alise I am going against the with which He loves every hu- ness of hearts (cf. Mt 19:8). mainstream, the importance of man being. The author of Hu- The matrimonial union of man the vocation to chastity is evi- manae Vitae wrote: ‘Marriage, and woman is indissoluble: dent, that is to say to the posi- then, is far from being the ef- God himself has determined it: tive integration of sexuality fect or chance or the result of ‘what therefore God has joined within the person. ‘Sexuality, in

the blind evolution of natural together, let no12man put asun- which man’s belonging to the forces. It is in reality the wise der’ (Mt 19:6)’. bodily and biological world is

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 15

expressed, becomes personal was right when he wrote in male is in a proper and specific and truly human when it is inte- 1968: ‘These considerations way ordered to the conjugal grated into the relationship of give us the opportunity to ad- love of man and woman. The one person to another, in the dress those who are engaged in corporeal intimacy of the hus- complete and lifelong mutual education and all those whose band and wife becomes in their gift of a man and a woman. The right and duty is t provide for marriage bond a sign and a virtue of chastity therefore in- the common good of human so- pledge of a spiritual commu- volves the integrity of the per- ciety. We would call their atten- nion between two persons who

son a16nd the integrality of the tion to the need to create an at- are at one and the same time gift’, and as a consequence mosphere favourable to the equal and different. Their acts the inner unity of man, male growth of chastity in such a concern the intimate core of and female, in his corporeal and way that true liberty may pre- their beings as human persons spiritual being. Let it be made vail over licence and the norms as such. Thus conjugal sexuali-

clear, with regard to the integri- of the mo1r9al law be fully safe- ty is expressed in a truly human ty of the person, that chastity guarded’. This is why I have way only if it is an integral part maintains the integrity of the sought to present a correct idea of the love with which the man

powers of life and love that are of sexuality in general and of and woman are committed t2o1 placed in man and woman, en- conjugal sexuality in particular. each other totally until death. It is then that their acts not only foster the meanings of mutual self-giving but also produce a reciprocal personal enrichment in a joyous mutual gratitude. ‘The Creator himself… estab- 15 lished that in the [generative] function, spouses should experience pleasure and enjoyment of body and spirit. Therefore… the spouses do nothing evil in seeking this pleasure and enjoyment. They accept what the

Creato2r2 has intended for them’. The Creator thus intended that through their union the spouses should achieve the twofold end of conjugal love: the good of themselves and the transmission of life. ‘These two meanings or values of marriage cannot be separated without al- tering the couple’s spiritual life and compromising the goods of suring not only the unity of the It remains to me address certain marriage and the future of the person but also opposing any solid beliefs about the real val- family. The conjugal love of behaviour that would impair it. ues of life and the family, above man and woman thus stands

It tolerates neither a doub1l7e life all in relation to the question of under the twofold obliga2t3ion of nor duplicity in speech. The responsible procreation. fidelity and fecundity’. With personal dignity of a man and a respect to fecundity, conjugal woman requires them to act out love naturally tends to be fruit- of conscious and free choice, as The Two Inseparable ful. ‘A child does not come moved and drawn in a personal Meanings of Every Act from outside as something way from within, and not by of Conjugal Love added on to the mutual love of

blind impulses in themselves o1r8 the spouses, but springs from by mere external constraint. ‘The question of the birth of the very heart of that mutual

Overall, chastity includes an children, like every other ques- giving2,4 as its fruit and fulfil- apprenticeship in self-mastery tion which touches human life, ment.’ In relation to this natur- which is a training in true hu- is too large to be resolved by al paternal and maternal fecun- man freedom. This self-mas- limited criteria, such as are pro- dity of the unitive love of a hus-

tery, and this is what of interest vided by biology, psychology, band and wife, the Church25, to us, is ordered to the integrali- demography or sociology. It is which ‘is on the side of life’, ty of self-giving. Chastity the whole man and the whole ‘teaches that each and every

makes the man and the woman complex of his responsibilities marriage act must remain ope2n6 who practice them witnesses to that must be considered, not on- to the transmission of life’. the faithfulness and tenderness ly what is natural and limited to Called to transmit life, the

of God. Such are the criteria for this earth, but also wha2t0 is su- spouses share in the creative the assessment of a conjugal pernatural and eternal’. What power and the fatherhood of communion of life and love, has been said hitherto in this God. Thus the spouses are re- united by God and thus indis- paper has emphasised that the sponsible co-operators with, soluble or annullable. Paul VI creation of the male and the fe- and interpreters of, the love of

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 16

God the Creator. This doctrine, ator-that of transmitting by pro- has vested with his authority’ (CCC, n. 2197). expounded on numerous occa- creation the divine image from 7 8CCC, n. 239.

sions by the Magisterium of the person to person’. Here the 9 CCC, n. 371. Cf. CCC, n. 1602. Church, is based on the insepa- evaluative ethical criterion as 10 The Second Vatican Council, rable connection – established regards responsible procreation Gaudium et spes, n. 47. Cf. also CCC,

by God and which man cannot is clearly indicated, namely the n.116103. PAUL VI, Humanae Vitae, n. 8, break of his own accord – be- originality of human generation 12 Cf. CCC, n. 1614. tween the unitive significance that derives from the very origi- 13 14 Cf. CCC, n. 2332.

and the procreative significance nality of the human person. 15 CCC, n. 357. inherent in the act of conjugal John XXIII had no doubts on JOHN PAUL II, Apostolic Letter 27 Mulieris dignitatem, n. 6. love. the matter: ‘The transmission of 16 17 CCC, n. 2337.

In safeguarding both these human life is the result of a per- 18 Cf. CCC, n. 2338. two essential aspects, the uni- sonal and conscious act, and, as Cf. CCC, n. 2339. tive and the procreative aspects, such, is subject to the all-holy, the conjugal act integrally inviolable and immutable laws

maintains the sense of mutual of God, which no29 man may ig- and true love and its ordering to nore or disobey’. This person- the very high vocation of a man al act is the intimate union of and a woman to the responsible the husband and wife, who in transmission of life. And it is giving themselves totally to this responsible motherhood each other give life. It is a and fatherhood that God has en- unique and indivisible act that trusted to them in creating them is at the same time both unitive

16 man, male and female. A child and proc3r0eative, conjugal and is not an object to which one parental. Thus the application has a right, there is no right to a to man of biotechnologies de- child, but only to the conjugal rived from the fertilisation of act that is open to the procre- animals, with the aim of mak- ation of a child. It is the child to ing possible various interven- have the natural right, that is tions on human procreation, from God, not only to be the raise grave questions of moral

fruit of the specific act, which is acceptability. Indeed, the vari- 19 PAUL VI, Humanae Vitae, n. 22. I specific and exclusive to the ous techniques of artificial re- here quote the reaction that the author of conjugal love of his parents, but production, which would seem Humanae vitae wanted to provoke: he also has the right to be re- to be at the service of life and ‘Everything therefore in the modern means of social communication which spected as a person from th2e8 which are frequently used with arouses men’s baser passions and encour- moment of his conception. this intention, actually open the ages low moral standards, likewise every With all this it is not my inten- door to new threats against life obscenity in the written word and every form of indecency on the stage and tion to underestimate the suffer- because they are unworthy of screen, should be condemned publicly ing of couples who find that human procreation since the and unanimously by all those who have at they are sterile. Indeed, I would human body, being in the image heart the advance of civilization and the not only like to encourage re- of God, is the summit of creat- safeguarding of the outstanding values of 31 the human spirit. It is quite absurd to de- search directed towards reduced matter. fend this kind of depravity in the name of ing sterility but I also hope that art of culture or by pleading the liberty such research produces un- Rev. BONIFACIO HONINGS which may be allowed in this field by the pub20lic authorities’ (ibidem). precedented results. OCD, AUL 21 P VI, Humanae vitae, n. 7. I would like to be able to ho- Professor Emeritus of the Cf. John Paul II, Apostolic Exhorta- PUL and URB Pontifical Universities, tion Familiaris consortio, n. 11. nour Pope Wojtyla, of most 22 Rome, Italy PIUS XII, speech of 29 October venerable memory, by conclud- 195231, quoted in CCC, n. 2362.

ing with his words written in 24 CCC, n. 2363.

25 Cf. CCC, n. 2366. his apostolic exhortation Famil- OHN AUL iaris consortio, (n. 28): ‘With J P II, Apostolic Exhortation Fam26 iliaris consortio, n. 30. the creation of man and woman I would like to observe on this point in His own image and likeness, Notes that I use the phrase ‘must remain open to the transmission of life’ for two reasons. God crowns and brings to per- 1 Firstly, because Pope Montini uses it ex- 2 Cf. Gaudium et spes, n. 3. fection the work of His hands: Cf. Episcopato Italiano, L’Evangeliz- pressly: ‘ut quilibet matrimonii usus ad He calls them to a special shar- zazione del mondo contemporaneo (Elle vitam humanam procreandum per se des- tinatus permaneat’ (HV, n.11). Secondly, Di 3Ci, Turin,1974), n. 4. ing in His love and in His pow- Cf. Orizzonte Medico, July-August, for reasons of a moral order – it avoids any form of biologism; for that matter re- er as Creator and Father, 20044, p. 23. CCC, n. 369. course to infertile periods involves non- through their free and responsi- 5 Cf. CCC, n. 370. openness. ble cooperation in transmitting 6 27 The proof of this representation is of- 28 Cf. CCC, nn. 2366-2367. the gift of human life: “God fered and confirmed by the fourth com- Cf. Congregation for the Doctrine of blessed them, and God said to mandment of the Ten Commandments. the Faith, Instruction Donum vitae, II, 8; Indeed, ‘The fourth commandment opens see29also CCC, n. 2378. them, ‘Be fruitful and multiply, the second table of the Decalogue. It JOHN XXIII, Encyclical Mater et and fill the earth and subdue shows us the order of charity. God has Ma3g0 istra, III, in AAS 53, 1961, 447. it.’”(Gen 1:28) Thus the funda- willed that, after him, we should honour Cf. JOHN PAUL II, ‘Udienza gen- mental task of the family is to our parents to who we owe life and who erale’, 16 January 1980, in Insegnamenti have handed on to us the knowledge of III/311, 1980, 148 ss. serve life, to actualize in history God. We are obliged to honour and re- Cf. JOHN PAUL II, Encyclical Evan- the original blessing of the Cre- spect all those whom God, for our good, gelium vitae, n. 14.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 17

1 Pain and Suffering: a New Approach?

1. One’s Own Experience as the sphere of public health mercialised vision that I want a Point of Departure care and with the rhythms of to stress here lies in the fact its significant and constant de- that despite the enormous dra- Very few aspects of human velopment over this period of ma released by many of these reality have been, are and will time. images or accounts, they are be experienced, contemplated, Catholic pastoral care and almost always transmitted and described, studied, thought health care are, therefore, the seen as mere events, that is to about and expressed in its var- fundamental contexts that say filtered experiences – on ious manifestations, as much have nourished and still nour- by no means a few occasions as suffering. The sciences, lit- ish my experience of suffer- they are manipulated by the erature, the plastic and scenic ing. What I will say about mass media that transform 4 arts, philosophy, theology, re- them is what I myself have ex- them into news and transmit ligious expression, whether perienced over the years side them – and seen by readers or liturgical or popular (and in by side with sick people and viewers at a distance in rela- their mass expression, the health-care workers – family tion to those that are suffer mass media), are the scenarios relatives, health-care profes- them in the first person. As a in which suffering appears, on sionals, pastoral workers and consequence, what happens is various occasions, as an ingre- volunteers – where these latter that this vision, despite the 17 dient of the human condition, allow the former to transfer horrors that it involves, which so obvious and at the same upon them a part of their suf- are frequently presented to the time so inseparable from that fering. It is certainly the case full, allows us to continue our condition, and also so resistant that this increasing experience normal lives without great to an understanding that is sat- led me to a reflection that is problems, at least at the level isfactory at a rational level. nourished and continues to be of appearances, because it Despite this fact, and with- nourished not only by what is leads is to think that suffering out neglecting this very abun- experienced in my relation- is always something that hap- dant source of information, I ships with suffering people but pens to other people. This is a would like to make it clear also by the testimonies of the very great error which fre- from the outset that it is my past and the present that be- quently has a heavy price. belief that one cannot manage long to the scenarios to which Is the same thing happening to really know what suffering I referred in the previous para- when one experiences suffer- is if one does not look into its graph. In the final analysis ing within oneself as when depths, which can form an what I am offering those who one helps sick people who are abyss, and enter it through ex- read this paper is the outcome, suffering a great deal and their 2 perience al vivo, experiencing of varying degrees of ripeness, family relatives? Undoubtedly it within oneself and through of this reflection. not, although in the case of an assiduous presence next to health-care, pastoral or volun- those who suffer. tary workers people usually For this reason, I believe 2. Suffering Filtered or believe that they are already that to engage in a reflection Perceived at a Distance habituated to seeing people on such a universal, complex suffer. and enigmatic subject re- I wanted to begin this paper quires, to begin with, a locat- by emphasising my personal ing of this experience in the and immediate experience as 3. The Semantic Confusion personal context of the person the pathway to a genuine per- between Pain and who provides it, that is to say a ception of suffering because Suffering clarification of the terrain in we are increasingly invaded which the person who decides by a commercialised vision of In the case of the word ‘suf- 3 to address such an undertaking suffering, available to every- fering’ something similar hap- moves, and the perspective or one, which is offered every pens to what was said about perspectives from which he day by the press, radio, televi- ‘experience’ (cf. section 2): it, does this. In my specific case, sion and cinema, through too, is not without confusion the terrain in which I move is news, reports or films, in as regards the attribution of its that of the experience of which there appear to the full meaning, above all because of Christianity from the perspec- people who are suffering in- the fact that habitual language tive of my priestly mission, tensely because of accidents, usually exchanges it with with almost thirty-five years natural catastrophes, atypical ‘pain’ and to the point that of experience in this ministry, or merely dramatic illnesses, both appear as synonyms for all of which, practically, I have conflicts in human relation- each other. This semantic in- passed in the field of pastoral ships or extreme forms of vio- terchange seems even to be care for the sick and those lence. consecrated by the Spanish who look after them, within A characteristic of this com- Dictionary which defines the

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 18

term ‘suffering’ in terms of consequences for him as a in the self. It is damage which, ‘affliction’, ‘pain’ and ‘grief’. whole, I will call ‘affliction’ against the will of the person In the field of medicine, refer- that general perception – in- who feels in its grip, trans- ence in all naturalness is made deed rough perception if you forms that person into a per- to ‘foetal suffering’ in obstet- will allow me this term – of an son in pain and a person who rics and to ‘spiritual pain’ in injury by which a person feels is a patient. palliative medicine. The same that he is affected in all the as- In expressing pain I have thing happens with the lan- pects of his being. Beginning seen that sick people see guage used by the Magisteri- with this there are those who themselves more as the ob- um of the Catholic Church, call ‘suffering’ human afflic- jects of passive affectation which is very scrupulous as tion that has origins or reper- than as active subjects en- regards precise expression. cussions that are prevalently dowed with spontaneity and Without having to go too far, of a mental character and con- initiative. Their exclamations the Apostolic Letter of Pope fine the term ‘pain’ to alluding are usually, for example, the John Paul II on the subject of to discomfort of a prevalently following: ‘my head hurts this paper is Salvific doloris, somatic character. I myself me’, ‘the wound’, ‘the indif- on the Christian meaning of adopted this terminology for a ference of other people’, ‘the 5 human suffering. rather long period of time be- lack of interest of my family’, Not even the scholarly dis- cause this distinction helps us ‘abandoned by God’…This is ciplines and forms of knowl- to assess, for example, the dif- how I hear sick people afflict- edge that try to clarify with the ferent nature of human and an- ed by pain of the body or the greatest possible precision the imal suffering. But what is of soul express themselves: see- meaning of the realities re- interest to me now is to help to ing their own organism or per- 18 ferred to by these two words distinguish with great preci- son, things and circumstances seem to provide greater clari- sion the human and humanis- that are in themselves differ- fication on the point. The In- ing value, the beneficial or in- ent, as the subject of their ternational Association for the jurious value, of pain and suf- pain; seeing pain from its ap- Study of Pain (IASP) defines fering. I think that in order to pearance as an extraneous pain as an ‘unpleasant sensori- honour this attempt it is neces- sudden reality that can be real and emotional experience sary to proceed with caution. jected. And in seeing them associated with a real or potential tissue injury or anyway 6 described as such’. For the most recent Catholic theology, suffering ‘is a both physical and mental feeling of loss, 7 damage or lack’.

4. Affliction, Pain and Suffering

I would not like to commit the sin of ill-placed audacity bordering on petulance but I believe that we can make an attempt at greater clarity and precision in the use of the meanings of these two terms because this will enable us to eliminate or to mitigate all misunderstandings that have been produced – or which are still being produced – in the assessment of the human and As I have seen and per- from this perspective, I came humanising realities of pain ceived from my own pastoral to believe that a person is re- and suffering. Or at least I will and health-care experience sponsible for the pain that he try to do this because this sub- over the years, pain is primari- consciously inflicts on himself ject deserves this propensity ly the affliction produced by or that he provokes in other for precision. With respect to the impact and the invasion of people when he acts upon ‘clarity’, Ortega y Gasset said a reality that arrives, wounds them as an injurious agent. To that this must be the courtesy and damages the person that it recapitulate, and bringing into of philosophers. afflicts; an injurious reality this sphere the terminology To honour the precision to that to begin with is not gener- applied to illness by that lead- which I refer above, and be- ated by the person who suffers ing thinker Pedro Laín Entral- 8 ginning with an overall view it – except in cases of con- go, I see pain as a disorder of a human being according to firmed psychopathologies – that is suffered and felt as which everything in him has but comes at times from with- damage and affliction.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 19

As I see things, with suffer- mental, social and spiritual re- respondence between what I ing the contrary occurs. My sources, that is to say the per- have expressed about the dif- experience has led me to see son as whole. Pain, from its ference between the character suffering as a painful reaction origins onwards, imposes it- of pain and the character of that most of those people who self on us, whereas we can suffering and the contents of 10 are struck by pain generate in achieve command over suffer- this poem. I believe that the themselves and beginning ing. And, in a reflection on observations that I make on with themselves in order to this subject from the point of this question, although rather combat it and eliminate it or to view of the humanisation of thin and summarising in char- try, when they are unable to do health, pain seems to me to be acter, constitute a base for ap- this completely, to bring it to pre-human, uncertain, invol- proaching, beginning with the tolerable limits and to accept untary and not a matter of re- perspective of the world of living with it because, in the sponsibility, whereas I see suf- health and health care, that end, they perceive or feel that fering as being born from the great question which together from then on it will be their in- innards of man, a subject to be with the ineluctability of death evitable, although unwanted, loved or rejected, modulated has concerned or concerns companion. or directed through the exer- each person during his journey The phrases that I have cise of intelligence, the will through life in this world: heard over the years employed and a freedom that is limited whether to have pain and suf- by suffering people have in the but with a sufficient margin of fer because of illnesses makes great majority of cases a manoeuvre and thus of re- us more human or whether it grammatical structure that is sponsibility. dehumanises us. significantly different from A sonnet by José Luis those phrases mentioned Martín Descalzo expresses 19 above and used in relation to this better than I have done in 5. Pain and Suffering as pain. In these phrases the per- the lines above because it does Factors of Humanisation son who suffers is an active so with the precision and subject whereas pain and its depth specific to poetic lan- Perhaps adopting an overly cause are relegated to the con- guage, which is much more schematic approach in the pre- dition of an indirect or circum- revealing that scientific or amble to the answer that I am stantial complement: ‘I am philosophical language when trying to offer, I should to be- suffering because I have a pain it comes to addressing the de- gin with make two observa- in my head’, ‘because of a scription of the interiority of tions which – once again be- wound’, ‘because of people’s man. For this reason, I cannot ginning with my own experi- indifference’, ‘because I am resist writing it down because ences – involve facts that are abandoned by God’… As I see it is the suffering expression of equally observable. First of things this semantic change a sick person in pain: all, the awareness that each could not be more significant. person has in the normal use To paraphrase Thomas Syden- Never, pain, can you make of his perceptive and intellec- 9 ham, who described illness in me afraid, tual faculties of the fact that terms of conamen naturae, a You can raise my eyes to both pain and suffering are effort by nature to eliminate weeping, two inseparable ingredients of the damage produced by the Dry my tongue, muzzle my the human condition: we are morbose agent that has singing, born, we live and we die at- brought it about, we should Break my heart and break tacked by pain, and as a conse- say that suffering is the cona- me down, quence we generate suffering men personale, an effort by You can shut me up behind without any of us being able to the whole of the person to deal bars, avoid any level of co-exis- 11 with the attack and the inva- Destroy the castles that I tence with these ingredients. sion of pain. build, To be human implies, amongst From this I deduce that the Anoint all my hours with other things, to feel pain and essential thing in the sphere of your horror. cause pain, to suffer and to pain is the injurious attack and But you can never make me make others suffer. the consequent affliction. In afraid, From this point of view, the context of suffering the I can love on a chair of pain and suffering are two re- protagonist is the person who, torture, alities that are genuinely and in suffering pain, does not re- I can laugh even when obstinately human however sign himself to being a mere pierced by your lances, much they may be undesired patient but reacts in order to I can see in the dark night, in most instances. The con- fight it as an active subject. In I arrive, pain, where you stant and ineluctable human principle, pain is uncertain and can not. aspiration to health is not in unexpected; suffering is, in- I decide my blood and its contradiction with what Gar- stead, reactive, original and thickness, cilaso de la Vega, Azorín and self-determined. Pain usually I am the lord of my hopes. Pedro Laín Entralgo call the always holds the initiative; in ‘painful feeling’ that afflicts suffering the initiative lies, to I leave to the reader the task, everyone because they are begin with, with our organism which I think is simple and persons and live as such. and often, after that, with our gratifying, of finding the cor- The second observation is

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 20

connected with the fact, evi- tween what is evident and of my experience to my read- dent for me as well, that in what is nebulous, between ers requires me to share with looking for the meaning or what can be expressed and them this problem that contin- sense of pain and suffering it what is ineffable, and between ues to present itself, as well as is necessary to divide human knowledge and non-knowl- the paths for a solution that beings into two graded cate- edge. have been adopted with the gories: the category of those The gestures, modes, mani- rhythm of my years as a pas- who see in pain and suffering festations and expressions of toral worker, that is to say a no beneficial meaning or the pained and the suffering human, spiritual and religious sense and the category of help those who observe them workers. The problem, as it those who, although they and share in their trials with presents itself to me, may be recognise that pain must al- care to measure the character formulated in the following ways and in principle be and intensity of their afflic- way: are those who take care fought with all the resources tions and to provide remedies of people in pain and suffering that the person subject to it has that the person at the time people ready to give their help available, believe that it can looking after them has accu- from knowledge not knowing, generate, and indeed does of- mulated through previous op- transcending every science? I ten generate, a so-called portunities for encounter or, in consider this a key problem in health-inducing suffering. the case of health-care profes- the humanisation of health in There is no unanimity but in- sionals, those people who with relation to pain and suffering. stead a profound and diversi- ever greater efficacy imple- To reduce it to the terms of fied division in opinion as to ment pharmacological, clini- contemporary and dominant the humanising or dehumanis- cal, surgical, psychological or health-care language, this is a 20 ing character, beneficial or in- psychiatric research. I will problem that involves a dis- jurious, character of pain and deal with this shortly in this proportion between the mag- suffering. paper. nitude of needs and the limits But these very manifesta- of the human means allocated tions of pained and suffering to meeting them. In terms of 6. ‘I Entered Knowing not people inform those people to pastoral care in health, the Where, I Stayed there whom they are addressed of problem is that of a concrete Unknowing, Rising above their symbolic value. That is capacity to achieve an accom- 12 Every Science’ to say, beyond the data that modation – both on the part of (St. John of the Cross) can be measured, they express those who are in pain and with much greater clarity those who are suffering and of This line from the mystic of ideas and feelings that cannot those who take care of them – Avila came into my mind be reduced to pure reasoning. between the humility involved 15 when I was thinking about As Cassirer well observed, a in human weakness, limitation how to prepare the reader for a symbol is the language of the and abandonment, and the fitting understanding of what I spirit and those who see it or boldness, which is also hu- will attempt to demonstrate listen to it perceive that man, the fruit of the in- below. I remembered it and through it they are invited to eluctable impulse to self-tran- wrote it down because it ex- penetrate an area there they scendence, to go beyond all actly describes how I often are not able to orientate them- the orders of our being and ex- feel in the presence of those in selves in a clear way and em- isting. pain and those who are suffer- ploy only the human intro- ing who reveal in front of me spective instruments that are their intimacy, thereby show- available. For this reason, 7. A Radical Disagreement ing me a panorama of pain such people perceive that they about the Humanising 13 without light, a dark night are present not knowing a no- Capacity of Pain and without meaning and the spir- table part, at the least, of what Suffering 14 it or what the hymn of the is presented to them specifi- divine office calls, employing cally because the beseeching I have always been very dis- fine metaphor, ‘believing eyes of the observed person mayed at the observation that 16 pain’. To draw near to the are not in a state of suspense. arises when seeing the quanti- world of human pain and suf- Thus I have encountered and ty of living, written or image- fering brought about by ill- continue to encounter people communicated testimonies to ness, the window of those who in pain and people who are be encountered – a very small experience it themselves, in suffering, of great qualities, quantity in the context of the their loved ones or those who that express their interior af- immensity of manifestations take care of them, is an experi- fliction in my presence: sub- offered both by the present ence that can be transformed merged in a cognitive and time and by past history – on into a scientific fact and thus practical ambivalence, the out- the meaning and sense, or one that can be measured at come of puzzlement, I feel in non-sense, of pain and suffer- the level of the organism, and relation to what I have in front ing. One is dealing here with – up to a certain point – at the of me, and, beginning with an observation not so much mental level as well. Starting that, to what I perceive in about the very numerous dif- from here, however, this expe- pieces. ferences that exist between rience moves alternately be- For this reason, the offering many of these testimonies

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 21

bearing on the subject of this However, faced with this as a general draft or an identik- paper but about the diametri- kind of testimony I can also it, which will help them ini- cally opposed and irreconcil- describe others which, without tially to see how sick people able approaches to be found in in any way concealing the live out their afflictions. them. Given the limited space range, the depth and the dra- When an illness irrupts and available to me in this paper, I matic character of the suffer- takes up dwelling within a per- am obliged here to refer to on- ings experienced by their pro- son it constitutes, first of all, a ly some examples by way of tagonists, allow a small spiral painful surprise; secondly, it is an illustration. of hope or allow a horizon of an obligatory halt on the jour- I place before my readers, hope to be seen. As a signifi- ney of life. The first observa- first of all, Job, the prototype cant example of this, together tion about pain that has to be of the suffering sick person in with the poem by José Luis addressed by a sick person is universal literature and Judeo- Martín Descalzo which has al- the fact that something unex- Christian Holy Scripture. In ready been quoted I would al- pected has arrived, something contradicting the belief that so like to quote the following that, in addition, threatens to Satan expresses in front of Je- by Amado Nervo in which he change the lifestyle with hovah about the immense at- expresses his feelings of sor- which that person previously tachment of human beings to row for the loss of a beloved was familiar up to that mo- life, that is to say: man is person: ment, something that he had ready to give everything that seen in other people which he he has for his life (Job 2:4), My God, I offer you my must now see in himself, with the suffering Job, oppressed pain. the further negative fact that by the excess of his sufferings, This is all that I can offer today illness is experienced curses the day he was born, re- you! with greater trial than in other 21 grets that he was not miscar- You gave me a love, a sole epochs because we are less 17 18 ried and at the height of his love, ready to shoulder it. despair exclaims: I would pre- A great love! fer to be suffocated, I would Death stole it from me. prefer death rather than these Only pain remains. pains! (7:15). Without reach- Accept it Lord: ing phrases as dramatic as It is all that I can offer you! these from this Biblical figure, I have been the witness of the Once the radical disparity in bitter laments of many sick the assessment of the human people expressed in terms that and humanising character of are very similar to those that pain and suffering has been Guadalupe Amor employs in observed, albeit in a brief and this short poem: schematic fashion, I believe the moment has come to an- Nights with my eyes open, swer the question that was Nights of terrible flights, posed to me. Beginning with Going beyond my my background in the health- heartbeats, care field, I will face up to this The sick person gradually Going beyond my passions, answer by presenting, first of exteriorises and gives form to My worries are not calmed, all, a clinical picture of people the major change that the ill- My senses are almost dead. in pain and of suffering people ness, which has laid him low, Unspeakable anxiety and that have come to me for help. provokes within him, and, to- worry gether with knowledge about Are there in the dark. the diagnosis that has been Everything goes round in 8. A Pastoral-Clinical made by the medical doctor – the night. Picture of Patients not always in a way that is Is filtered through my soul. clear and accessible to the lev- And I call out to have calm: I will begin with three con- el of education and state of My God, my God, for how siderations. First of all, I am mind of the patient – he per- long? convinced that if we use the ceives new feelings that come terms involved correctly there from his body. His body is no For all those sick people are no illnesses but only sick longer the silent and obedient whose situation in one way or people; no pain but people in companion on which the pa- another matches that patho- pain; and no suffering but peo- tient was used to counting logical situation and situation ple who suffer. The second when he was healthy but a sort of the soul of Job, pain is an consideration is that I see that of troublesome and rebellious abominable and atrocious evil each human being is unique intruder who has threatening that must be combated at any and unrepeatable in his way of features that were previously cost. And the suffering that feeling pain and reacting and unknown, and which requires comes from it is an unfair, in- suffering in relation to his that he pays much more atten- human, radically unbearable, pain. The third consideration tion to it that when he had and in definitive terms, dehu- is to invite the reader to see the good health – attention that is manising price to pay. observations that follow only often full of physical pains of

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 22

varying levels of intensity and dependent on them than he of the pains and sufferings of of anxieties and worries of the was before. This feeling of de- the sick person but there are soul. Starting with this condi- pendence can be painful for others that arise naturally from tion, the sick person begins to his character but it can be even the family and which, to sum- look back with regret on the more painful when those who marise, are as follows. health that he has lost, which surround the patient (family First of all, the suffering that for him meant what Laín En- relatives, friends, health-care arises in a large number of tralgo calls not feeling one’s professionals, pastoral work- families that are very ready to body and the silence of one’s ers and volunteers) do not do help, as far as they can, their 19 organs. what is expected of them in an sick family relatives, and However, it is not only his adequate way. There are times whose causes can be a lack of body that demonstrates the pa- when the patient asks for more material resources, the inade- tient’s weakness to him; the than others are prepared to quacy of homes, a working day whole of his person feels with- give, especially when he is in- that is incompatible to varying out strength, feels fragile and fused with feelings of great degrees with the provision of 20 feels vulnerable. In addition, selfishness and thinks that he such help, etc. At other times, the very character of a lasting is the only person who suffers. however, these causes are of illness, and the slowness in ef- At other times, however, it strictly personal character. The fecting diagnostic tests and happens that those who are en- sick person does not change therapeutic treatment, which trusted with looking after him solely in relation to himself; he are very frequent occurrences are not up to his needs, and also changes in relation to his in our health service, mean this provokes logical reactions family relatives, for whom it is that the sick person moves of bitterness, resentment, dis- often difficult to understand 22 from having the very busy life trust and frustration in him. the reactions and the alter- of a healthy person, which al- In addition, today sick peo- ations of his mood which be- lowed him just enough time to ple suffer not only because of forehand, when he was relate to himself, to having a a possible lack of understand- healthy, they did not encounter. great deal of time to observe ing on the part of those people It is not unusual to hear a fami- himself, perceive himself and who talk to them but also be- ly relative say with displea- feel himself much more accu- cause of the kind of care that sure, referring to the sick per- rately. Inevitably he comes to is offered by a health-care sys- son: ‘they don’t recognise him; question that image of himself tem organised in a way that he is not what he was’. that had been created before has as its starting point a set of Without reaching such ex- he fell ill. There thus begins a structures that, unfortunately, tremes, a long-lasting illness painful itinerary that can lead may not only assure efficacy implies for the family a con- him to wound himself or to and quality at the level of care stant accumulation of suffer- grow and mature. but also oppress or maltreat ings that come both from ‘We are nothing’, sick peo- specifically those to whom those that are witnessed in the ple often say; poor me, who should be given the greatest sick person and which they of- will free me from this body di- restoration or relief possible. ten do not know how to re- rected to death, they ask them- Today, the care relationship lieve and from those that are selves like St. Paul (Rom between a patient and those openly transferred from him to 7:24) when observing the tem- who take care of him runs the those he considers most suit- porary character of his condi- risk of always being distant able, in principle, to sharing tion. Placed in front of them- and instrumental and less hu- them with him. In this sense, a selves, they experience the man, near and interpersonal. family needs even greater help coming forth of the deepest of The advances in medicine than the sick person which, questions that previously they have involved great advan- when it is provided, is trans- had not been able, or had not tages as regards the treatment formed into a benefit for him. known how, or had not want- of syndromes and symptoms Lastly, one should mention ed, to pose: what is the mean- of pain but they have also led the need that the family has to ing of my life? Why have I fall- to psychological, social and find a transcendental meaning en ill? What have I done to spiritual debilitation in rela- both in the sufferings of its end up like this? What is the tion to pain and suffering. sick member and its own suf- point of suffering as I am sufferings. V. Frankl has well fering? What will happen to brought out the destructive me? How can God allow this? 9. A Clinical-Pastoral character of suffering without 21 Why is this happening Lord? Picture of the Family a meaning. The search for help in this Relatives of Patients situation, and the search for people to talk to who can help In most families the pro- 10. A Clinical-Pastoral him to answer such questions longed illness of one of its Picture of Health-Care and to unload the anxiety that members nearly always pro- Workers as Patients such questions generate, duces a painful wound in the forces the sick person to come body of the family, a set of It is a common view that out of himself and to observe pains and sufferings of vary- health-care workers are, as a other people more carefully ing kinds. Some of its forms general rule, beyond the pains because he feels much more are a pure reflex and extension and sufferings of the patients

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 23

that they look after and of the minds and their spirits that it transferred onto them by those family relatives of these pa- very high. In addition, health- to whom they provide care. tients. In fact, as I observed care personnel belong to that This is a problem that secular above, it is not unusual to hear list of categories which in our health-care institutions, the both patients and their family society receive the highest Church and Christian commu- relatives state in convinced number of complaints both nities have not yet properly tones, when addressing health- through the mass media and addressed. I will make an – of care workers: ‘You are used to legal actions (ombudsmen, necessity – brief reference to seeing people suffer’. courts, letters in the newspa- this matter so as not to length- The reasons for this view pers and journals) and directly en my paper. seem to be three in number. from the general public. Some First of all, the image that so- of these complaints arise be- ciety has of health-care per- cause of authentic negligence 12. The Possibility of sonnel, who are seen as mere or bad practice on the part of Humanising Pain and technicians of health and heal- health-care personnel but most Suffering ing, and whose efficacy must of them are due to the structur- involve, as a system, a cold al and functional defects of the Despite what was said 22 objectivity that is insensitive health-care system which they, above about the semantic to the pain and suffering expe- too, suffer in the front line of confusion over pain and suf- rienced by other people. For duty and at every moment. For fering in the field of the med- that matter, the very training this reason, they feel that they ical sciences and the limited that they receive has involved are not understood and even ability of these sciences to un- hitherto the primacy of scien- maltreated, and this is some- derstand pain and suffering 23 tific disciplines over disci- thing that are used to express- and treat them, it is here that 23 plines involving personal care. ing; and with good cause. greater precision is being ob- Lastly, the activity of by no tained as regards knowledge means few of them tends to about the nature of the physio- transform their uniform and 11. A Clinical-Pastoral logical and mental aspects of their approach into a barrier Picture of Voluntary pain and about therapeutic that immunises them against Workers and Pastoral remedies designed to combat the enormity of the suffering Workers pain with increasingly incon- that they witness every day testable efficacy. and they treat. The contemporary interest 24 However, the majority of in voluntary work and the in- 12.1 Medicine and pain health-care personnel do not creasing demand for it are of- know how to channel in a sat- ten not accompanied by suffi- Medicine has made enormous advances in the study and treatment of physical pain. In summing up the discoveries and the results of this study we can say that clinical pain should be divided into two categories: acute pain and chronic pain. The differences between the two are so specific that they should be seen as two entities that are totally different. Acute pain is pain that begins in a sudden way, caused by a traumatic lesion or by illness. Acute pain performs an important biological function: it informs the individual and warns him that something is wrong and that consequently he must seek medical help. For medical doctors, acute pain has great diagnostic utility. Most of the problems that isfactory way the transfer of cient concern (at times this is are associated with it can be the sufferings that they receive even non-existent) about the suitably controlled with phar- from their patients and their care, support, and accompany- maceuticals, anaesthetics, pain family relatives or to detach ing that these people need in killers, nerve blocks or other themselves in a suitable way order to heal the wounds that forms of treatment, With such from such sufferings. For this they receive in providing care remedies, or spontaneously, inability they may come to and in order to detach them- acute pain tends to disappear pay a price at the level of their selves from the sufferings with time through the process

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 24

of scarring – if a wound has ceral pain has to be directed reaction to pain. Only in this been the cause – or because of towards understanding it as a way can one understand why I the disappearance of the irri- painful entity into which dif- describe consolation as its tating harmful stimulus in oth- ferent kinds of pain may flow, stimulus and vehicle. Given er cases. from purely visceral pain to this, I should add that I do not In contrary fashion, chronic neuropathic and osteo-muscu- know a better definition for pain has no biological value lar pain. Today it is hoped that comfort than the one that ap- but acts as a corrosive process genomics will identify treat- pears at the beginning of chap- that imposes severe physical, ment for visceral pain alter 40 of the book of the emotional, spiritual and even though this is a research area Prophet Isaiah: ‘Comfort, economic stress on the indi- that has still be explored. comfort my people, says your vidual who suffers it, as well God. Speak tenderly to as on his family and on soci- 12.2 Relief, the antidote to Jerusalem’ (Is 40:1). Accord- ety. Any painful situation that pain ing to this text and its numer- does not respond to conven- ous parallels, to comfort tional forms of treatment and All the medical responses to means to know how to speak which lasts for six months or human suffering have or to the heart, that is to say to 29 more should be seen as an ex- should have as their aim the re- the interior world of a human ample of chronic pain. lief of the patient, where this is being afflicted by pain. Com- Chronic pain in its turn can understood as the action or the fort, contrary to the superficial be divided into two types: be- effect of attenuating, mitigat- opinion that is usually held of nign chronic pain and malign ing or making less burdensome it, does not involve speaking chronic pain. In the case of be- (but never eliminating com- loving and not very compro- 24 nign chronic pain the symp- pletely) the set of sufferings of mising words to sick people 30 toms are connected with a varying kinds associated with but, rather, possessing the art physical problem that is not the experience of illness. that is needed to not leave be- progressive and does not con- Hence the famous saying, seeching eyes in suspense. It stitute a threat to the life of the when correctly understood, requires, prior to persuasive individual concerned. Malign that medicine is once again oral ability, readiness to help, chronic pain is associated with turning into a watchword: treat magnanimity and personal de- potentially terminal or fatal ill- often, sometimes heal, always votion; in definitive terms, it nesses and a typical example console. Relief understood in requires overflowing love. of this is the pain that accom- these terms is, as regards those Comfort must be directed to- panies various kinds of cancer. who offer it and those who ex- wards providing help, to alle- In such cases, the pain is a sig- perience it, effective but hum- viating (cf. Lam 1:16s) a dis- nal of the progressive deterio- ble in its aspirations with posi- consolate person through the ration in the health of the pa- tive but always limited effects, invitation that the comforter tient. Psychologically, and at and never complete in its elim- makes to him to look for spiri- 26 the level of the soul, this pain ination of human suffering. It tual strengthening, and the of- comes to be the cause and the seems that this is how the fer of his personal and above symbol of profound suffering mindset of clinical medicine all else internal energies. It is, and even of despair. understands it, thereby going therefore, that means that con- Recently, another classifica- beyond the chimera of the total tinues to have validity even tion of clinical pain has ap- elimination of pain and suffer- when the other antidotes to peared which divides pain into ing by technical means that re- pain are not successful. To somatic pain and visceral ceived very severe criticisms summarise, comfort is the 25 27 pain, with emphasis being during the 1970s. stimulus with which softly, placed on this last which is Today, pain units and pal- firmly and slowly a man in said to be produced by lesions liative medicine manage to pain is encouraged to create a and illnesses that strike the in- eliminate malign chronic pain reaction of liberating suffering ternal organs. This is a symp- or to reduce it to perfectly tol- in relation to pain or the vehi- tom that is habitual in most erable limits in the absolute cle by which he is helped to acute and chronic syndromes majority of cases treated in channel this reaction once it of pain of clinical interest. Its line with these two forms of has been generated in his per- neurophysiology is still not medical care. In this growing son. very much known about but efficacy I perceive a real ful- In providing comfort, the the distinction between this filment of the aspirations that lenitive instruments that are kind of pain and somatic pain were present in ancient medi- provided with increasing effi- has been proposed because it cine as is borne witness to by cacy by medical research and is seen as being relevant and the voices of some of its most psychological strategies can 28 necessary as it makes a dis- eminent representatives. come into play. However, they tinction at the level of the ori- remain at the most basic help gins of the lesion and empha- 12.3 Comfort: a stimulus and without managing to become sises that the neurophysiologi- vehicle of suffering the authentic core because this cal mechanisms of visceral is the outcome (and here I pain are distinct from those in- First of all I would like to go come back to speaking begin- volved in somatic pain. The back to reminding the reader ning with my personal experi- therapeutic approach to vis- that I understand suffering as a ence) of a wisdom acquired

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 25

through the cultivation and scription of what is perceived, or possesses it, has as its pri- implementation of spiritual the creation of concepts and mary aim an upright orienta- values that are connected with the invention of metaphors tion towards an achievement a supreme taking into account and symbols. There is a close of the ultimate meaning of of a neighbour in need. In a kinship between metaphors life. As I, said, Laín Entralgo, few words, comfort is an ef- and symbols. A metaphor is strives to call this sapiental fective crystallisation of over- the essential and almost con- knowledge. The whole of reli- flowing love which the New stant theme of the formal ele- gious literature, in the broad- Testament calls agape or char- ments of poetic language. Or- est sense of the term – ascetic, ity, and its consequences: in- tega said that poetry is parenetic, philosophical or ner peace and personal matu- metaphor, and added that theological (this last under- ration. From the point of view metaphor is an intellectual stood as itinerarium mentis in 33 of Christian and pastoral care, procedure through whose me- Deum) – seeks to generate comfort is the great humanis- diation we manage to appre- sapiental knowledge in the ing response to pain, the most hend what is beyond our con- soul of the reader. All other worthy and mature outcome of ceptual strength. What true forms of knowledge – scientif- suffering. poetry essentially offers – to- ic, philosophical or poetic – gether and beginning with its have by definition a penulti- aesthetic charge – is a specific mate meaning. Only when one way of acceding to reality and focuses in on the search for or penetrating it mentally. A po- discovery of the ultimate et, faced with the unfath- meaning of reality or the reali- omable bottom of reality, ties to which they are ap- 34 takes words from common plied, do the above-men- 25 language to which he and his tioned forms of knowledge ac- sector do not usually concede quire the condition of sapien- greater meaning than that of tal knowledge, a pathway of the topos. But in creating poet- access to personal salvation ry these words are employed and even the general salvation to refer to realities that are of mankind and the cosmos. very different from those indi- It is precisely this last form cated by common language, of knowledge that I have re- thereby ensuring, and this is ceived, accepted, and cultivat- certainly the case, that the re- ed as that which is most suited lationship between the vulgate to the way in which I conceive meaning of such words and the realisation of my life and the meaning that they acquire which has been entrusted to 12.4 The poetic and sapiental through their transfer into a me to transmit to others and to understanding of pain, poem is not arbitrary and ab- help them to develop it with so suffering and comfort surd but susceptible to certain much decisiveness by me as understanding on the part of discretion and respect. This What I have just said intro- the reader. brings me to begin the last part duces the reader to a world of For this reason, I have ha- of this paper in which I offer realities and meanings whose bitual recourse to poems to the reader what is most gen- perception and understanding understand and make under- uine and appropriate in my ex- completely rises above the stood my experiences in rela- perience of pain and suffering, realm of scientific-technical tion to human realities such as that which, drawing year after knowledge and from certain pain and suffering. Without year from the sources of my 35 points of view also philosoph- underestimating the scientific- Christian faith, testing it with ical knowledge. However, this technical language that I hear those with whom I form a is the world in which my ex- being used, for example, by community of believers in perience about pain and suf- the health-care professionals I space and time, and with those fering has specifically taken often work with in providing who, although they do not place. For this reason, before care to sick people, and with profess my faith, share with proceeding, I think it is advis- whom I share some of their me the task of caring for sick able to clarify what kind of terminology, the most specific people in a context which, knowledge I adhere to, above form of expression of my vo- thanks be to God, is increas- all to acquire and communication and my care-providing ingly inter-disciplinary in cate this experience. I do so, activity is that of poetic lan- character, and the task of re- 32 once again, through the distin- guage; indeed, as I will point flecting on various aspects of 31 guished thinker, Laín. out below, language which is this care, is everything that, To express adequately a vi- called by Laín as well, sapien- with varying degrees of ex- sion of reality in relation to tal language. pressive success, I will try to some of its specific aspects – Max Scheler called salva- expound. In doing this I hope the fact of living, love, the tion knowledge that knowl- that I will not be incompre- context, pain, suffering, death, edge which, whatever the reli- hensible or a translator/traitor etc. – the mind is offered three gious and ethical assumptions as regards the Christian mean- pathways: an objective de- of the person who looks for it ing of pain and suffering.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 26

39 12.5 The pastoral argues that nothing escapes right, and Job set in motion a 37 understanding of pain His control. The Israelite tra- trial of God and asked Him for 40 and suffering dition never abandons the au- explanations, scandalised as dacious principle formulated he was at feeling that he was a) in the Bible by Amos: ‘Is a trumpet blown the recipient of undeserved The first source of my faith in a city…unless the Lord has pain. is the revelation of God which, done it? (Am 3:6; cf. Ez 8:18- Prophets and sages of the embodied in human language, 22). Statements such as this Old Testament, oppressed by 38 comes to illuminate, begin- give rise to extreme reactions pain but sustained by their ning with the Biblical texts, in front of the spectacle of faith, progressively entered its 41 the darkest corners of humani- pain as a paradigmatic expo- enigma and mystery. They ty. My assiduous reading of nent of evil in the world. The discovered the purifying and 42 the Bible enables me to see to Israelites knew how to distin- educative value of the suffer- what deep point this book guish the causes of pain that ing generated by pain and end- takes seriously the reality of was produced by illnesses of a ed up by seeing an effect of di- human pain. It does not seek natural kind, or specific vine benevolence in such suf- 43 to conceal it, camouflage it or wounds or the consequences fering as well. Thus the Old minimise it. On the contrary, it of old age. But they also at- Testament explains the mean- immediately points out that it tributed pain to the existence ing of the premature death of a is an evil that should not exist of malign powers that were sage (Wis 4:17-20) and the and is compassionate towards present within the universe blessedness of a sterile woman those who are afflicted by it. and were hostile to human na- and a eunuch (Wis 3:13ss). From Holy Scripture was ture, above all they attributed t Thanks to this progressive un- 26 raised an immense cloud of to sin, which was held to be at derstanding, Jeremiah moves cries and laments which are so the origins of every misfor- from rebellion to a new con- 44 version. Lastly, as regards the Old Testament, a value of interces- sion and redemption was ap- preciated in suffering, as emerges in the pained prayer of Moses (cf. Ez 17:11ss; Nu 11:1ss) and, above all, in the figure of the Servant of Jeho- vah. The Servant experienced pain and generated suffering in the most dramatic and scan- dalous forms to the point of not even provoking compassion but rather horror and contempt. Sins were the cause of this suffering but not the sins of the Servant but the sins of other people, which brought the scandal to its apex. It is here that is rooted the core of the mysterium doloris: the design of God is achieved through the will with which the Servant accepts taking up- frequent that it gave rise to a tune, as was repeatedly ex- on himself the pains and suf- specific literary genre – pressed by the friends of Job ferings of others and in this lament. The psalms are full of in their interpretations of what way offered up peace and these cries of affliction and the was happening to him. How- healing. Thus the supreme litany provoked by pain is ex- ever none of these causes, nei- scandal was transformed, in tended until the loud cries and ther nature nor chance, nor the the eyes of the biblical author tears of Christ in the face of universal influence of sin or of the poems of the Servant, death (Heb 5:7). This rebellion malediction, nor even Satan, into the unprecedented won- of sensitivity begins with the in the approach of the Old Tes- der of God, into the revelation 45 observation that pain is a uni- tament, were not subject to the of His unstoppable goodness, 36 versal evil in relation to power of God. The lacerating although He is mysterious in which nobody resigns them- reality of pain put God into His ways. selves in principle. doubt: He was above all else To move on to the New Tes- With this basic horizon, the He who was involved in this tament, the first thing that the Bible, which is so profoundly scandal. For this reason, the gospels show with clarity is sensitive and sincere in rela- prophets could not understand the fact that Jesus could not be tion to pain, does not try to ex- the happiness of the impious a witness to human sufferings cuse God but, on the contrary, and the ill-fortune of the up- without being profoundly

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 27

46 moved. The healings and the were coming to an end. This those who rejoice, weep with resurrections that he worked illusion brought with it the those who weep’ (Rom 12: 15; were signs both of his com- danger that the faith of the dis- cf. 1 Cor 12: 26). passionate character and of his ciples would become ship- St. Paul could say, because messianic mission (Mt 11:4; wrecked with the continued of his own experience and in cf. Lk 14:18ss) and preludes to and inexorable experience of the name of all Christians, that the final victory that he the painful realities that exis- we are fellow heirs of Christ preached over pain and the tence in this world involves, ‘provided we suffer with him overcoming of suffering. He amongst which, in dominating in order that we may also be fulfilled the prophecy of the fashion, is to be listed illness. glorified with him’ (Rom 47 Servant and to his disciples The writers of the New Testa- 8:17). For this reason, we are he gave the power to heal in ment, however, clearly point- ‘persecuted but not forsaken; his name (Mk 15:17). Howev- ed out that the resurrection of struck down, but not de- er, Jesus did not eliminate ei- Jesus did not undermine the stroyed; always carrying in the ther pain or as a result the message of the Gospel regard- body the death of Jesus, so need to suffer from the world. ing pain and suffering but con- that the life of Jesus may also He did not suppress them but firmed it. The allusion in the be manifested in our bodies’ (2 instead he dedicated himself Beatitudes to the afflicted (Mt Cor 4: 9-10). He could equally 59 to comforting those in pain 5:5) and the need to carry say that ‘it has been granted to and those who suffered whom one’s cross, which may be the you that for the sake of Christ he encountered on his path fate of people (Mt 16:24ss), you should not only believe in and to affirming the strength conserve all their validity in Christ but also suffer for his 48 of comfort. He showed that a the light of the destiny of the sake’ (Phil 1:29), that is to say nexus does not necessarily ex- Lord in this world: if the striving with him to share in 27 49 ist between sin and illness Teacher experienced great the pain that afflicts humans. and its consequence pain and tribulations, his disciples have suffering, and he even reached to follow the same path (cf. Lk b) in the Testimonies the point of stating that suffer- 24:25ss; Mt 10:24ss). of Christian Tradition ing can be an expression of the For St. Paul, Christians have Here I will confine myself therapeutic and comforting to share this path with Jesus in for reasons of space and evi- 50 60 power of God. pain and in joy, in suffering dence to referring to only However, Jesus was no and in comfort. Because if a some of the innumerable testi- mere onlooker as regards Christian can say with St. monies which, in Christian those in pain and those who Paul, ‘it is Christ who lives in tradition, have restated the suffered. Long before his pas- me’ (Gal 2:20), he must know original message on pain and sion, pain and suffering were that he shares ‘abundantly in suffering and explored its fun- already familiar to him. In- Christ’s sufferings’ (2 Cor 1:5) damental observations. What I deed, he suffered because of because a Christian is a person refer to below have been of 51 people and because he felt who has freely given his be- great help to me, together with 52 rejected by his own, he wept longing to Christ and who, be- other statements, both in my 53 in front of Jerusalem, and de- cause of this, ‘may know him own personal maturation and spite the amazement that his and the power of his resurrec- when in providing spiritual declaration provoked in them tion, and may share his suffer- care to those who in one way 61 he warned his disciples on a ings’ (Phil 3; 10). For this rea- or another asked me for it. number of occasions that he son the Letter to the Hebrews I will begin with some would have to suffer a great states that just as Christ ‘in the words of St. Gregory of 54 deal. When the hour of his days of his flesh…offered up Nazianzus whom I have al- passion arrived, the suffering prayers and supplications, ways held to be illustrative of of Jesus was transformed into with loud cries and tears, to the distinction between pain 55 mortal affliction, into authen- him who was able to save him and suffering that I proposed 56 tic agony provoked by fear from death…he learned obedi- in section 4 of this paper: ‘I and worry about experiencing ence through what he suffered suffer pain in my illness and I the concentration of pains that (Heb 5:7ss), so we must ‘run am happy, not because of the he would have to undergo and with perseverance the race pain but because I teach others which, apart from physical that is set before us, looking to to bear their own pain patient- tortures, ranged from the be- Jesus the pioneer and perfecter ly and with acceptance’ (Epist. trayal of his disciple to the of our faith, who for the joy 36). However much the mean- feeling of being abandoned by that was set before him en- ing expressed by this saint 57 God. His passion, however, dured the cross, despising the does not coincide with mine, revealed that Jesus was and is shame, and is seated at the and without seeking to engage capable of coming to the aid right hand of the throne of in a forced exegesis of his of those who are afflicted by God’ (Heb 12: 1-2). Christ, words, I believe that they pain and of identifying with who expressed solidarity with demonstrate with sufficient 58 those who suffer. those in pain and those who clarity the character of my dis- With the arrival of Easter suffered, left his disciples the tinction between these two and faith in the Risen One, an same charge. In St. Paul’s forms of affliction: the patient illusion threatened the disci- view, to share in the life of character of he who is in pain ples – that pain and suffering Christ means to ‘rejoice with and the reactive character of

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 28

he who suffers, manifested fering seems to be, and is, al- sick people, whatever it may here with patience, acceptance most inseparable from man’s involve, must be seen as evan- 62 and even joy. earthly existence’. gelical preparation and after a After a great leap of over Taking a step forward, and certain fashion takes par in the fifteen centuries, but without alluding to my previous ob- comforting mystery of leaving the human community servation about the fracture Christ… All the immense ef- which is united through time that divides human beings in forts of men of every culture 63 in the experience of affliction, assessing pain and suffering, to overcome illness, the ad- I see the universality of pain it seems to me that the follow- vances of medicine and the and its destructive and extenu- ing sonnet of Juan José unsuspected advances of ating force in the following Domenchina, a Spanish poet surgery are recognised by the poem by Blas de Otero. At the of the twentieth century, is ex- Church as the fulfilment of a end of his life, sick, in pain, emplary because it expresses design of full salvation out- and a believer, he wrote: the radical character of this lined by God, although it tran- opposition and because of the scends them, at the same time, Fighting body to body with way in which it has its roots in illuminating in the light of death, first and foremost in those faith the true and ultimate des- 64 On the edge of the abyss, who have to face up to the af- tiny of man’. As directly re- I cry out to God. fliction of a grave illness: gards the subject of this paper, And His silence, rolling on, both the documents cited al- Drowns my voice in the I am here in my cage, lude to care for the body and inert void. With my mute voice. the spirit, to the simultaneous O God, if I have to die, The scarce nutrition and integrated treatment of 28 I want to hold you close. Of my flesh is no both, to help through physical And, night after night, sustenance means and spiritual comfort I do not know when For voracity that is dying that must be provided to sick You will hear my voice. Of this devouring madness people. O God, I am speaking to that yearns However, this is not an ob- myself. My daily breaking, stacle because Christian tradi- I scratch shadows to see And which bites, searching tion constantly and demon- you. for nutrition, strates and makes very clear I raise my hand and you cut There is no greater pain the mysterious character of the it. than the pain I feel. human being and thus his pain I open my eyes: you tear My bones broken night and and his suffering as well. His them out alive, day, expressions, therefore, are, for I am thirsty and salt But I do not complain, those who listen to them only becomes your sands. I could not lament, Lord, of from a technical and scientific This is a human being: my torment, point of view a ‘I don’t know’ Horror in full hands, Near to your cross it that that leaves those in pain and 65 To be – and not to be – would be blasphemy. the suffering stammering. eternal, fleeting Great was your equipoise For this reason, the language Angels with great wings of For all your suffering. used by Christian tradition to chains. refer to such realities is specif- A very important point in ically that of poetic knowl- A universality that possess- the tradition of the Catholic edge and sapiental knowledge, 66 es suffering as well, the pained Church has been the constant as Laín calls them. These two reaction with which we re- attention paid to reflecting on forms of knowledge, in addi- spond to the affliction im- the value given to various in- tion, coincide at the level of posed by illnesses, as the fol- struments and strategies that expression in the psalms and lowing words of John Paul at- lead to pain being combated the lamentations of the Old 67 test: ‘suffering… is a universal and to developing, in those Testament, and in the hymns theme that accompanies man who are afflicted by pain, con- of the divine office of the litur- at every point on earth… what structive relief and suffering. gy of the hours. From all these we express by the word ‘suf- Authentic Catholicism has writings spring human excla- fering’ seems to be particular- never generated an opposition mations that cry out or lament ly essential to the nature of at the level of assessment be- because of pain, ask for help man. It is as deep as man him- tween science and faith, medi- because of suffering or render self, precisely because it mani- cine and religion, technical thanks for the relief or comfort fests in its own way that depth care and pastoral care, physi- that has been achieved. which is proper to man, and in cal relief and spiritual com- A specific and distinctive its own way surpasses it. Suf- fort. Rather, it has stressed characteristic of this tradition fering seems to belong to their mutual complementari- is also the relationship of God man’s transcendence; it is one ness. This is stated by various with pain and suffering and of those points in which man sections of an emblematic His way of presenting Himself is in a certain sense ‘destined’ document of pastoral care in to pained and suffering hu- to go beyond himself, and he health that I read again a little manity. In the face of an image is called to this in a mysterious time ago: ‘all the care that is of insensitive divinity that is way… in whatever form, suf- with good will provided to apathetic and inaccessible in

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 29

74 other religious or philosophi- this reason, in Jesus Christ, the and principal comforter. This cal traditions, Christianity pro- overcoming synthesis of the is what an Israelite submerged claims that the image of the dialectic between the divine in pain and suffering under- 75 true God revealed the suffer- and the human through the in- stood. At the same time, the ing, corporeal and friendly tegration in his person of these belief that the era of the Mes- representation of Himself, two worlds, are to be found for siah would be the final time of above all beginning with the Christian tradition the keys by happiness thanks to the prior moment when this image was which to approach the humani- comfort received from God 76 revelatory for, with, and in the sation of pain and suffering. and brought by the Messiah, humanity of Jesus of Jesus Christ is infirm God, in to whom was given the title, Nazareth. The following hymn pain, suffering and exultant in amongst others, of Menahem, from the divine office acts as a the humanity of Jesus, in comforter, was an expression representation of this which is which dwells in a corporeal of this widespread view that 70 beautifully poetic and densely sense the fullness of divinity. was deeply rooted in the peo- theological at the same time: For this reason, he is the con- ple. cealed and revealed, evident Thus I need you in flesh and and at the same time mysteri- b. Comfort: the mission of bone, ous, key that has to be known Christ A living fire needed by the in order to respond at a theo- It is above all else in the hu- soul is a pretext! retical and practical level to man-divine person of Christ Man I wanted to become, the problem posed by the hu- that God continues to draw not naked manisation of pain and suffer- near to the afflicted. The old Immateriality of thought ing. Simon saw in him the Messiah Flesh I am and of flesh I I will return to this key at who was coming to fulfil the 29 want you the end of this paper. First, hopes of those who were I am a diminutive incarna- however, I must engage in a awaiting the comforting of Is- tion… brief survey of revelation re- rael (Lk 2:25) and Jesus him- The whole universe is Incar- lating to comfort in the Bible self, to whom people afflicted nation! and the Tradition of the by numerous illnesses turned And he who placed this law Church. for help and comfort, express- in our nothing, ly declared that the time of Make your word flesh! comfort had come with him: To see your feet that look for come to me all of you who are my path, tired and oppressed and I will To feel your hands in my give you rest (Mt 11:28). Jesus blind eyes, repeated that the Spirit – the To place like John in your arcane and mysterious being womb, of God who dwelled in him – And – Judas without betray- is a Comforter (Paraclyte), and al – give you my kiss. promised his disciples that the Charity that came to my in- Spirit would be sent to them digence. (Jn 14:16-26) so that they You well know how to speak could be witnesses to (cf. Acts my dialect! 1:8) and bearers of divine Thus, suffering, corporeal, a comfort. He charged them friend. with putting the beatitudes in- How I understand you! to practice: blessed are the af- Thus: tangible, human, flicted because they will be brotherly. 12.6 The pastoral comforted (Mt 5:5). Sweet madness of mercy understanding of comfort 68 The two in flesh and bone! in the Bible and in c. Comfort, the task Christian Tradition of comforting entrusted For Christian tradition, the to the Church keys to assessing pain and suf- a.Comfort, an expression of The climate in which the fering are not an enigma to be the mode of being of God first Christian communities unfolded through procedures For the believer of the Old existed, according to the Acts of analysis and perception ad- Testament, comfort was much of the Apostles, was impreg- 77 ministrated by the human sci- more than a human approach – nated with such comfort, and ences and to be treated with it was the moving and com- to such an extent that this ex- their scientific or philosophical forting expression of the Holy perience gave St. Paul an op- discoveries. These keys also Spirit, that is to say the mode portunity to draw up a theolo- 71 belong, and more specifically, itself of being of God. In oth- gy of comfort at the beginning to the mysterious domain of er words, it was the expression of his second Letter to the 72 78 the human spirit because this of His mercy, which was Corinthians. Here he briefly, 69 is the divine in man, what translated into a divine ap- but with complete clarity, out- constitutes him in all his being proach of grace above all in lines the salvific itinerary of as the image, interlocutor and contemplating the tribulations comfort that flows from God 73 potential friend of God. For of His people. God is the first the Father to Jesus Christ,

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 30

from Christ to his disciples must move from suffering as a 13.3. Pain is always in prin- and from them to the Christian foetus (to a certain extent) and ciple an evil to avoid or to communities where, thanks to the cries of birth to the spiritu- combat to eliminate it or con- the present of the Spirit, it al pain of being near to death. trol it because it attacks and must be a generated, commu- To live in a healthy way re- causes injury to those people it nicated and shared reality. quires, at a root level, that this afflicts. Pain in its most in- constraint is accepted and that tense expressions makes life d.Comfort, the help of the a person knows how to live unbearable. The fight against Spirit in the presence of with pain and suffering. Not to avoidable pain is, therefore, a pain and suffering do this is symptomatic of de- form of liberating and redeem- 82 I began this section by refer- formed living. From this ini- ing humanisation. ring to the Spirit as the mode tial point of view, pain and of being of God the comforter, suffering are already opportu- 13.4. Pain that cannot be 80 and I will end by referring nities for humanisation. avoided or combated com- once again to him: come, Di- pletely can be relieved with vine Spirit, source of the 13.2. Pain and suffering af- the help and the combination greatest comfort! These are flict the whole human being. of resources of medical doc- the words of the sequential Whatever the causes may be tors and psychologists, as well hymn of the Eucharistic litur- in individual cases, they affect as social or spiritual resources. gy of the Sunday of Pentecost, with varying degrees of inten- The relief of pain allows a pa- and it adds that he is the sweet host of the soul, rest for our efforts… joy that dries tears and 30 comforts in mourning. Later it contains this supplication: ‘heal the sick heart!’And if the liturgy is a symbolic expression par excellence of the specific contents of pastoral care, here we encounter the fundamental theme that must inspire to its roots the approach to, and further development of, the relationship of pastoral help with those in pain and those who are suffering.

13. The Humanisation of Pain and Suffering in the World of Health from Pastoral Experience: Theoretical and Operative Conclusions sity all the points of their be- tient to react in a human way, The time has come to end ing. The pain produced by that is to say by generating this paper and I will do so by bone cancer induces in the constructive suffering but suf- offering the following conclu- spirit of a patient a malaise fering that is not without con- sions to the judgement and in- comparable to the shock pro- trol. For those who generate sight of my readers in the form duced in his body by the news and build such suffering with- of a series of theses, which in of the diagnosis of cancer sup- in themselves, such suffering my view are sufficiently plied to him by a doctor. is one of the highest factors of demonstrated beginning with Therapeutic remedies do not humanisation to be understood the criteria of my Christian be- exist to completely eliminate in terms of personal matura- ing and my work of pastoral this pain with its multiple as- tion and spiritual health. care in the health-care field, pects. Palliative control of ma- that is to say by the experience lign chronic pain does not 13.5. The human capacity referred to at the outset as an manage to completely calm the for constructive suffering is exact form of knowledge spirit of the patient, and spiritu- limited. The intensity and the about pain and suffering. al comfort does not completely duration in time of certain dissolve his corporeal disquiet. pains, such as, for example, 79 13.1. Pain and suffering, The utopia of an annihilation malign chronic pain and pain 81 their inseparable reaction, are of pain through pain-killing produced by a process of ineluctable. Pain and suffering methods, techniques of mental mourning, at times exhaust the are two universal human expe- control or falsely spiritual eso- ability to suffer that people riences. Every person must of teric techniques, is only a de- cove within themselves and necessity encounter them dur- ceptive chimera and this dehu- make the active compassion of ing the period of living and manising as well. others totally necessary. Com-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 31

passion is the source from understand such situations in how the Church of Jesus which springs relief and com- all their depth and treat them Christ sees those who in his fort. Generating it is what through a wise combination of name dedicate themselves to transforms sick people into physical and mental relief, as pastoral care in health: as a stimuli for the humanisation well as spiritual comfort. paradigm of humanity in pain of those who provide them because of physical, mental, with relief and comfort. 13.9. The encounter with social and spiritual evils of pain and the experience of suf- which we are all victims and 13.6. A patient in pain is a fering strike the image of God, at times injurious agents. But teacher, most of the times an or those who take the place of also the paradigm of the involuntary and unconscious God for those who are not be- strength to begin with weak- one, for those who do not pass lievers. Excessive pain and ness that is manifested in all by but are at their sides and pain felt to be underserved or those who do not pass by take an interest in their situa- highly disproportionate has those in pain but, moved by 86 tion. With his body, his ap- been and is a factor that un- compassion, provide them proach, his ways and his lan- leashes fervent religious con- with relief and comfort. guage, the first says to the sec- versions or flagrant apostasies. ond nearly always in a tacit There are no rational argu- Rev. JESÚS CONDE way: learn from me, from my ments to explain in a complete HERRANZ condition, from my pain, from way the cause or the inherent Delegate for Pastoral Care in Health, the Diocese of Madrid, my suffering… Every sick cruelty of certain forms of Spain. person gives us, in good and in pain. Even philosophical evil, lessons in humanisation, knowledge channelled towards if we know how to perceive so-termed natural theology en- 31 them and want to learn them. counters here an insuperable Bibliography To know how to suffer is one obstacle for those who decide of the most important lessons not to recognise the existence JESÚS ÁLVAREZ GÓMEZ, “... Y él los curò “ (Mt 15, 30). Historia e identidad for most human beings still of mystery. The great question evangélica de la acción sanitaria de la untouched by grave pathologi- that the pain of Job poses to Iglesia (Claretianas, Madrid, 1996). cal pain. Ramón Sampedro – is God the EMMANUEL BUCH CAMÍ, ‘Sufrimen- to’, in Diccionario de Pensamiento Con- great Inhuman or Dehuman- temporáneo, Mariano Moreno Vila (ed.) 13.7. Active compassion al- ised or, in contrary fashion, is (San Pablo, Madrid, 1997), p. 1126-30. ways transforms comforters He the highest Good and Com- ERIC J. CASSELL, The Nature of Suf- fering and the Goals of Medicine (Ox- into wounded healers, that is to fort? – has neither received nor ford University Press, Oxford, 1991). say people who are in pain and now has a rational answer that JESÚS CONDE HERRANZ, ‘Aspectos suffering in their own way. To can satisfy to the full. Pure rea- Espirituales del Sufrimento’, in La Bioética en la encrucijada, doc. del I relieve and to comfort, when son faced with pain always Congreso de la Asociación de Bioética done with conscience, require looks for God in the fog, as Fundamental y Clínica (Madrid, 1997), in varying degrees that one Antonio Machado says. p. 77-89. JESÚS CONDE HERRANZ, ‘El sufrimen- takes on part of the pain of to y el sentido de la vida’, Dolentium those in pain and gives to one- 13.10. ‘We have not a high Hominum, Iglesia y Sanidad en el Mun- self creative suffering in the priest who is unable to sympa- do, n. 31, 1996, pp. 127-132. Comisión Episcopal Española de presence of that suffering that thise with weaknesses, but one Liturgia, Officio Divino, ‘Liturgia de las they undergo. This is the les- who in every respect has been Horas según el rito romano’, 4 vol. 83 son of the Servant of Jehovah tempted as we are’ (Heb 4:15; 1981. Consejo Pontificio para la Pastoral de that Jesus of Nazareth trans- 5:10). The answer of Chris- la Salud, Carta De Los Agentes Sanitar- formed into his divine-human tianity to the problem-mystery ios (Vatican City, 1995). way of redeeming pain of pain and suffering is not a DEREK DOYLE et al. (eds.), Oxford 84 Textbook of Palliative Medicine (Oxford through his own suffering, discourse that is exclusively Medical Publications, Oxford, 1993). and this is the human price that epistemological or hermeneu- VIKTOR E. FRANKL, El hombre healers must pay for humanistic. It is, rather, a living human doliente. Fundamentos antropológicos de la psicoterapia (Herder, Barcelona, ing through relief and comfort. model: Jesus Christ. He offers 1990). through his person the inte- BURKHART GÄRTNER, ‘Sufrimento’, in Diccionario Teológico del Nuevo Tes- 13.8. Pain and suffering are grated image of the passion of tamento (L. Coenen y otros, ed.), vol. IV experiences that always have men which prolongs his pas- (Sígueme, Salamanca, 1984), pp. 236- something that is unfath- sion in time and shows in his 245. omable, indescribable and in- action what the constructive DIEGO GRACIA GUILLÉN, ‘El Dolor en 85 la cultura occidental’, in Fe Cristiana y effable. Karl Jaspers calls suffering is that God generates Sociedad Moderna, vol. 10 (SM, these experiences, together in him and through him: suf- Madrid, 1990). Hnas. Hospitalarias del Sgdo. with others, limit situations fering, corporeal and friendly. Corazón, Pastoral en el mundo del sufri- because they push towards Through the life and lastly the mento psíquico, 2000. transcendence. For this rea- Passion of Jesus, God shows IVAN ILLICH, ‘The Killing of Pain’, in Limits to Medicine: Medical Nemesis. son, it is necessary to have re- how the suffering that human- The Expropriation of Health (Penguin course to poetic and sapiental ises human pain should be. Books, London, 1976). knowledge, the only forms of JOHN PAUL II, Motu proprio Dolen- tium Hominum (1985). knowledge that are able to ex- 13.11. The Church, the JOHN PAUL II, Apostolic Letter Salvi- press the human world of the pained and suffering, sick and fici Doloris on the Christian Meaning of spirit through symbols so as to caring, Body of Christ. This is Human Suffering (1984).

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 32

RAZOH KITAMORI, Telogía del dolor the Apostolic Letter of the Latin term not as a hidden untimely birth, as infants de Dios (Sígueme, 1975). ‘dolor’ and the Spanisn term ‘sufrimien- that never see the light?... Why is light EDRO AÍN NTRALGO P L E , Antropología to’.6 given to him that is in misery, and life to médica para clínicos (Salvat, Barcelona, Cf. Definition cited by KATHELEEN the bitter in soul, who long for death, but 1984). M. FOLEY in ‘Pain Assessment and Can- it comes not, and dig for it more than hid PEDRO LAÍN ENTRALGO, Historia de cer Pain Syndromes’ in Oxford Textbook treasures... For my sighing comes as my

la medicina (Salvat, 1978). of P7 alliative Medicine, p. 149. bread, and my groanings are poured out J.M. MCDERMOTT, ‘Sufrimento’, in Cf. J.M. MCDERMOTT, ‘Sofferenza’, like water’ (v. 3.10s.13.16. 20s.24). Diccionario de Teología Fundamental in Diccionario de Teología Fundamen- These are dramatic words of contempo-

(Paulinas, Madrid, 1992), pp.1395- tal,8p. 1395. rary relevance if we look at the debates 1400. Cf. P. LAÍN ENTRALGO, Antropología that take place today on abortion and on DWARD CHILLEBEECKXM E S , ‘La histo- méd9 ica para clínicos, p. 204. what is termed, with an un happy phrase, AÍN ria del dolor humano en busca de sentido On Thomas Sydenham cf. P. L ‘me18rcy death’. y liberacíon’, in Jesús. La Historia de un ENTRALGO, Antropología médica, p. 216 Commissione Episcopale di Pas-

Viviente (Cristiandad, Madrid, 1981), and10Historia de la Medicina, p. 315. torale, ‘La asistencia religiosa en el hos- pp. 577-588. From Testamento del Passero Soli- pital. Orientaciones pastorales’, Madrid, DWARD CHILLEBEECKXM E S , ‘Recuer- tari1o1 (Ed. Verbo Divino, 1991), p. 68. 198197, n. 2. do critico de la humanidad doliente’, in Hence one of the fundamental de- LAÍN, ‘Qué es la salute: el criterio

Cristo y los cristianos (Cristiandad, rivations of what Catholic doctrine calls sub2j0etivo’, in Antropología, p. 193. 1982), pp. 653-705. the consequences of original sin and the All these causes are increasingly DOROTHEE SÖLLE, Sufrimento Scholastic theologians defined in terms emphasised in social care/health care (Sígueme, 1978). of vulneratio in naturalibus, wound in which thus becomes a palliative instru- RANCESC ORRALBA Y OSSELLÓ F T R , human nature, a phrase used by the Ven- me2n1t against the pain added to illness. IKTOR RANKL Antropología del cuidar (Fundación erab12le Bede. Cf. V E. F , El hombre Mapfre-Medicina e Inst. Borja de Cf. CRISOGONO DI GESÙ, Vida e doliente. Fundamentos antropológicos

Bioética, Barcelona, 1998). obras de San Juan de la Cruz (BAC, de l2a2 psicoterapia (Herder, 1990). OSÉ ICO EINADO J V P , Profetas en el 1955), p. 1311. 23 In the last two paras. of part 3.

Dolor. La enfermedad vista desde los 24 Cf. 7. paras 2 and 3. enfermos (Paulinas, 1981). The ideas on acute and chronic, be- (VV.AA.), ‘Aspectos científicos y nign and malign, pain from the artiche asistenciales del dolor y del enfermo ter- by J. L. MADRID ARIAS, ‘Clinical del do- 32 minal’, in Sobre el dolor y el derecho a lor intolerable’, Labor Hospitalaria, cit- una muerte digna, n. 222, Labor Hospi- ed in the bibliography, pp. 287-291. Nu- talaria, Oct-Dec. 1991. merous data and references can also be (VV.AA.), ‘Sofferenza’, in found in the Oxford Textbook of Pallia-

Dizionario di Teología Pastorale Sani- tive25Medicine. taria (Camilliane, 1997), pp. 1164-1230. Cf. Diario Medico.com, 3 April

(VV.AA.), Vivir sanamente el sufri- 200261. mento. Reflexiones a la luz de experien- The Spanish Dictionary is explana- cias de enfermos (Edice, Madrid, 1994). tory when it say that to alleviate means to diminish or mitigate illnesses, the trials of the body and the afflictions of the soul. Notes 27 Reference to Ivan Illich has by now 1 The text of this paper was published become classic: ‘The Killing of Pain’, in with the title ‘Sofferenza’ in the book 10 Limits to Medicine. Medical Nemesis: parole chiave per umanizzare la salute The expropriation of Health (Penguin

(Ed. Verbo Divino in 2002. It has been Boo28ks, London, 1977), pp.140-160. revised to be published in the journal The work by Hippocrates, De arte Dolentium hominum of the Pontifical (L. IV, 14), expresses itself in the following terms: Medicine has the task of free- Cou2 ncil for Health Pastoral Care. 13 A word with an apparently clear Phrase taken from a famous poem ing sick people of their pains, alleviating meaning but in reality a diffuse meaning by Manuel Altolaguirre which begins: the grave attacks of illness, and abstain- because it is, as the phrase goes, ‘poly- From eyes that no longer see/spring very ing from treating those who are already semic’, that is to say used with different black tears/that forget their task/of being dominated by their illnesses, given that

meanings such as the meaning of a reali- star1s4 in the night. in this case it is known that the art is un- ty by an individual, a way of being and St. John of the Cross wrote the work able to do anything. For the physicians doing, a way of living, the teaching ac- Salita al Monte Carmelo to describe the of antiquity the fight against pain had a quired throughj practice… The Spanish itinerary towards mystic union with God clinical and religious relevance. As a Dictionary brings together and sum- which begins in a dark night whose first Latin apothegm declares: Divimun opus marises these meanings and states that part includes, in its turn, an active night sedare doloreem, the calming of pain is experience is ‘the teaching that is ac- of sense and an active night of spirit-un- divine work, and a text of the Book of quired with use, practice or living’. I em- derstanding. Both are characterised by Sirach speaks in the same terms when re- what St. John of the Cross calls high sen- ferring to doctors and chemists: ‘they too plo3y this last definition. A commercialised vision because to- sorial and interior nakedness (cf. Criso- will pray to the Lord that he should grant

gether with pure information what press gon15o di Gesù, pp. 506-512.550). them success in diagnosis and healing agencies and the mass media in general A Neo-Kantian German philoso- (38:14). Many centuries later Sir Francis want is the highest possible economic is pher who lives during the last years of Bacon echoed these aspirations: the of- of news business. For this reason, it is the nineteenth century and the first half fice of the medical doctor is not a matter perfectly legitimate to affirm that suffer- of the twentieth century. One of his most solely of restoring health but also of mit- ing is traded in at the level of simple important contributions was to establish igating the pains and torments of illness- points of mutual comprehension be- es; and not only when this relief leads to new4 s. In the common view news is not a tween the positive sciences and philoso- recovery but also when, all hope of re- fact but a fact chosen from many others phy, on which he wrote his principal covery having disappeared, it helps the by the professionals of information and work, the Philosophy of Symbolic passage over to the other life to be easy

presented by them through the mass me- For16ms. and29well done. Book of Ecclesiastes or of Jesus According to the anthropological dia5in conformity with their criteria. Despite this, in the case of the Mag- Ben17 Sirach, 4:1. meaning of the Biblical term ‘leb’. In isterium of the Catholic Church there is a I cannot resist reproducing here cer- Biblical anthropology the heart is the in- determining fact that excludes it from the tain phrases contained in chapter 3: ‘Let side of man because distinct from what is above-mentioned semantic confusion. the day perish wherein I was born, and seen. It is the seat of the faculties and The official language of the documents the night which said, ‘A man-child is personhood when thoughts and feelings,

of the Magisterium is Latin and in Latin conceived’… because it did not shut the wo3r0ds, decisions and actions are born. there is no terminological equivalent to doors of my mother’s womb, nor hide For this reason, it must be well un- the Spanish term ‘sufrimiento’ which is trouble from my eyes. ‘Why did I not die derstood and constantly cultivated so as derived from the Latin verb ‘suffero’ at birth, come forth from the womb and not to fall into the rebuke of Job to those which does not have a noun form and expire? Why did the knees receive me? who were accompanying him: ‘How does not means the same as to suffer in Or why the breasts, that I should suck? then will you comfort me with empty Spanish, Latin used as noun synonyms For then I should have lain down and nothings? There is nothing left of your for suffering the terms ‘dolor’, ‘passio’, been quiet; I should have slept; then I answers but falsehood?’ (21, 34). This is ‘aegrotatio’ Hence the use in the title of should have been at rest… Or why was I a rebuke that is very often justified is

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 33

52 other purported relationships of help that have uttered what I did not understand, Mk 3:21: ‘When his relatives heard discourage sick people more than they things too wonderful for me, which I did of this they set out to seize him, for they help them because of a lack of sincere not know. ‘Hear and I will speak; I will said, “He is out of his mind”.’ Jn 1:11: will, adequate training and sufficient ef- question you, and you declare to me.’ I ‘He came to what was his own, but his

fort3.1 had heard of thee by the hearing of the ow5n3 people did not accept him. My observations on poetic knowl- ear, but now my eye sees thee, therefore Lk 19:41s: ‘As he drew near, he edge and sapiental knowledge are taken I despise myself, and repent in dust and saw the city and wept over it, saying, “If

almost literally from his book Creer, es- ash4e2s’. this day you only knew what makes for perar, amar ( Ed. Círculo de Lectores - Dt 8:2-5: ‘Remember how for forty peace - but now it is hidden from your

Galaxia Gutenberg, 1993), pp. 74-80 and years now the Lord, your God, has di- eye5s4.” (cf. Mt 23:37ss).

I ha32ve adopted them almost completely. rected all your journeying in the desert, Mt 16, 21ss: ‘From that time on, Je- Because symbolic and thus specific so as to test you by affliction and find out sus began to show his disciples that he

to t3h3e spirit (cf. 6, para. 3). whether or not it was your intention to must go to Jerusalem and suffer great- The journey of the mind towards keep his commandments. He therefore ly… and be killed… Then Peter took God. A phrase that was the title of a fa- let you be afflicted with hunger, and then him aside and began to rebuke him, mous theological work of the Medieval fed you with manna… in order to show “God forbid, Lord! No such thing shall

Fra3n4 ciscan St. Bonaventure. you that not by bread alone does man ever happen to you.” He turned and said For example the ultimate meaning live, but by every word that comes forth to Peter, “Get behind me, Satan! You are of health or healing, pain and suffering, from the mouth of the Lord… So you an obstacle to me. You are thinking not deterioration, dying, death, or health must realize that the Lord, your God, dis- as God does, but as human beings do”.’

care35. ciplines you even as a man disciplines (cfr5.5 17:22s; 20:17ss). I am aware of the fact that the ap- his son’. Prov 3:11s: The discipline of Mk 14:33-38: ‘He took with him proach to pain and suffering varies a the Lord, my son, disdain not; spurn not Peter, James, and John, and began to be great deal from culture to culture and his reproof; For whom the Lord loves he troubled and distressed. Then he said to specifically today, because of the mass reproves, and he chastises the son he fa- them, “My soul is sorrowful even to movements of migration and the globali- vors’ 2 Cor 32, 31: ‘God abandoned him, death. Remain here and keep watch.” He sation of information and cultural ex- Ezechiel, top ut him to the test and dis- advanced a little and fell to the ground

change, we have to live with patho-vi- cov4e3 r what he had in his heart’. and prayed that if it were possible the sions that are different from the Christian 2 Mac 6:12-16: ‘these chastise- hour might pass by him; he said, “Abba, one, for example the Islamic, the Bud- ments were meant not for the ruin but for Father, all things are possible to you. dhist and the Hindu. However, I remain the correction of our nation…He never Take this cup away from me, but not convinced of the fact that specifically in withdraws his mercy from us. Although what I will but what you will.” When he 33 an increasingly pluralistic world it is he disciplines us with misfortunes, he returned he found them asleep. He said

necessary, advantageous and construc- doe4s4 not abandon his own people. to Peter, “Simon, are you asleep? Could tive to present with greatest fidelity and Jer 15:18s: ‘Why is my pain contin- you not keep watch for one hour? Watch simplicity the foundations of one’s own uous, my wound incurable, refusing to and pray that you may not undergo the religious tradition in this area because be healed?... Thus the LORD answered test. The spirit is willing but the flesh is

this involves our most valuable contribu- me: If you repent, so that I restore you, in wea56k.” tion to the shared spiritual heritage of my presence you shall stand; If you bring Lk 22:44: ‘He was in such agony

con3t6emporary and future humanity. forth the precious without the vile, you and he prayed so fervently that his sweat

Cf. for example, Job14: 1-5: ‘Man sha4l5l be my mouthpiece’. became like drops of blood falling on the

that is born of woman is of few days, and It is worthwhile reading the hole of gro5u7 nd.)’ full of trouble. He comes forth like a the fourth son of the Servant: Is 52:13- Mt 27:46: ‘And about three o’clock

flower, and withers, he flees like a shad- 53,4612. Jesus cried out in a loud voice, “Eli, Eli, ow, and continues not’, and Wis 7:16: ‘I Mt 9:36s: ‘At the sight of the lema sabachthani?” which means, “My also am mortal, like all men…and my crowds, his heart was moved with pity God, my God, why have you forsaken

first sound was a cry, like that of for them because they were troubled and me5?8” all…there is for all mankind one en- abandoned, ike sheep without a shep- Heb 2:10-18: ‘For it was fitting that trance into life, and a common depar- herd. ‘ Mt 14:14: ‘When he disembarked he, for whom and through whom all

ture37’. and saw the vast crowd, his heart was things exist, in bringing many children to Is 45:5-7: ‘I am the Lord and there moved with pity for them, and he cured glory, should make the leader to their is no other…I form light and create dark- their sick (cf 15:32). Lk 7:13: ‘When the salvation perfect through suffering. He

nes3s8, I make weal and create woe’. Lord saw her, he was moved with pity who consecrates and those who are be- Ps 10: 4: ‘Why dost thou stand afar for her and said to her, “Do not weep.” ing consecrated all have one origin. off, O Lord? Why dost thou hide thyself ‘Jn 11, 33.35s: ‘When Jesus saw her Therefore, he is not ashamed to call them in times of trouble?... In the pride of his weeping and the Jews who had come “brothers,”… Now since the children countenance the wicked does not seek with her weeping, he became perturbed share in blood and flesh, he likewise

him; and his thoughts are, ‘There is no and47deeply troubled…And Jesus wept’ shared in them, that through death he God’. Job 2:9: ‘Curse God’ (Job says to Mt 8:16s: ‘When it was evening, might destroy the one who has the power

his3w9 ife), and many other texts. they brought him many who were pos- of death… and free those who through Jer 12:1-4: ‘Righteous are thou, O sessed by demons, and he drove out the fear of death had been subject to slavery Lord, when I complain to thee; yet I spirits by a word and cured all the sick, all their life. Surely he did not help an- would plead my case before thee. Why to fulfill what had been said by Isaiah the gels but rather the descendants of Abra- does the way of the wicked prosper? prophet: “He took away our infirmities ham; therefore, he had to become like his

Why do all who are treacherous thrive? and48bore our diseases.”(cf. Is 53:5). brothers in every way, that he might be a Thou plantest them, and they take root; Mt 5:4: ‘ Blessed are they who merciful and faithful high priest before they row and bring forth fruit… How mourn, for they will be comforted.’. Ap God to expiate the sins of the people. Be- long will the land mourn, and the grass 21:4: ‘He will wipe every tear from their cause he himself was tested through of every field wither? For the wicked- eyes, and there shall be no more death or what he suffered, he is able to help those

ness of those who dwell in it the beasts mourning, wailing or pain, (for) the old wh5o9 are being tested’. and the birds are swept away., because order has passed away”’(cf 7:17; Is An allusion that in Luke is directly

men said, ‘He will not see our latter end.’ 25:489). addressed to people who are in pain and Hab 1:13: ‘why dost thou look on faith- Jn 9: 1-4: As he passed by he saw a suffering: blessed are you that weep

less men, and art silent when the wicked man blind from birth. His disciples asked now60, for you shall laugh (6, 21). swallows up the man more righteous him, “Rabbi, who sinned, this man or his Cf. Rom 12:15: ‘Rejoice with those

than40 he?’ parents, that he was born blind?” Jesus that61rejoice, weep with those that weep’. Job 13:18-23: ‘Behold, I have pre- answered, “Neither he nor his parents I deliberately do not present here pared my case; I know that I shall be vin- sinned; it is so that the works of God these testimonies in historical order or dicated…Only grant two things to me, might be made visible through him. We according to theological criteria but only then I will not hide myself from thy face; have to do the works of the one who sent with the criterion of pastoral expressive- withdraw thy hand from me, and let not me while it is day. Night is coming when ness. I believe that I have already suffi-

dread of thee terrify me. Then call, and I no 5o0ne can work”. ciently explained that I am – and thus I will answer; or let me speak, and do thou Jn 5:16s: ‘Therefore, the Jews be- do not write as – a systematic theologian, reply to me. How many are my iniquities gan to persecute Jesus because he did in this case a kind of pathologist of theol- and my sins? Make me know my trans- this on a sabbath. But Jesus answered ogy, but a pastoral clinician, that is to say

gre4s1sion and my sin’. them, “My Father is at work until now, a person who takes as a point of refer-

Job 42: 1-6: ‘Then Job answered the so I51am at work”.’ ence the theology and other expressions Lord: ‘I know that thou canst do all Mt 17:17: ‘Jesus said in reply, “O of Christian tradition in order to achieve, things, and that no purpose of thine can faithless and perverse generation, how with the greatest care possible, comfort- be thwarted. Who is this who hides long will I be with you? How long will I ing care beginning with Catholic pastoral counsel without knowledge? Therefore I endure you? Bring him here to me”.’ care.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 34

62 78 Cf. Salvifici doloris, 2 and 3. The give thanks to the Lord, for he is good; 2 Cor 1:3-6: ‘Blessed be the God

Pope had already experienced suffering his7s3teadfast love endures for ever!’ and Father of our Lord Jesus Christ, the in his own flesh when he wrote this Cf. for example. Ez 3:7: ‘I have Father of compassion and God of all en- Apostolic Letter, which comes after the seen the affliction of my people who are couragement, who encourages us in our assassination attempt of St. Peter’s in Egypt, and had have heard their cry every affliction, so that we may be able Square and his convalescence in the. In because of their taskmasters; I know to encourage those who are in any af- this case as well we are daling with the their sufferings, and I have come down fliction with the encouragement with testimony of a sick person in pain and a to deliver them…’. Judg 2:18: ‘for the which we ourselves are encouraged by

suff63ering sick person. Lord was moved to pity by their groan- God. For as Christ’s sufferings overflow

64 Cf. 5. para 3. ing because of those who afflicted and to us, so through Christ does our en- Cf. Praenotanda del Ritual de la oppressed them’. Judg 10:16: ‘and he be- couragement also overflow. If we are Unción e de la Pastoral dei Enfermos, came indignant over the misery of Is- afflicted, it is for your encouragement

and Orientaciones Doctrinales e Pas- rael74’. and salvation; if we are encouraged, it is torales del Epsicopada Espanol, Ed. Is 6:13: ‘As a mother comforts her for your encouragement, which enables

Litú65rgicos, 1986, nn. 32 and 43. child so will I comfort you!’ Hos 11:8: you to endure the same sufferings that OHN OF THE ROSS Cf. St. J C , ‘Cántico ‘How can I give you up. O we7s9 uffer.’ espiritual’, in Crisógono de Jesús, p. Ephraim?...My heart recoils within me, Whatever the case I refer here to

90466. my compassion grows warm and tender’. simple to simple irritation which the

67 Cf. 12.4 paras. 1-4. Is 49:13: ‘For the Lord has comforted his Spanish Dictionary defines, among other Many of which are addressed by people, and will have compassion on his things, as ‘irritation generated by light

clas68sic and contemporary poets. afflicted’. Is 51:12: ‘I am your com- phy80sical damage or lack of health’.

Hymn of the Praises of I Friday of fort7e5 r’. Here it is helpful to remember the

ord6i9nary time. Psalm 94:19: ‘When the cares of poem by Amado Nervo quoted in 7, at

Making the perhaps not necessary my heart are many, thy consolations the8e1 nd of para. 4. exception that the spiritual dimension cheer my soul’. Psalm 119:50: ‘This is The killing of pain mentioned in

concerms the whole man, both his exteri- my comfort in my afflictions, that thy not8e2 29.

or and his interior. He is body and spirit pro7m6 ise gives me life’. The Catechism of the Catholic in all his being; he is spiritual flesh or For example in the messianic pas- Church states that palliative care is a ‘ emb70odied spirit. sages of Isaiah 61:1-3: The spirit of the privileged form of charity and as such

St. Paul in his Letter to the Colos- Lord God is upon me, because the Lord mu8s3t be encouraged (n. 2279).

sian71s 2:9. has anointed me; He has sent me to bring 84 Cf. 12.5. par. 4. 34 Is 57:18: ‘I will lead him, and re- glad tidings to the lowly, to heal the bro- The is the interpretation of the quite him with comfort’Is 51:3.12: ‘For kenhearted… to comfort all who mourn; Evangelist St. Matthew of the healing

the Lord will comfort Zion…joy and To place on those who mourn in Zion a acti8v5 ities of Jesus (cf. citation note 49). gladness will be found in her, thanksgiv- diadem instead of ashes, To give them A psychiatrist, existential philoso- ing and the voice of song’. Is 52:9 oil of gladness in place of mourning, a pher, and at the last stage of his life a

‘Break forth together into singing, for the glorious mantle instead of a listless spir- can8c6 er patient. Lord has comforted his people, he has it. They will be called oaks of justice, Cf. Lk 10, 33. Cf. also John Paul II

red7e2emed Jerusalem’. plan77ted by the Lord to show his glory.’ . in Salvifici doloris where the figure of We may refer, inter alia, to Psalm Acts 9:31: ‘The churches… were the Good Samaritan exemplifies what 118 which repeats the formulation: ‘O full of the comfort of the Holy Spirit’. the Pope calls the gospel of suffering.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 35

The Anthropological Dimension of the Right to Health

1. That the right to health solutely banal and self-evident lish compensation for an indi- should be listed amongst fun- and precisely for this reason, as vidual because of the damage damental human rights is not a consequence, could give rise caused to the health of that per- only a matter of fact (demon- to possible and not to be son by an act, held to be unjust, strable empirically, beginning wished for misunderstandings. of a third party, as is well with the innumerable Charters It is indeed evident even known he is obliged to refer to of Rights that refer to it), it is, with an immediate (or superfi- absolutely extrinsic criteria even more, a principle by cial) approach, that the appear- (the length of the stay in hospi- which to interpret the times in ance of illness – at least at cer- tal, the percentage of loss of which we live, a statistic (to tain levels of relevance – opens the physical functions, etc.) use the term of Jaspers) that al- up obvious relational dynamics and is evident that it could not lows us to achieve a better fo- (between those who need care be otherwise. When (but this is cus not only on our under- and treatment and those who a rare hypothesis) a judge is standing of the juridical-social take on responsibility for care, called to establish in cases of dynamics of the modern epoch and between those who cause controversy the right fee that a but also, and more generally, injury to health and those who medical doctor can legitimate- our own self-understanding. As undergo such an injury), which ly request from the patient he is 35 is known, we are dealing here have equally obvious juridical treating, the judge adopts crite- with a sociological-cultural ac- consequences. But they are not ria that are fundamentally soci- quisition (or perhaps a spiritual constitutive relational dynam- ological-economic in character one) that is relatively recent ics; they are, in fact, after a cer- which do not have any specific but which by now is absolutely tain fashion, derivative and relevance to the specificity of rooted in the consciousness of the diagnosis carried out by the modernity. medical doctor and to the existential relevance of the therapy 2. What is the foundation of indicated to the patient and im- the right to health? Such a plemented by him (for exam- question should not be held to ple a correct diagnosis of pneu- be ingenuous, or ineluctable, monia and the application of a with a mere appeal to common coherent therapy – which in- wisdom which places ‘being volve, for example, a limited well’ at the top of any possible number of home visits – on the and imaginable hierarchy of one hand, can, at the level of ‘values’. This is an essential the ‘historical’ unfolding of question, if only because it has events, objectively save the life priority importance in any of the patient but, on the other, complete analysis of this right they do not appear at a strictly of a juridical character juridical-social level to allow (whether, for example, this the medical doctor to ask for right is individual or collective, secondary. In fact they seem to very high fees). It is as though, promotional or repressive, involve, despite appearances, a that is to say, being well and whether it can be enforced fleeting self-referential a being unwell concerned in through legal action, etc.) and a priori: being well like being themselves and for themselves sociological character (namely unwell appear, in fact, when an absolutely private experi- how much the defence and/or subject to a rigorous analysis, ence of the person; at a social the promotion of this right pos- as absolutely personal and sub- level the ‘in themselves’ of sesses a real effective character jective states, whose interper- these phenomena would not in the current historical mo- sonal communicability appears acquire relevance were it not ment and in what geopolitical very arduous, if thought about for their reflection in relational contexts). For that matter, it is from the perspective of objec- dynamics. Or, to be even more to be observed that the very tivity. In other words, a com- precise: it is as though being formulation by jurists of the mon yardstick does not exist to well and being unwell were category ‘the right to health’ define wellbeing produced by strictly naturalistic dynamics often lacks full awareness of ‘health’ or ‘malaise’ produced and pre-juridical and pre-so- what its specific epistemologi- by ‘illness’. What is defined is cial; and acquired juridical and cal context is : a context that is not ‘wellbeing’ or ‘malaise’ in social relevance only when constitutively relational (this is themselves, but wellbeing or they rise to effective contents a phrase in which stress must malaise induced by relational of interpersonal experiences ex be placed on constitutively). dynamics which appear, for contracto o ex delicto. This is This is a category that at first any reason, actionable. When a the paradigm that is at the base sight could appear to be ab- judge is called upon to estab- of one of the most widespread

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 36

bioethical models of our time – ‘nature’. Health and illnesses be more pursuable the more that formulated by H.T. Engel- define our being in the world they are based upon an image 1 hardt Jr. as persons in relationships and of man that is adequate at the are not indices of our ability to level of epistemology. The par- 3. Today this paradigm is no relate to the world (a high abil- adigm of the right to health, a longer sustainable. The rela- ity in the case of health, a low fundamental human right, tional character of the right to or at the most absent ability in helps us construct this image health has a deeper meaning the case of illness) but of the correctly. The foundation of and at the same time a more very general constitution of the the right to health is not to be radical meaning. And this is world. In other terms, illness attributed to the spirit of com- the meaning that explains its and health are not refracted in passion nor more generally to entrance into the list of funda- the personal sphere of individ- fraternal solidarity: compas- mental human rights and its uals but are reflected in the sion and solidarity are given universal diffusion. To para- possibility that in general there immense areas of action as a 2 phrase Rawls, we could say are subjects, subjects who, be- prerogative but these do not that the fact some people have ginning only with relationality coincide tout court with the an- good health and others have ill (and the effectual level of this), thropological sphere of the ju- health (whatever the reasons manage to construct a world of ridical and the social. This for this may be) cannot be de- meaning, which means that sphere – the only sphere in fined as just or unjust – they health and illness do not pre- which the approach to rights are dynamics that should be at- cede a relationship but build it; has a meaning and seems to be tributed to fate or, to employ or, if one prefers to put it an- practicable – is the sphere of other way, that is possible to our identity as a relational 36 refer to health and illness sole- identity: that identity that each ly because subjects exist who person acquires in referring to 3 are within a relationship. others, through others or with The right to health thus ac- others, and in which our per- quires a new meaning which sonal physical-biological histo- by now has probably defini- ry acquires all of its anthropo- tively entered the collective logical meaning. consciousness, even though it is not always explicit: that Prof. FRANCESCO meaning where the very identi- D’AGOSTINO Ordinary Professor ty of the person comes into of the History of Law, play. In upholding health as a The Faculty of Law, right, the subject upholds, in The University of Rome the final analysis, the right to ‘Tor Vergata’, be recognised in his own iden- Member of the Pontifical Academy for Life. tity, as a right that is based not Italy. upon nature but upon relationality; in recognising health as a the phrase used by Rawls, to fundamental human right the the ‘natural lottery’. What, in- juridical system (beginning Note

stead, can be defined as a just with the international juridical 1 and unjust is the way in which system) recognises and takes Cf. the well known Manuale di Bio2etica, Italian edition, Milan, 1991. these facts are addressed with- seriously the common and J. RAWLS, Una teoria della giustizia,

in the overall system of social equal subjectivity of all human Ital3ian edition, Milan, 1982, p. 99. relations. In fact, independent- beings. This means that the very categories of ‘health’ and ‘illness’ are anthropologi- ly, that is to say, of who or The new paradigm of sub- cal categories which only by analogy can what are possibly the cause of jectivity which, through refer- be extended to non-human living beings. the malaise of a person, it is ence to the right to health, is This does not imply any devaluation of the life and moral dignity of animals to the fact itself of the existence taken into consideration here assert that animals, specifically speaking, of malaise that has acquired in does not have a primary ethical do not fall ill, just as, specifically speaking they do not die because they do not the consciousness of out time a meaning, nor, and even less have the ability to formulate that no- new absolute relevance as a than ever before, does it have a longer-being as a foreseen experience, problem of justice. The rela- political-pragmatic meaning. It and more in general they do not have awareness of a pathological kind (in the tional characterisation of the has a epistemological meaning. sense of being unnatural) of their possi- being of man – which increas- What is immediately brought ble ‘being unwell’. Given that for ani- ingly seems to rise to a consti- into play is not ‘humanising’ mals it is not congruous to speak about relationality in the specific sense, it is not tutive feature of contemporary medicine, by eliminating or re- congruous as well to attribute to them anthropology – involves ill- ducing its cold image of ab- any experience or any connotation that nesses, like health itself, no stract scientific knowledge so requires a relationship as being necessary to t4hem a priori. longer being able to be seen, as to lead it back parenetically On this point see the important re- depending on the case in hand, to the much warmer sphere of flections of F. BOTTURI, ‘La medicina as misfortunes or ‘private’ ben- a culture of welcoming:4 these come prassi della cultura dell’accoglien- za’, in AA.VV., Modelli di medicina. efits, which individuals are and similar objectives, which Crisi e attualità della professione, edited said to be affected by because are obviously to be wished for, by P. CATTORINI and R. MORDACCI (Mi- of a blind or obtusely active must be pursued but they will lan, 1993), pp. 105-112.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 37

Pastoral Actions to Defend and Promote the Right to Health

The Second Vatican Council able to allow mankind to hear ble him, or the cultural expres- called the attention of the her words which infuse hope. sions that conform him in an whole of mankind to the In intensifying her pastoral increasingly full way to his ‘be- supreme norm of ‘divine law – action, the Church perceives ing the son of God’. the eternal, objective and uni- that her doctrinal principles Far from being an obstacle to versal – whereby God orders, cannot be only proclaimed: true progress, the action of the directs and governs the entire they must be constantly upheld, Church is carried out with re- universe and all the ways of the corrected and tested in practice newed commitment to service 1 human community’. so as to foster, at every level of and in dialogue with mankind On the basis of this funda- reflection and practice, the on its journey in the hope of be- mental fact, the Church per- communion of the Church with ing able to achieve an adequate ceives the obligation to pro- the suffering, and thus manage, response to the theoretical and claim the right to health, draw- as a consequence, to bear upon practical problems of medicine. ing upon the Gospel of Christ, the mentality and customs of The Church does this in order and to be able to say words, modern man. As Pope John to throw light on the moral as- where she is competent, not on- Paul II warned, this is because pects of illness and, through re- ly on prevention in relation to ‘unfortunately the beneficial flection and practice, to thereby 37 the overall health of the human action of the protection and the formulate adequate spiritual as- person but also on the multiple defence of health encounters sistance both at the level of ed- forms, concealed to various de- obstacles not only in a host of ucation and the conservation of grees, concerning diagnosis, ancient and recent pathogenic health and at the level of its full therapy and rehabilitation, that factors which imperil live on recovery. do not foster that health and earth but also sometimes in the It is the profound belief of which, in attacking man’s psy- mentality and behaviour of the Church that the life of every 5 cho-physical and spiritual equi- men’. human creature, who carries 2 librium, injure him. with him pains, illnesses, suf- If, therefore, the search for ferings and deaths, will culmi- truth must conform to ‘the dig- Pastoral Action nate in the resurrection, that is nity of the human person and to Promote Health to say in full participation in 3 his social nature’, it follows the life of Christ. This is a life, from this that also in the sphere Faced with the numerous however, that is perceived by of every health-care action one challenges and multiple emer- the believer and shared in by cannot depart from the mission gent problems in the health- the believer here and now in 6 of the Church, whose specific care field, what are, in positive the faith that transcends him task requires making the re- terms, the specific actions of and in the reality of the mystic demption of Christ real today the Church that safeguard, pro- body of which he forms a part. and fostering its full achieve- tect and promote the right to In this Christian perspective, ment so as to direct mankind health in every man or woman? pastoral action is not only soli- towards salvation in Christ. darity, and even less is it mere In this search, the Church, 1. Pastoral action creates assistance for its own sake. It through her help, her teaching healthy relations with God is, rather, ‘personalism of com- and dialogue, renders a valu- and between men munion’ which harmonises in able and irreplaceable service itself all human dimensions and to man, whether healthy or The Church believes, first of sees man as God willed him: 8 sick, in addition to her specific all, that her programme contin- His image and likeness. That is and ineluctable obligation to ues the work of Christ, who to say, it sees him as a being-in- engage in the ministry of salva- came into the world to give life a-relationship both with God 7 tion. Because of the fact that in abundance and by this life, and with men. the concept of health refers in which is light, to dissipate the practical terms to everything ‘misterium iniquitatis’ which 2. The pastoral action of the that concerns the concrete multiplies the troubles and suf- Church humanises health spheres of health care – such as ferings of mankind. This eccle- structures, planning, legisla- sial action is designed, there- The Church, with her pres- tion, policies and investments – fore, to circulate the life of God ence and action in the defence the Church cannot draw back; in its true nature of agape by and promotion of health, wants indeed, she calls for and re- expressing it in concrete ex- to be liberating, healing and quires her presence in public pressions of service to man saving on the model of Jesus, places of care and treatment to both as regards his primary nourished by the power of the 4 be assured by states. The needs – such as hunger, illness, Holy Spirit and making herself Church does the same in rela- clothing and housing – and the available to man so as to help tion when it comes to being cultural expressions that enno- him in his situations of need.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 38

She also seeks to offer a specif- she has been liberated and has seen the dawn of a new culture ic contribution of deep and already become, although not that expresses a choral action warm humanity. Just as the di- fully, a people won over by of a community united by the vine Samaritan is the true pro- God that proclaims His won- love of Christ. Thus isolated moter of healthy life, ‘so also derful works, because it has ob- ecclesial action is not conceiv- 11 the Church surrounds with af- tained mercy. From this exis- able – ecclesial action should fectionate care those who are tential state of a divine charac- be unitary because it involves afflicted by human suffering, ter ecclesial activities for the reflection, dialogue, testing, indeed…in them she intends to defence and promotion of programming and planning, 9 12 serve Christ’. The fact of health begin with motivations and it should be carried out not knowing how to recognise the of health and embrace man in with useless parallel initiatives image of suffering, poor and all his human and spiritual di- but in cooperation with the crucified Christ, and of wanti- mensions, setting in motion or modern world. ng in every way to serve him in completing everywhere the Scientific advances, tech- men who find themselves in process of humanisation. niques of intervention, opera- similar situations, is for the tional modules, legislation be- Church a task that refers to the 3. Pastoral care in health ing applied or being prepared mandate of her founder which bears upon social and in various countries in the field cannot be reduced to a mere cultural transformations of contemporary health care, if beneficial act but which con- illuminated by faith, which has tains in itself a ‘power that The Church through the Sec- its foundation in revelation and comes from above’, a divine ond Vatican Council also wants its explanation in the Magis- force that extirpates the roots of to encourage dialogue with the terium, acquire an inestimable 38 evil present in the multiple and modern world which during meaning at the level of values varied sufferings of which this historical period manifests which is respectful of the sa- mankind is the victim. profound and rapid social and cred value of life and a promot- 13 cultural transformations in an er of a more welcoming and attempt to adopt as her own this human society, especially in re- period’s worries and hopes and lation to those who according as a response to the profound to a mentality based on the cri- aspirations that modern man teria of efficiency are consid- bears within him. She wants to ered the ‘least’, although they promote the culture of life and were privileged by Christ. to indicate to every man the path of Christ, the key to solv- 4. Pastoral action promotes ing contemporary questions the value of ‘being’ and a point of reference so that as opposed to ‘doing’ in man can shine forth that excellent vocation specific to man Pastoral care that has the that was willed and conceived above mentioned objectives is by God. constantly in contact with The pastoral actions of the health professionals and their Church cannot elude address- respective socio-health care ing an honest cultural dialogue projects, as well as with nurses with the ideologies that under- and their respective families. lie forms of behaviour that Hence the need to foster and Thus the subject of the pas- wound the dignity of the hu- encourage suitable the training toral action of health is the man person. In addition, the and constant up-dating of pas- Church, and such action at the Church is called to create a toral workers in this very deli- outset has its well fixed point ‘culture of the people’ that is cate field of health in order to ‘the priority of the transcendent incisive as regards the forms of be an authentic expression of and spiritual realities which are behaviour that satisfy the de- the love of Christ and in order premises of eschatological sal- sires of the human heart. The to engage in a transparent medi- 10 vation’. The Church, by her life of Christ is always the way ation of his salvific work. Such nature, is born from the Spirit for man who looks for truth, training has theoretical/practi- and receives nourishment and and thus to illuminate the mys- cal requirements. life from the Spirit. Her action tery of man with faith and pro- Pastoral effectiveness occurs within and without takes place mote his full health ideas are if there are suitable people who in the image of the Trinity. not enough: what are needed have experienced within them- Thus the Church, the mystic are ideas that take the concrete selves at least a part of the ben- body, has flowing in her veins form of life witness. During an eficial effects of the salvific the life of Christ which mani- epoch when the utility of pro- healing of Christ. Every man, fests itself to the world as love ceeding with synergy in all who needs redemption, discov- that unleashes a paschal dy- work activity is emerging with ers, through a gift of grace, that namism of salvation. The ac- ever greater clarity, the witness he is redeemed to the extent tion of the Church is liberating, of pastoral action of the Church that, in full liberty, he accepts healing and saving if she is on behalf of the inestimable the lordship of God in his life. healthy within herself because good of health allows to be To accompany other people in

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 39

18 this process, especially during er forms of health-care exper- tween the flesh and the spirit, illness or any other kind of suf- tise, in relation both to preven- a journey marked by actions fering, requires full personal in- tion and to treatment and care. that express a constant conver- 19 volvement permeated by the sion, so that in all those who same feelings of compassion, 5. Pastoral action, prayer and experience celestial reality a disquiet, struggle and response the sacraments of healing complete personal transforma- that are specifically of Christ. tion takes place which touches These requirements of suitabil- One form of power of pas- the heart of human beings and ity can be identified in the pastoral action, which is certainly leads towards a future resurrec- toral worker when there are ob- not negligible, is contained in tion. And this dynamism, al- served contemporaneously: hu- prayer. All the signs worked by though shaking the mystery of man maturity, social and psy- Jesus that manifested the won- man to the roots in order to pu- chological relational capacities, derful works of God – mira- rify him and to locate him in di- and a level of spiritual growth cles, healings, resurrections – vine mystery, can only be the that is able to integrate tran- begin with a prayer that makes work of God who was the first scendent values. In this sense, a request, they take place in full to love and who at the end of one can state that through peo- unity with the Father, and they life waits for His children so as ple who consecrate themselves end with a prayer of thanksgiv- to give them, if they have to service to the sick, Christ ing. Pastoral action in favour of known how to take up their truly reveals man to man, and health is called to be carried out cross every day, the crown of helps him to understand that in conformity with this ap- joy. nothing can separate man from proach. A man who is not very Him. attentive spontaneously over- Rev. MARIANO STEFFAN To achieve this priority of looks some of these passages or 39 being over doing, Marian spiri- expects inconsonant forms of tuality should be borne in mind Messianism. In his parable of 16 and experienced more wholly. the ten lepers, Jesus warns It has been written that ‘with- against these superficial ap- out Mariology, Christianity im- proaches. Pastoral action that perceptibly runs the risk of be- knows how to maintain union 14 Notes coming inhuman’. The inte- with God both in prayer and in 1 2 Dignitatis Humanae, n. 3. gration of the male and the fe- the apostolate is always ex- Cf. Charter for Health Care Work- male requires at an operational pressed as contemplation, ers,3 n. 9. 4 Dignitatis Humanae, n. 3. level to know how to go be- recognising God in the intima- Cf. John Paul II, ‘Message to the yond the sectional alignments cy of the soul and the heart of Heads of State who Signed the Final specific to certain ideologies so every man, especially when af- Helsinki Accord’ (1 August 1975), in 5AAS 72 (1980), p. 1256. that the whole of mankind be- flicted by various trials, and is John Paul II, ‘The Totalitarian Ide- comes an ‘offering accepted by joyful with him when the signs 15 ologies that have Deliberately Degraded God’. Partial and limited vi- of grace become present. Man Find Worrying Parallels in Certain sions, if they permeate Chris- An evangelising pastoral ac- Manipulations of Life’ L’Osservatore Rom6 ano, (1998/57), p. 138. tians, run the risk of reducing tion is the indispensable The Pope refers to ‘attacks on life’ the Church to practice without premise for the sacraments, and due to human causes such as ‘overbear- ance, violence, war, drugs, kidnappings. a soul, to an ideology of effi- especially the Eucharist, recon- The marginalisation of immigrants, abor- ciency that is only capable of ciliation and the anointing of tion7 and euthanasia’ (ibidem). bitter, polemical and sterile the sick, to produce the benefi- 8 Jn, 10:10. Gen 1:27. criticism from which people cial effects that they contain. 9 10Lumen Gentium, n. 8. flee, whereas convinced faith The sacrament of penance 11 Redemptoris missio, n. 20. and witness have greater pas- and the sacrament of reconcili- 12 Cf. 1Pt 2: 9-10. Redemptoris missio lists some of toral efficacy. ation, the sacrament of the these: ‘dialogue, commitment to justice To the training of pastoral anointing of the sick and the and peace, education and care for the workers should also be added Eucharist as viaticum, are seen sick, aid to the poor and to children’ (n. 20). the raining of health-care work- by the Church as being ‘sacra- 13 14 Cf. Gaudium et spes, nn. 4-10. ers. To them is addressed that ments of healing’ that express H.U. Von Balthassar, Punti fermi (Milan, 1972), p. 130. capillary action that creates a the constant approach of Jesus, 15 Gaudium et spes, n. 38. new conscience, a professional physician of our souls and bod- 16 17 Cf. Lk 17:11-19. training that isincreasingly ies, an approach that the Catechism of the Catholic Church, n. 1421. worthy of man. The Christian Church must know how to con- 18 17 19 Cf. Rom 8:5-11 anthropological vision, in its tinue in her practice. The gestures of reconciliation re- most reliable meaning, cannot The life that Jesus Christ ferred to by the Catechism of the Catholic Church are: ‘concern for the poor, the ex- be compared to one of the very through his incarnation and ercise and defence of justice and right by many transient ideologies: it is paschal mystery came to pour the admission of faults to one’s brethren, born from, and is completed in, in abundance over mankind is fraternal correction, revision of life, examination of conscience, spiritual direc- Christ, the Living One. It is fully achieved in his limbs tion, acceptance of suffering, endurance here that the health profession- when these, touched by the of persecution for the sake of righteous- al improves his skills and ex- work of healing and salvation, ness’ (n. 1435). These approaches are equally expressive and pastorally produc- pertise and places his profes- are led back to the Father. The tive for a person’s spiritual growth, to sional role at the service of, and earthly journey, therefore, is sustain others in trial and for the health it- in communion with, all the oth- lived in a constant tension be- self of the Mystical Body of Christ.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 40

The Figure of the Ecclesiastical Assistant

‘Special care should be taken a. The Identification and of the association which he is to select priests who are capa- Identity of the Ecclesiastical invited to serve. For his mission ble of promoting particular Assistant to bear fruit, he must be capable forms of the apostolate of the The purpose of priestly ser- of integrating himself, as a laity and are properly trained. vice is always to make possible priest, in the association, work- Those who are engaged in this encounter – encounter that ef- ing with the secular heads of ministry represent the hierarchy fects salvation – between the the association with respect and in their pastoral activity by Lord and every Christian or faithfulness. He should under- virtue of the mission they re- community. stand the objectives, the pro- ceive from the hierarchy. Al- gramme and the teaching of the ways adhering faithfully to the b. His Task as a Priest association and locate them spirit and teaching of the Every association has de- within the context of the mis- Church, they should promote fined roles: there are the sion of then Church. He should proper relations been laity and ‘founders’, the ‘directors’ and pay due pastoral attention to the hierarchy. They should devote the ‘ecclesiastical assistant’ society in which the association themselves to nourishing the who must provide a theologi- operates. It is thus advisable spiritual life and an apostolic cal, spiritual or pastoral direc- that the association should pro- attitude in the Catholic societies tion. Others can deal with ques- pose a list of expert and compe- 40 entrusted to them; they should tions connected with the organ- tent candidates for the choice contribute their wise counsel to isation and the structure of the and the appointment of its ec- the apostolic activity of these association itself. The work of clesiastical assistant. associations and promote their the priest has differing charac- The fundamental aspects of undertakings. Through continu- teristics according to the situa- his service are: ous dialogue with the laity, tion. First of all, and above all a) A creator of unity: the ec- these priests should carefully else, the work of the assistant clesiastical assistant has the investigate which forms make priest has to involve the preach- mission of helping the associa- apostolic activity more fruitful. ing of the Gospel and the ad- tion to deepen its awareness of They should promote the spirit ministration of the sacraments. being a member of the Church of unity within the association It is specifically through this and to become aware of the as well as between it and oth- service that he keeps alive the pastoral orientations of the ers’ (Apostolicam Actuositatem, awareness of the people of God Church and of the tasks and the n. 25). that it is ‘a chosen race, a royal principal concerns of her pas- ‘In the organisations and as- priesthood, a holy nation, God’s tors. It is his responsibility to sociations in which you render own people’ (1 Pt 2:9) ensure that the association lo- service – do not be drawn into cates itself within the pastoral deceit! – the Church wants you The Appointment of care of the Church in an overall to be priests and the secular the Ecclesiastical Assistant sense in line with its own char- people who meet you want you acteristics and goals. The eccle- to be priests and nothing else The existence and the work siastical assistant is also a cre- but priests. The confusion of of the ecclesiastical assistant ator of unity when he helps oth- charisms confuses the Church; are not legitimated by the asso- er heads of the pastoral care of it does not enrich her in the ciations in which he carries out the Church to have a clearer least…In these associations you his service. If they were, this idea of the nature, the objec- should be the builders of com- would mean that it is the associ- tives and the activities of other munion, educators in the faith, ation that ‘calls’ or ‘delegates’ associations and to analyse to- witnesses to the absolute God, the assistant. Instead, the min- gether the various experiences true apostles of Jesus Christ, istry is a gift that Christ has that are encountered. ministers of the sacramental conferred on his Church for the The ecclesiastical assistant is life, especially the Eucharist, community. The ecclesiastical therefore the person who in a and spiritual animators’ (John assistant is thus appointed by visible way is a link between Paul II, ‘Address to the Ecclesi- official and responsible minis- the universal Church and the astical Assistants of Catholic ters of the Church. The ecclesi- association. In placing the pas- International Organisations’, 13 astical assistant shares in the toral concerns of pastors linked Dec. 1979). mission of the bishop in rela- to their bishop within the asso- In the light of these texts, the tion to associations of secular ciation, the ecclesiastical assis- document of the Pontifical people on which are conferred a tant preserves it from sectari- Council for the Laity, ‘Priests specific autonomy and respon- anism by opening it to the in Associations of the Faith- sibility in the achievement of Church. ful’, Rome 1981, outlined cer- their apostolic goals. Being ap- b) An educator in the faith: tain guidelines of great impor- pointed explicitly by the rele- the ecclesiastical assistant must tance. vant ecclesiastic authority is not constantly encourage the mem- The identity and the mission in opposition, amongst other bers of the association at a per- of priestly service within asso- things, to the fact that the assis- sonal and community level to ciations of the faithful: tant fully participates in the life direct themselves towards Jesus

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 41

Christ through the preaching of watched over and supported by make him make mistakes and the Word and sacramental ser- the bishop or the respective su- which cause his downfall. First vice (especially the Eucharist). periors. of all, Saul shows that despite c) A true apostle of Jesus d) The ecclesiastical assis- the appearances of great force, Christ: the grace of God is not tants should not be appointed he is a man who is afraid and only a gift; it is also a task. for an indefinite period of time even suspicious. In chapter 10, Thus the ecclesiastical assistant or ‘for life’. Instead they should verse 21 we are amazed when is a true apostle of Jesus Christ, have a mandate for a specific we read about his election. In that is to say a ‘wise co-opera- period of time. defiance of fate Samuel went to tor of the bishop’. As such, the the tribe of Benjamin and his ecclesiastical assistant is called family and tried to identify Saul to service to the apostolate, the son of Kis: ‘But when they strengthening the faith of the sought him, he could not be members of the association so found. So they inquired again that God is always the absolute of the Lord, “Did the man come criterion in overcoming every hither?” and the Lord said, “Be- uncertainty. His faith will behold, he has hidden himself come more vigorous the more amongst the baggage”’. he meets the problems and the One has the impression that hopes of every man. Saul is conscious of his power d) A spiritual animator: the but that he is also diffident. ecclesiastical assistant must in- This diffidence expands into troduce all the members of the suspicion, one of the dominant association to the mysterious characteristics of his tempera- 41 and fascinating reality of the ment. In chapter 18, when presence of God. With them he speaking about David, we are must try to read the ‘signs of told: ‘And the women sang to the times’. To achieve the spiri- Which Style? one another as they made mer- tual growth of individuals and ry, “Saul has slain his thou- the community he must ensure The figure of Saul: the wrong sands, and David his ten thou- that the charism of the associa- style. King Saul is the image of sands.” And Saul was very an- tion and its members acquires a rich man of talents, qualities, gry, and this displeased him; he its specific form. and courage; he is even rich in said, “They have ascribed to e) A witness to the absolute of heroism. Saul has first and fore- David ten thousands, and to me God: in being a ‘witness to the most great potentialities. He is a they have ascribed thousands; absolute of God’, the ecclesias- powerful and strong man in- and what more can he have but tical assistant assures the reli- vested with the spirit of God, as the kingdom?”’ He had taken a gious dimension of the motiva- we read in the Bible: ‘Then rhetorical song too seriously tions and the goals of the asso- Samuel took a vial of oil and precisely because of his ciation. poured it on his head, and propensity to suspicion which kissed him, and said, “Has not closed him up in himself and Practical applications con- the Lord anointed you to be made him rigid. cerning his integration into the prince over his people Israel? A second characteristic is ecclesiastical structure: And you shall reign over the that Saul, although he has pow- a) Every association normal- people of the Lord and you will er, charism, and the capacity to ly has a single ecclesiastical as- save them from the hand of lead, deceives himself about his sistant at each one of its levels their enemies round about”’ possibilities and become pre- (diocesan, national, internation- (1Sam 10:1). cipitous. He does not realise the al). It may need other priests When Saul is consecrated he conditions – which require pa- who are members of the associ- has all the talents that are need- tience – to which the kingdom ation or can be asked by it to ed for his ministry. Indeed in of Israel is subject. In the provide various services de- verse 6 he is given, in addition episode narrated in chapter 12, pending on their ministry, such to the gifts of rule, also the gift when the entire people was as, for example, assuring theo- of prophecy: ‘Then the spirit of afraid of the Philistines, Saul logical reflection or spiritual the Lord will come mightily up- hurried to engage in a sacrifice animation. In this case, the as- on you, and you shall prophecy to encourage the people. Given sociation chooses the priests it with them and be turned into that Samuel was late in arriving needs in agreement with the ec- another man’. In verse 23 his Saul himself gave the order: clesiastical assistant and the rel- physical strength is also empha- ‘“Bring the burnt offering here evant authority. sised: ‘Then they ran and to me, and the peace offerings.” b) A priest can be an ecclesi- fetched his from there; and And he offered the burnt offer- astical assistant in more than when he stood among the peo- ing. As soon as he had finished one associations, working, for ple, he was taller than any of offering the burnt offering, be- example, in the same field or in the people from his shoulder hold Samuel came; and Saul the same social context, and upward’. went out to meet him and to harmonising their mutual co- Saul is a man who has all the salute him. Samuel said, “what operation. characteristics to establish him- have you done?” And Saul said, c) It is to be hoped that the self as a leader. But despite this “When I saw that the people ecclesiastical assistant will be he has some defects which were scattering from me, and

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 42

that you did not come within his own life to the point of sell- been done by him and knows the days appointed, and that the ing his field, which made him how to encourage: ‘So Barn- Philistines were mustered at rich, without fear or worry. In abas went to Tarsus to look for Micmash, I said, “Now the addition to generosity, he has Saul, and when he had found Philistines will come down up- the characteristic of consolation him he brought him to Antioch. on me at Gilgal, and I have not and this means that he is worthy For a whole year they met with entreated the favour of the of the name ‘son of encourage- the church, and taught a large Lord”, so I forced myself and ment’. Indeed, he is able to company of people, and in An- offered the burnt offering”. And comfort and to open up tioch for the first time the disci- Samuel said to Saul, “You have prospects and horizons. He is ples were called Christians’. done foolishly; you have not not simply the man who rigidly The greatest act of Barnabas kept the commandment of the pays in his own person by sell- was certainly that of discover- Lord your God, which he coming his field; he is the man who ing a new evangeliser – Paul of manded you; for now the Lord opens hearts and minds, as all Tarsus. would have established your of his work would later demon- A final passage is really spe- kingdom over Israel for ever”’ strate. cial. We read in Acts 13:7ss that (vv. 9-13). Saul deceives him- Barnabas, after understanding self into thinking that he can that Paul has greater talents something that is not his re- than he does, puts himself at a sponsibility; he has dreams secondary level. Barnabas had greater than his prerogatives perceived that it was precisely and in the end he is disbarred the superiority of Paul, to by those who had bestowed the which he gave greater value, 42 anointing upon him. that required Paul to assume re- Another characteristic typical sponsibility for the mission, and of his temperament is melan- thus it was that he followed choly and sadness. Many him. episodes bears witness to this. We know that the talents of In 1Sam 16:14-15 we read: Barnabas did not impede him ‘Now the Spirit of the Lord de- from making mistakes both in parted from Saul, and an evil his argument with Paul about spirit from the Lord tormented the second mission and in his him. And Saul’s servants said to opposition to Paul over the him, “Behold now, an evil spirit question of sitting at the same from the Lord is tormenting We read, for example, in Acts table as converts from pagan- you”’. So they looked for a man 9:26-28, that Paul, after his ism. However, he remains one who was able to play the lyre conversion, ‘attempted to join of the most encouraging and and they took David to him the disciples; and they were all most open figures of the first who played the lyre and man- afraid of him, for they did not Christian communities. aged to comfort him. And in 1 believe that he was a disciple. To sum up, we may repeat Sam 18:10 an evil spirit took But Barnabas took him, and the four points: hold of Saul who ‘raved within brought him to the apostles, and – the style of Barnabas is en- his house, while David was declared to them how on the couraging. Today people, the playing the lyre, as he did day road he had seen the Lord, who apostolate, ask for hope from by day. Saul had his spear in his spoke to him, and how at Dam- us, ask for understanding, com- hand; and Saul cast the spear, ascus he had preached boldly in fort, consolation; for he thought, “I will pin the name of Jesus’. Barnabas is – Barnabas knows how to see David to the wall.”’ But David the man who sows trust in the good and everything in terms of evaded him twice.’ The dramat- relations between the suspi- its possibilities, its positive ic conflict with David begins cious community of Jerusalem forces. He has a great vision of here and it finishes only with and Paul. He is the man who faith in the victory of Christ. the death of Saul. In Saul all his opens up paths in a difficult – Barnabas knows how to ap- talents, his abilities, and his city, where there were still very preciate other people, all peo- possibilities all come to nothing few Christians, where persecu- ple, all the forces that work because of an erroneous style. tion had just taken place and within the community; The figure of Barnabas: the where people were living in – Barnabas knows how to right style. Acts 4:36-37 de- fear. take a step back in relation to scribes Barnabas: ‘Thus And in Acts 11:21ss we read Paul. This is the approach of Joseph, who was surnamed by that Barnabas succeeds in his one who lives by recognising the apostles Barnabas (which attempt to retrieve Paul for the the primacy of the Word and means, Son of encouragement), ministry: ‘When he came and the grace of God and thus tries a Levite, a native of Cyprus, saw the grace of God he was to heal all divergences between sold a field which belonged to glad; and he exhorted them all people who are called to ser- him, and brought the money to remain faithful to the Lord vice. and laid it at the apostles’ feet’. with steadfast purpose, for he Barnabas is described as a gen- was a good man, full of the Rev. ARMANDO AUFIERO erous man who takes the word Holy Spirit and of faith’. Barn- FELICE DI GIANDOMENICO of God seriously and thus for it abas knows how to perceive Centre of the Volunteers of Suffering, and relation to it he measures good even though it has not Rome, Italy.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 43

Testimonies

Witnesses to Love in Pain

Health Care and Utopia

Gynaecologists and Obstetricians Called to Service to Life

The Anchor of Life

The Journey of the Office for Pastoral Care in Health of the Archdiocese of Bari-Bitonto under the banner of creativity

Pastoral Care in Health in Poland DH n.63 ing 1-80 16-01-2006 17:14 Pagina 44

Witnesses to Love in Pain PAPER GIVEN BY H.E. MSGR. JOSÉ L. REDRADO, OH TO THE SEVENTH CONGRESS OF THE AFR (ASSOCIATION OF THE FATEBENEFRATELLI FOR RESEARCH) BRESCIA, 14 SEPTEMBER 2006.

‘Suffering is… a great hu- But how can the Gospel be quence of the bad use that we man symbol that bears within Good News for the man who make of our freedom. it opposites: silence and the suffers, for the man who does God does not want this cross word of God, the misery and not have a home or work, for and this pain for us. He is not a the splendour of man, the the man who, because of an sadist who wounds man. God darkest absurdity and the most accident, has had his leg am- does not want us to suffer; God luminous meaning, blasphemy putated? How can the Gospel is our Father, He is full of love, and praise. It is, therefore the be Good News for a child who mercy and forgiveness and He great risk run by us all, sooner begins his life with an illness cannot send us illness. And yet or latter, involving us and or whose mother has breast man suffers, and he suffers a 1 overwhelming us’. cancer? Or for those people great deal! ‘One day suffering, the in- who are constantly in clinics I have witnessed many evitable guest of humanity, ar- and are subjected to an infinity pained faces, faces of suffer- rives without advance warn- of trials, and who pose major ing. Faces of hunger, of pover- 44 ing, enters our lives without questions about their health ty and of unemployment, asking our permission, settles without knowing what is hap- faces of peoples at war, ter- down in our homes, becomes pening to them? And lastly, rorised faces, faces without an the obligatory companion of how can the Gospel be Good identity, anonymous faces, our journeys… Its molesting News in a home where there is faces of desolate mothers, of presence breaks the daily rou- an AIDS patient, or an invalid marginalised women, faces of tine of our lives… Suffering or a drug addict? It is not easy exploited children, faces of contextualises our apparent se- to give an answer to so many sick people (people with can- curities. It breaks our integrity, questions. cer, with AIDS…), and the crumbles the foundations on A society that breathlessly faces of the dying. which we base the develop- looks for prosperity, posses- Suffering, enigma, mystery ment of our lives, renders our sion, being young and beauti- and in the face of mystery, si- plans vain… Suffering, and ful, a society that misuses lence, admiration; we do not the point must be made, laughs drugs and cosmetics, to ap- have the data to formulate an at our masks, our forms of pear, only for the physical im- opinion; ‘now’ we see things pride, our exterior experiences, age… a society of hurry and in a confused way, ‘then’ we our qualifications or public po- haste, of ‘unavoidable’ ap- will see them in the face (1 sitions… It is like a black star pointments, of stress, of think- Cor 13:12). in the firmaments our of our ing that one is important, and Can we free ourselves from lives. More than a problem, it of having to do many things, is suffering? However much is a mystery. The problem is a not ready for difficulty, illness, knowledge we have and how- difficulty that can be solved suffering and death. Illness is ever much love we may have and from which we can free a misfortune that can happen, for those who suffer, usually ourselves. Mystery is a part of but it is better not to think we are only able to alleviate human reality and we mature about it, and thus suddenly suffering or at the most to becoming aware of it… Suf- when it arrives, everything eliminate it in part. fering is a river of questions, collapses. Man, therefore, must give of cries. There are many mo- Without doubt we must meaning to suffering; he must ments of loneliness, nights preach that the Good News of know why he suffers and how without sleep, a series of Jesus passes by way of the he should suffer so that this re- nights without meaning, feel- cross, pain and suffering. The ality, life, has a meaning. A ings of powerlessness, ques- cross is not a ‘piece of wood’, key by which to manage to do tions searching for a meaning but the imitation of the cross, this is love and resurrection. that return without answers to being a witness, being patient The cross – suffering – with- our wounded hearts… To give and persevering; it is to go out love has no meaning. East- space to the wounded… to against the trend in obedience er Friday without Easter Sun- give space to pain, means to to the commandments of God: day has no meaning; just as 2 give space to love’. incomprehension and margin- Sunday without Friday has no alisation are the cross, physi- meaning. cal malady is the cross: cata- In the phrase ‘cross-pain- 1. Pain: a Place of strophes, illnesses, death, the suffering’ many concepts are Evangelisation consequences of our finitude, involved; we cannot confine and also the moral evil pro- ourselves to the materiality of The Gospel: Good News, voked by our behaviour – words. I do not believe that the God loves me, God saves me. wars, oppression, the conse- Fathers of the Church, when

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 45

they speak about the cross, the pression and tiredness. For himself must suffer and die for liturgy or messages of the this reason it is necessary to us, for our supreme good (cf. Church, have in mind that this transform this experience of Lk 9: 44); ‘the Son of Man cross is only pain and Easter fragility into a space that pro- must suffer many things, and Friday – they also believe that vides perspective, horizon and be rejected’ (Lk 9:22). This it is also and above all else a full meaning to life. suffering of his opened the place of love and a pathway This space is the love that il- doors of the kingdom of Heav- towards resurrection. luminates, vivifies and gives en to us. Good News: doors The paschal mystery is cross meaning to human suffering. that open, in this life, with the and resurrection; it is Friday Accepted in this way, with sole key of our personal ac- and Sunday. At many mo- faith and love, suffering is ceptance of the cross, that is to ments of life, however, man transfigured, is transformed, say of pain. Jesus proclaims experiences one more than the and to such an extent that in it this with the example of the other, at times more Fridays we can reach the joy and the grain of wheat that falls to the than Sundays. But they do not action of grace. One can also ground and dies in order to exist without each other. Both praise God with tears in one’s produce fruit’ (cf. Jn 12,24). of them were present in Christ eyes and suffering in one’s – Christ reveals himself and thus when he was put on body or one’s spirit: ‘those with great clarity in this sense the cross it was not the suffer- who sow in tears reap with to his apostles, and to the point ing, the nails, the lashes, the shouts of joy’ (Ps 125). that when Peter demonstrates cross, to speak materially, that ‘We have this treasure in his disagreement after hearing saved us but his love. A God earthen vessels, to show that that the Teacher must die and who loves us infinitely and the transcendent power be- rise again, Christ answers him: who, mysteriously, chooses a longs to God and not to us’ (2 ‘Get behind me, Satan! You 45 pathway that at first sight sur- Cor 4: 7-15). Paul, too, turned are a hindrance to me; for you prises us and which we do not to the Lord to free him and to are not on the side of God, but understand, which seems to us distance him from suffering. of men’ (Mt 16:23). In this to be a mystery. And joined to But the Lord said to him: ‘My statement of Christ we thus this paschal mystery of Christ grace is sufficient for you, for see the need to take into ac- the Christian suffers with, dies my power is made perfect in count the link that exists, in with and rises again with, weakness’ (2 Cor 12: 9). Your the light of the Gospel, be- thereby giving meaning to his strength is in the hands of the tween suffering and happi- own cross and suffering be- Lord: ‘you have struggled on ness, between death and life; cause he suffers, dies and rises earth: I will be your reward’ and whereas it is often the again with Christ. (Antiphony of the Office of case that man can do nothing This ideal is not always easy Readings, common of one or to avoid pain, illness and but on the pathway of suffer- two martyrs). death, Christ declares that we ing we meet people who are In the light of these ‘ex- can live in them an experience very much ready to help and planatory’ phrases about the of peace and profound life be- they know how to integrate ill- meaning of suffering, we will cause of his cross. ness, death and suffering; they be able to better understand show that they possess great the texts of Holy Scripture, the interiority and they are at ease messages of the Church and with themselves and other the examples of witness re- people. ferred to below. The writings and the examples of witness presented as an example and a model during 2. Preaching and Reality this paper are many in number in Christ and significant. However when suffering is experienced The cross talks to us about in a negative way, with con- love and forgiveness. In the stant rebellion or passively, as ‘madness’ of the cross there is something that ‘has’ to hap- the victory of love that Christ pen, then life loses meaning when dying showed to us. and value. In the life of Christ, the Research, hope, love and cross and suffering are reali- the capacity to give meaning ties that are always present. to our sufferings are the strate- His teaching is marked by an gy that is available to us and invitation to live a clear ap- Christ not only proclaimed which make us share in a proach towards pain: ‘If any the redemptive value of suffer- process of transformation and man would come after me, let ing but also experienced it to interior growth. We find this is him deny himself and take up the extremes of his passion, many experiences – how love, his cross daily and follow me’ crucifixion and death, accom- solidarity, trust and openness (Lk 9:23). panied by the moral anxiety of to great values grow! But dur- – Christ not only invites his Gethsemane: ‘My soul is very ing many moments of suffer- disciples to ‘take up their sorrowful, even to death’ (Mk ing there are also anger, de- cross’ but tells them that he 14:34). And true and authentic

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 46

evangelisation is rooted in this by the Acts of the Apostles the disciples like a fire that suffering: ‘walk in love, as and the letters of Paul. A sum- would later thread its way Christ loved us and gave him- mary of the life of Paul can be through the centuries of heroic self up for us, a fragrant offer- outlined in the following way: survival and expansion of the ing and sacrifice to God’ (Eph ‘But we have this treasure in Church in the Greco-Roman 5:2). This is the good news for earthen vessels, to show that world. mankind! the transcendent power be- Naturally, the sacrifice of longs to God and not to us. We Christ cannot be understood are afflicted in every way, but 4. In Martyrs unless is to linked to the love not crushed; perplexed, but of the Father for us: ‘God in not driven to despair; perse- ‘The blood of martyrs is the fact so loved the world that He cuted, but not forsaken; struck seed of Christians’ (Tertullian, gave his only Son, that who- down, but not destroyed; al- Apologeticus, 50: PL 1, 534). ever believes in him should ways carrying in the body the During the first centuries of not perish but have eternal death of Jesus, so that the life Christianity, the tandems life’ (Jn 3:16). ‘He who did of Jesus may also be manifest- ‘pain-glory’ and ‘death-glory’ not spare his own son but have ed in our bodies. For while we were present with an immense him up for us al, will he not al- live we are always being given vital force amongst the believ- so give us all things with up to death for Jesus’ sake, so ers who, subject to persecu- him?’ (Rom 8:32) ‘He still had that the life of Jesus may be tions, lived every day in the one other, a beloved son; final- manifested in our mortal flesh, danger of being tried or mar- ly he sent him to them saying, so death is at work in us, but tyred because of their faith; “They will respect my son”’ life in you’ (2 Cor 4: 7-12). but their faith comforted them 46 (Mk 12:6). The trajectory of total gen- and the Gospel, through their Christ teaches us the perfect erosity in pain, opened by the blood and their pain, gradually way of living pain: blood of Christ, after the apos- penetrated not only the path- With generosity: ‘Greater tles understood this thanks to ways and the culture of the love has no man than this, that a man lay down his life for his friends’ (Jn 15:13). In essential terms the reason for this is as follows: extreme love leads to total self-giving; his divine love leads Christ to crucifixion and death, for all men. With humility: ‘he humbled himself and became obedient unto death’ (Phil 2:8).

3. Pain, Suffering and the Evangelisation of the Apostles

Indeed, under the guidance of the Holy Spirit, the mission outside Jewish territory began with the persecution of the Jews in Jerusalem (acts 8) even though the risen Jesus had told them: ‘you shall receive power when the Holy Spirit has come upon you; and you shall be my witnesses in Pentecost, became a pathway Roman Empire but also the Jerusalem and all Judea and of light for the emerging hearts of men, witnesses to Samaria and to the end of the Church. Thus it is that the great pain experienced with earth’ (Acts 1:8). And at this apostle Paul exclaims: ‘Now I love in the same faith: ‘and if point Luke narrates the con- rejoice in my sufferings for children then heirs, heirs of version of Saul (Paul) and your sake, and in my flesh I God and fellow heirs with from this moment the mission complete what is lacking in Christ, provided we suffer to the pagans began to the full. Christ’s afflictions for the sake with him in order that we may Like Jesus, the apostles, too, of hi body, that is, the church’ also be glorified with him’ used events of healing to pro- (Col 1: 24); ‘always carrying (Rom 8:17). The Christians of claim the Gospel. in the body the death of Jesus, the first centuries conserved The history of the apostles so that the life of Jesus may al- the freshness of the words of and in particular the history of so be manifested in our bod- the Teacher which led them to Paul is intrinsic with pain and ies’ (2 Cor 4:10). embrace every new experi- suffering, as is demonstrated This spirit spread through ence with a new spirit.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 47

5. Sending Out the Original vocation, and they experi- often say to us: we were ex- Call Today enced illness by being in con- pecting you! tact with people who suffered. – And that father, Paco, who Like the first evangelisation, Belonging to the first cate- was desperate about his son the new evangelisation also gory, we encounter St. Ignatius who had spina bifida and did passes by way of suffering giv- of Loyola who, when recover- not believe in anything and en that this experience is coming from a wound, found God said that he had lost his faith… mon to all men and was the and offered Him his life. Be- We encouraged him to move way that God chose redemp- longing to the second category, out of his darkness, his sad- tion for us. Pope John Paul II we find two great paladins of ness, and after a few days we clearly observed that ‘evange- charity: St. John of God and saw more light and more lisation would not be authentic Camillo de Lellis. Both had serenity in that room, and that if it did not follow the foot- negative experiences in hospi- couple at the side of their steps of Christ who was sent to tal because of the way in child. 3 evangelise the poor’. For this which patients were treated. – And what should I say reason the Church trusts in the This experience led them to about Alice, aged twelve, and value of the suffering of every found religious institutes John, aged 8, and Gemma, Christian for the salvation of which would be an expression aged nine and sick with the world: ‘the Gospel of suf- of a more human and charita- leukaemia, and José Manuel, fering… speaks unceasingly ble treatment of sick people. aged six, and Maria, aged with the words of this strange three? paradox: the springs of divine b) My experience as a – Miguel Angel is aged sev- power gush forth precisely in chaplain of a paediatric en and has a malign tumour. the midst of human weakness. hospital His is a desperate case. The 47 Those who share in the suffer- child is ill, he feels that he is ings of Christ preserve in their The most surprising thing, ill, and with the conscience of own sufferings a very special the thing that is of the greatest an adult he says quite fre- particle of the infinite treasure riches in the experience of quently through his weeping: of the world’s Redemption, evangelisation is life, the sur- “Mummy, mummy, kill me, and can share this treasure prise of living every day by let me die”. We speak to the 4 with others’. asking oneself about the life of parents, we try to be very near The new evangelisation those children who, just after to them, to encourage them, must proclaim to us that ‘the being born, are threatened by but we do not have enough poor are always with us’, that suffering and illness. The sur- time for a conversation with- illness is not an evil, and that prise is to see many mothers out interruptions. Everything the cross is a sign of salvation. –many families – at the foot of has been broken. The situation Not only must the new evan- the cross of their children in is so difficult; there is so much gelisation say this but it must pain. worry! also bear witness to us. It must How much tenacity, how – Here is an observation not only speak about suffering much strength, how much made by a father: “In my work but also experience it, take it pain, how many questions, I feel far off and I do not trust upon itself, that is to say suffer. and how much mystery! Our my colleagues. I have always religious service is not an or- thought that there was a lot of ganisation and it is not a cold wickedness amongst people 5 6. Examples of Witness and chronometric presence. It but after so many days of hos- is, rather, a life, a sign, We see pital I have discovered that Pain, illness, and suffering this in many things relatives there are very good people are observation posts, schools, do. Allow me to refer to only who dedicate themselves to universities, opportunities for some by examples way of a those who suffer, I have dis- a new approach to life and at recollection: covered this human value in times also for authentic con- – ‘Many thanks Elvira, you health care workers, in volun- version and for the apostolate. have helped me a great deal’: tary workers, and in religious To demonstrate this statement this was the sentence of a service. I am happy despite the I will now refer to two groups mother to a visitor after the fu- fact that my child is still sick. of examples of witness: one neral of her baby daughter. The hospital has been a sur- made up of saints who – I remember the worry of a prise!” changed their lives in coming young couple because of the – And another father: “We into contact with pain; the oth- illness of their baby boy who parents demoralised and er composed of people of all died at the age of three frightened by the incurable ill- situations in life. months: how much time they ness of our daughter are con- spent in the chapel between soled only by the words of the a) Saints hope and discouragement! priest who celebrated the bap- – And the mother of Jordi: tism and the funeral of our Some saints lived out the how much love and hope did daughter”. experience of illness in their she bestow upon her baby – Allow me to tell you about own bodies; for others – the boy! the witness of a girl aged eight majority – this experience act- – How many families wait who had an accident together ed to redirect their lives, their for us to visit them, and they with her cousin and whom we

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 48

visited with a certain assidu- – Did you pray at that time? toral Care in Health of Spain. ousness. After being dis- – Yes, I prayed. It is a book with very many charged one day she came to – What is prayer? questions, experiences, and visit us in hospital and – An extremely rational and transformed lives. A book full amongst the various things intelligent way of laying down of life in suffering. that she brought with her was the heaviest burdens of life Here is further strong wit- the following letter: “Dear St. and entrusting someone with ness to suffering and love. It John of God, my granny offers the weight of worries and begins as follows: ‘We parents you this bunch of flowers be- doubts. of Alice touched with our cause you healed me and my – Did you think about God? hands a very strong experi- cousin. Heal all the children in – How would it be possible ence of suffering and love; we this hospital. Help Jolanda to live without thinking about met children who got through and Gustavo, Raffa, etc. to get Him? and others who were not able better as you did with me. My to slay the ‘great dragon’. We granny has sent you this bunch On another occasion the dedicate this letter to all those of flowers for you to heal the same newspaper printed the who do not stop at merely other children. I want you to declarations of the tenor José shedding a tear but want to go give a lesson to those cooks Carreras: “As a result of my beyond and we hope that this who produce very bad food illness I learnt to appreciate experience of ours can help which the children in the hos- the religious experience, a cer- other parents who like us have pital do not like at all. I leave tain mysticism, a certain kind lived through or are living you my crutches because I no of reflection and this was one through this painful journey. longer need them because you of the positive experiences Alice, you were the first to 48 healed me. I am leaving them that I have from that situa- accept with courage every dif- for you so that if some other tion… I matured more as a ficulty of this journey of ours; child needs them he can use man because of that episode in indeed, often you reassured us them but I ask you to make my life and I see things in a by telling us: “mummy, if it sure that nobody in the world deeper way”. has to be done, let’s do it!” and has to use them. Because I be- Paul Claudel and Em- with those words you immedi- lieve that people don’t have to manuel Mounier left us the ately gave us a great deal of die and suffer because if these following very beautiful ex- energy in order to go on fight- things did not exist the whole amples of witness in relation ing. 6 world would live happily. I tell to suffering: ‘God did not Only a few times, when dis- you this will all my affection, come to eliminate suffering, or may afflicted you, did you Isabel Maria”. even to offer an explanation say: “I am tired of being a for it. He came to fill it with good girl”, but then you ac- c) A river of witness his presence’, says Paul Clau- cepted every situation with (Fellini, Carreras, Paul del. And he adds: ‘pain is a your usual tenacity. Your opti- Claudel, Mounier and many presence, thus it requires our mism and enthusiasm as re- other stories of suffering presence: a hand holds ours gards life were very valuable people) and keeps us together’. for us and gave us the strength And Mounier, at the time of to go on. Your great passions Here below I refer to signif- the illness of his daughter were your school, your friends icant examples of witness that Françoise, wrote to his daugh- and dancing, what you most concern people of our days, ter: ‘we must not see this ill- wished to do was to go back to famous representatives of the ness as though it were some- living and dreaming with world of the contemporary thing that we give in order not those who loved you so much, arts who had to go through an to lose the merit – the grace – with a pure, simple and uncon- experience of pain. I may refer of this ‘little Christ amongst ditioned love. To them a spe- to the famous film director us’… I do not want us to lose cial thanks. Federico Fellini and the tenor these days by forgetting that When you were most bur- José Carreras. they are days full of unknown dened by your illness we re- I will reproduce here first of grace’. discovered a poem that we all the declarations of Federi- There are many examples said out aloud together be- co Fellini to the Barcelonan and forms of witness that have cause you liked it so much: newspaper La Vanguardia on been experienced and written ‘one day cuddly was playing 29 August 1993 when he had about; they are expressions of hide and seek and nobody been admitted to a nursing life turned into journeying and looked for him and he fell home in Rimini: experience. asleep’. “I have discovered that a From many examples I We now like to believe, as hospital is a wonderful way to would like to emphasise Testi- Jesus said: if the grain of corn think about one’s own projects monios de enfermos which that falls to the ground does and one’s life”. The interview was presented to Pope John not die it remains alone; if in- continued as follows: Paul II at Seville at the time of stead it dies it produces much – Now, for you, what is the International Eucharistic fruit (Jn 12:24). fear? Congress (3-7 June 1993). And you our small daughter, – First of all I will tell you This is a work produced by the with only eleven years of fruit that I was afraid. National Department for Pas- you have already borne a great

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 49

deal because Jesus was always his witness: ‘I, too, believe that ending. I asked myself very in your heart. You were a great God loves me. He loves me al- many questions about two re- example of life for all of us; so in my suffering and my in- alities: illness and work. I felt you made so many people dis- valid state. I lived a strong ex- the support of the technician, I cover the joy of prayer; you perience of God that trans- was in ‘good hands’; I felt the made us understand that true formed my life and made me nearness of many people, and things come from within and live for Him, not only in my to such an extent that my ex- you lit in so many hearts the physical invalid state, where perience bears the title ‘I never flame of solidarity! God came to meet me, but also felt so accompanied’. My ill- For this reason we want to in my dedication to other peo- ness was an opportunity for a thank all the people who were ple and I want to be a reflec- new relationship with God, as near to us in prayer, with sim- tion of the love of God that I a religious and a priest I can 9 ple but great actions of daily myself have experienced’. say that I saw God from closer life, with smiles and words of – Julia, also an invalid, tells to hand through very many comfort that reduced our pain. us about her experience: ‘I small things. Thanks to all those who like worked in a hospital until the us believe that hope needs the age of twenty-two when a tu- contribution of each individ- mour of the spine left me im- ual person so that suffering mobilised on a wheel chair. may create a new light in peo- Until that time I had seen pain ple’s hearts. as a punishment, instead, little Thank you Alice for you by little, during the course of wish to smile, to live and to this illness I believe that I met love. God and since then, since I 49 Mummy and Daddy’ have had faith, pain, for me, has constituted an authentic 10 Witnesses to the Cross and liberation’. 7 Joy. This is the title of a book – Rev Ildebrando Gregori, in Italian. It is a spiritual jour- the founder of the Suore Ri- ney engaged in by a group of paratrici del Santo Volto di cancer patients, men and N.S.G.C., had an immense pri- women who, with their lives ority which he often repeated, full of suffering because of that of ‘drying tears and I 11 their illness, but full of great dried a great deal’. For him, love, transmit to us an authen- to serve Christ in man meant My illness helped me to tic and valuable message. to serve him in extreme suffer- give greater value to health – Illness is also a place of en- ing, the synthesis and com- mine and that of other people; counter for Manuel Lozano pendium of all physical, moral I believe that I gained in sensi- Garrido, for Jaime, for Juana, and spiritual suffering. tivity, that I learnt to trust God for Rev. Ildebrando Gregori more and to contextualise and for many others – innu- d) The experience of my dual many things that appear to be merable histories full of life: illness important but which in fact are – Manuel Lozano Garrido, not. I saw, especially in the ‘Lolo, a journalist and an in- The first arrived in June acutest moments of the illness, valid, when the Church pro- 1995; the second ten years lat- that prayer is not easy, espe- claims him a saint will be a er, in March 2005. cially ritual prayer, the prayer saint of our times, the victim of every day. The prayer of the of an illness contracted during • The first experience: June rosary was difficult for me, I 12 his youth which made him in- 1995 did not feel that it was my firm for the whole of his life. prayer, during that period that As a journalist he ‘saw the Never during my fifty-nine I was going through. footsteps of God in computer years of life had I ever had ex- My prayer when I was in writers’ and he left this life in perience of illness – only bed, to begin with, and then in the scent of holiness. Although small things. But suddenly I the small chapel of the com- he was blind, he did not inter- felt that my body was telling munity afterwards, was for the rupt his work as a journalist me that something was wrong. most part made up of invoca- and a writer, even during the Such, indeed was the case. Af- tions: Lord, my your will be worst moments of his illness ter examinations the diagnosis done, but give the strength to or during his days of greatest was clear: ulcerotomy, and se- follow it. I often invoked the pain. He founded and directed lective vagotomy. Everything Lord with this cry. a review for patients who of- happened in the form of an I remember that one day, af- fered up their illness for jour- emergency: I was admitted to ter the second relapse, I nalists, for newspapers, and hospital. My via crucis began, prayed to the Lord with Psalm for information. One day we not because of the pain in my 136: ‘How shall we sing the will see a journalist, a sick body which I did not feel, but Lord’s song in a foreign land?’ man, a model of the aposto- because of the ‘annoyance’ And I said to myself: that’s 8 late, on the altars’. caused by a whole series of true, it is difficult and I applied – Jaime, an invalid, offers us medical tests that were never it to myself because the for-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 50

eign land at that moment was on Easter Tuesday, 22 March out ever taking any precau- my illness, my doubts; the for- 2005. After the process of ill- tionary steps, nothing had hap- eign land was not being able ness – I had contracted malar- pened to me. This time, how- to lead a normal life; the for- ia – I rediscovered my body, I ever, after the celebration of eign land was so many med- felt it again after a month the World Day of the Sick, ical tests, so many analyses, when I felt that I had lost it. that is to say 11 February, I re- and so many injections. Better, I had found it again. In turned from Cameroon with In the same way I identified these pages I will tell you malaria. The first steps that with the cry of the psalmist: about my experience. were taken were not the right ‘Lord my God, I cried to thee ones. I thought that I had in- for hlp, and thou hast healed Ten years ago fluenza, which was ‘making me’ (Psalm 29). the rounds’ at the time, until, Another strong moment of It was the year 1995. After a in the end, I decided to go to prayer was the feast of St. Pe- journey in India I began to feel the emergency department ter and St. Paul; I felt their joy, unwell; my body was not in a where I began to have test af- courage and apostolic strength good condition; I felt that ter test until they told me that I near to me: ‘I know who I something was happening to had to be admitted to hospital trusted, I fought my battle me – ‘duodenal ulcer’ was the because, from what I had been well, I ran to the end, I kept diagnosis that was made. Af- able to read from the numer- the faith… the grace of God is always with me’ (Antiphony of Praises). ‘My Lord is my strength and my power, he 50 was my salvation’ (Antiphony 2a. Praises, I week). ‘Humble yourselves therefore under the mighty hand of God, that in due time he may exalt you’ (1 Pt 5, 6-7). At the end of everything this is what is left to you, this is the substance of life. During those days the sheet of the Office of the Reading of the 71 Blesseds of the Order fell into my hands – martyrs to hospitality during the Spanish Civil War, and I felt a thrill go through me when I read some of the texts; I saw in those martyrs generosity, love for the sick, faith in God, strength on difficult moments, and I said to myself: come on! And I saw that it was true, that human and Christian ter an emergency operation, I ous papers about me, I had life grow and mature with suf- underwent intensive care. I contracted Malaria da Plas- fering. I would like to con- spent many days in hospital midium Falciparum. clude here by bearing witness and underwent a large number I then began very intensive to another experience under- of tests until the phrase was treatment, first in the resusci- gone during my illness. I felt spoken: ‘you are cured’. Al- tation unit, where I spent a the prayer of other people near though they give you a lot of whole week, and then in the to me as never before; very advice you go back to your department of medicine, many people told me that they normal life as though nothing where I spent a further number were praying for me and I re- had happened. And you go on of days. ally felt this ‘push’, this force, because your body has been and I thought to myself: if ‘taken care of’. And because The itinerary of my illness men are near to you, how can you do not feel anything, you God not be as well? believe that everything is go- For the whole of Lent and ing well until, once again – af- Holy Week I underwent med- • The second experience: ter a period of ten years – ical tests and received nursing March 2005 once again your body does not care. As the Pope said in those function, and something hap- days, I was ‘sick amongst the I published this in edition n. pens to you. sick’, followed, ‘watched 60 of the review Dolentium over’, so that nothing escaped Hominum under the following What is happening to me? attention. title: ‘I Have Recovered my Body that was ‘Lost’ because Even though I had been on a The first stage – resuscita- of Illness’. This was my cry, thousand trips to Africa, with- tion. During the first moments

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 51

of the illness I was almost un- then, almost like a miracle, I also able to appreciate their aware of what was going on, felt strong and I no longer professional responsibility, and this was so much the case needed other people’s help in their welcoming attitude and that I asked myself: am I in order to get out of bed and to their cordiality, their respect such a bad state that they are deal with my body – this was a for the individual, the humani- ‘forbidding’ me to receive vis- liberation. My body told me sation of their care, and their its, telephone calls, and so this and it was confirmed by readiness to help. forth? They told me that I other signs – my complexion, sweated a great deal. I think my voice, and the lower levels My Easter of 2005. I, too, this is true because once I had of tiredness that I felt. My ‘sick amongst the sick’, to em- been discharged I found a very body began once again to be ploy the phrase of the Pope, large number of pyjamas. So my body. The words of my experienced Easter without be- many changes, so many medical doctor, however, were ing a ‘protagonist’, without be- checks, and so many medical ‘don’t run’, and I was told the ing a celebrant or a concele- tests, now this, now that, and same by other friendly voices. brant. For the first time, I ex- then having ‘to obey’ because I had to take things slowly and perienced both Lent, Holy the situation was grave. My to recover my lost strength. Week and the first days of body translated this without Easter, with my illness as my any strength, without wanting Having arrived at this point, starting point, with only a few to do anything. It was no after being discharged, I went presences, the less tiring ones longer my body, it was very on to the third stage, which that is to say, in the celebra- tired, it needed everything, saw me in my community, in tions. I experienced them, and it belonged to other peo- my home, but always rigor- however, with serenity and ple, to the medical doctors, to ously following the indica- peace, asking the Lord to come 51 the nurses… tions of my medical doctor, to my aid, because my heart Although I did not feel and I went on being, so to was beating more than usual physical pain I could not do speak, ‘controlled’. I some- and I lacked strength (Psalms anything on my own; I did not what delayed matters in 21 and 37). I cried out to the have any strength and I was restarting my normal life. But Lord and he cured me (Psalm totally dependent on other the battle against malaria had 29). My Good Friday was people, I was dependent on been won and for this I give transformed into Easter Sun- them even to have food put in thanks to God, to the medical day. I was not able to take part my mouth. I had been so doctors, and to the nurses. in the Easter vigil but I cele- strong and so autonomous and brated the Eucharist with the now I was so dependent. I was The experience of my illness sick on the evening of Easter no longer the same person. Sunday. I wanted to proclaim Then my body reacted, the In the previous section – that Christ was risen, and it results of technology, medica- ‘The Itinerary of my Illness’ – was true; I myself noticed this tion, the tests…they soon pro- I described a part of my expe- in my own body, which had vided positive results, which, rience, the first steps that were improved. The Church, joyful indeed, I felt in my body, and taken, what I felt through my at the triumph of Christ, sang my body, although it needed to body. It felt as though my out full of joy: ‘Brightly shines be supported, began to react, body was another body, a dif- the Sun of Easter, the Earth is to regain its strength. ferent body, a sick body. full of joy…the Lord has risen’. Rise again with the One The second stage. They dis- The encounter between the who rose again, run, turn it in- charged me from the resusci- technical and humanity. When to an experience! He is alive. tation unit and I was the trans- passing through our hospital He has risen again. This ferred to the department of which is located on the island paschal reality coincided with medicine. This was then fol- in the Tiber in Rome, as a sick my rapid cure, with the state- lowed by nursing care in the person I realised the impor- ment, which was repeated orthopaedics section on the tance of technical knowledge many times by my medical fourth floor of the hospital. I and know-how: how much doctors, that the results were was hospitalised in that place technology, how much sci- positive. These were state- perhaps in order to be near the ence, are placed at the service ments of life, of resurrection, home of my community and of sick people – a veritable and I noticed this in my body, to be near my home. bombardment. This was one which, indeed, was increasing- Here they followed me of the realities that I was able ly becoming my own. meticulously and rigorously; to ‘touch with my own hand’. everything was recorded and And if this is a reality which In illness you discover other noted down. With the passing provides you with a feeling of values. In my letter expressing of time, I began to notice a security, I should also say the my gratitude, which was sent very major improvement. same about the people that I to the management of the hos- They began to take the tubes met in the different services pital, I said that my illness had out of my body and to cease and who were for me the best been ‘beneficial’ for me be- the probes…; then I managed medicine there was. At the cause it had helped me to re- to get out of bed, even though same times as their technical flect and had been an opportu- I was still being helped, and expertise and training, I was nity to apply the brakes to my

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 52

agitated and ‘stressed’ life. Once the first ‘torment’ of be ‘vibrant’ and appropriate. And also because it had been a the illness had finished and I And then St. Augustine once moment of friendship and a had recovered my strength, I again: ‘why are you troubled. moment to realise that around began, in a very gradual way, He who made you is looking us there are many good peo- to engage in light reading: re- after you’. ple. New people are discov- views offering information; Later, in the complete works ered in a hospital, in one’s the last two documents of the of St. Teresa d’Avila, I greedi- own community, in one’s Pope addressed to priests and ly sought that ‘Nulla ti turbi, working life. During my ill- to those responsible for social that is to say poem n. 30 in ness I was accompanied by the communications; the reflec- which the saint invites us to Superiors of the Hospital Or- tions of Msgr. Ravesi on Holy raise our thoughts and to as- der to which I belong. The Week, with texts by Bernanos, pire to heaven. three communities of the is- Claudel, Unamuno, and Turol- I was passing a good, posi- land on the Tiber, the service do...; and the letter of the Pope tive, reflective time of prayer, of pastoral care, the Superiors to Paolo Mosca; ‘Memory and and I slowly went over, on a and my companions at the Identity’. This was because ‘I number of occasions, the fol- Pontifical Council for Health had nothing to do’ and the only lowing poem of the great Pastoral Care in the Vatican, thing I had to do was to look Teresa: were all very near to me; after my health. This was a many religious communities ‘privileged’ opportunity to Nothing troubles you, and members of the lay faith- read and also to listen to good Nothing frightens you, ful who prayed for me were music. I went through the great Everything passes, also very near to me. I felt masters of music once again: God does not change, 52 near to me a river of prayers, a Mozart, Beethoven, Bach, Vi- Patience great deal of solidarity, a large valdi. Choirs and organs. Obtains everything; number of friends – all of Russian folk songs, music for He who has God them were medicine for my meditation and relaxation. Lacks nothing: body and for my spirit. They Gregorian chants, classical God alone is enough. helped me to overcome my ill- pieces for Holy Week and ness with peace and serenity. Easter (‘Mandatum novum’; For me, during those mo- Pain and illness give rise to ‘Ubi caritas’; ‘Exultet’; the ments, this poem was spiritual prayers; they are a time for the ‘Messiah’, the Halleluiah of medicine. raising of supplications to the Händel...). How much this mu- Although it is true that I Lord. As I have already said, I sic helped to ‘distract me’, to trusted a great deal to medi- felt that many people were give me serenity, to raise my cine and to people of knowl- praying for my recovery. I spirit, and to heal me! How edge, and that I ‘held onto’ prayed as well, as, indeed, one much good music heals! It is them, so to speak, in order to prays when one’s body is ‘bro- good medicine. escape the illness as soon as ken’. Every day, during prayer, possible, it is equally true that an infinity of faces and of in- ‘The Lord is my strength I experienced the presence of stitutions passed through my and my power, he has been my God within my own person mind. I did this again in a spe- salvation!’ During the most through a very large number cial way the first day that I be- critical and difficult period of of ‘mediations’, the very many gan to reintegrate myself into illness, a great powerlessness people that I came into contact my work, on 4 April, by offer- is experienced not only in with during those days of my ing the Eucharist as an action one’s body but in the whole of life who encouraged me and of grace for my recovery and one’s person. One does not gave me their advice. Such for all those people who had want to do anything, not even ‘mediations’, such short texts contributed to that recovery: to pray ‘officially’. A book from Holy Scripture and from the medical doctors, the nurs- falls from one’s hands. Neither other authors, were medicine es, the community, my family one’s spirit nor one’s mind re- for me, because they gave me and the friends who had all acts to the large number of strength, hope, and the desire been near to me with knowl- psalms, readings and prayers. to walk. edge, solidarity and friendship. And a weak and simple prayer I cannot but quote here a I prayed for all of them. is raised up, helped by brief thought of Teilhard de Chardin thoughts from Holy Scripture which I ‘chewed the cud’ over Therapy through reading and at times also by sentences many times. That thought and music. I love reading. By from the saints. says: the end of the year I had read I remember that in my hos- about fifty books, both long pital room, when I had begun Do not be troubled at the and short in length. Reading is to read a little once again, until, difficulties of life, as necessary as food. St. that is, my eyes clouded over, I At its ups and downs, its Bernard said that ‘a good book went to get a book containing disappointments, teaches you what you have to the Confessions of St. Augus- At its varyingly dark future. do, it instructs you on what tine. That ‘late I loved you’ or WISH FOR WHAT GOD you must avoid and shows you ‘you made us for you and our WANTS. the goal to which you should heart will not be at peace until Live happy. I beseech you. aspire’. it rests in you’ seemed to me to Live in peace.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 53

Let nothing disturb you. his relationship to suffering most on the eve of the con- Let there be born, and and to the sick. Our Pontifical clave, he has been in this hos- always conserve on your face, Council brought together this pital and he is in a really seri- 13 A sweet smile, a reflection witness in a fine book, ous condition, I wanted to pay of the smile the Lord which has subjects and titles him a visit, and a visit not only continuously addresses to that are full of realism: to him but also to all the other you.. – John Paul II, a Pope who patients’. When you feel afflicted and came from suffering, the her- The Holy Father then went sad, ald of the Gospel of suffering, on by recalling what he had WORSHIP AND TRUST. a Pope who explained suffer- said that morning to the Cardi- ing, who was at the service of nal Fathers, of his wish to ‘rest I could go on for page after those who suffer, a Pope who my papal ministry above all page giving an account of my loved the sick, and a Pope on all those who suffer and experience. I believe, howev- who suffered. unite their prayer to suffering, er, that I have addressed what – A Pope who sent an apos- passion, and pain’. ‘Dearest most surprised me and what, tolic letter – Salvificis Doloris brothers and sisters’, the Pope with most intensity, I experi- – to the Church on the Christ- also said, ‘I would like to en- enced. A shared experience ian meaning of human suffer- trust myself to your prayers’. and shared memories. Many ing (11 February 1984); a John Paul reminded the pa- human things, but also many Pope who also established the tients that even though they things of God: God writes, as Pontifical Council for Health were, as regards their physical Pope Lucani said, ‘not in Pastoral Care (Motu Proprio condition, weak and sick, they bronze or marble but in the Dolentium Hominum, 11 Feb- were also ‘very powerful, in dust of the earth, so that it is ruary 1985) and created the the same way as the crucified 53 clear that everything is the World Day of the Sick. Jesus Christ was powerful’. work of and, everything is to ‘Thus your power lies in your be attributed to, the Lord He is also symbolism, even similarity to Christ himself. alone’. more an example, of witness Try to employ this power for to life. His pontificate was the good of the Church, of born, developed and was con- your neighbours, of your fami- cluded ‘attached’ to pain. This lies, of your countries and the fine book on his pontificate whole of humanity. And also begins with a page that is all for the good of the ministry of life. The day after his election, the pope who is, according to John Paul II visited a friend of other meanings, also very his who was seriously ill. The weak’. daily newspaper L’Osserva- In finishing his speech the tore Romano (19 October Holy Father also said: ‘in 1978) printed news of this vis- thanking God for this signifi- it under the following head- cant occasion and for this line: ‘John Paul II amongst the meeting which is so valuable sick at the Policlinico Agosti- for me, and I think for every- no Gemelli’. Together with one, I also want to thank all this headline there were also those who serve the sick in the the words of the Holy Father, hospital of the Catholic Hospi- printed by this daily newspa- tal of the Sacred Heart – the per of the Holy See: ‘I also professors, the medical doc- want to thank all those who tors, the sisters, the male and e) An exceptional witness: guided me here and also saved female personnel and every- John Paul II me because as a result of the one else. Behold, Christ is great enthusiasm which has amongst you, in the hearts of I would like now to focus in been expressed the Pope could the sick and in the hearts of on an exceptional witness in also have had to stay in this the ‘Samaritans’ who serve the the field of in over recent hospital to be treated’. ‘But sick. Praise be to Jesus Christ’. years – Pope John Paul II, a above all’, he continued after ‘The weakest, the poorest, Pope who ‘travelled’ the the short interruption almost the sick, and the afflicted – it world of suffering, who expe- imposed on him by the ap- is to these people, in particular, rienced suffering in his own plause of those who were pre- at the first moment of our pas- flesh during the days when he sent, ‘I think that all this is a toral ministry, that we wish to was in the Policlinico Gemelli fact due to Divine Providence. open our heart. Is it not in fact for a variety of reasons. I came to visit a friend of you, brothers and sisters, who This Pope will go down in mine, my colleague as a bish- with your suffering share in the history for his very large num- op – Msgr. Andrea Deskur, the passion of the Redeemer him- ber of trips, for his opening to President of the Pontifical self and after a certain fashion the East, and for his tenacity in Commission for Social Com- complete it? This unworthy striving for unity and peace; I munications. To him I owe so successor of Peter, who aims to also dare to say that he will be many good things, so much peer into the unfathomable remembered in particular for friendship. For many days, al- riches of Christ, has the great-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 54

est need of your help, of your Cardinal Fiorenzo Angelini ‘salvific meaning of your sor- prayer, of your sacrifice, and well outlined the importance row and valid answers to all of asks you most humbly for of suffering as a generator of your questions’ (Apostolic these.’ Such was the program- life when it is shared: ‘it is Letter Salvificis Doloris, n. matic address of John Paul II pain that can generate life, and 31). Your mission is of very yesterday morning given in the this comes from sharing in the great value both for the Sistine Chapel to the men of suffering of others, from the Church and for society. ‘You the whole world’. ability to place the great lesson who carry the burden of suffer- This is a great programme learnt from our personal suf- ing are amongst the first that based upon the poor, upon the fering at the service of God loves. Like all those that 14 sick, upon weakness, but with others’. Belief in the value of he encountered along the ways the ‘power possessed by suf- suffering joined to love effects of Palestine, Jesus has looked fering’. This would be a con- an encounter of extraordinary at you with a glance full of ten- 15 stant pathway in the pastoral spiritual fertility. derness; his love will never go work of John Paul II. The The Gospel is a school of away’ (address to the sick and book on his life ends with the love, just as God Himself is the suffering given in Tours on same witness to the power love, and it is also a school of 21 September 1996, in present in suffering. As a con- strength in suffering. Man suf- L’Osservatore Romano, 23/4, valescent in the Policlinico fers, the Church suffers; every September 1996, p. 4). ‘May Gemelli, he gave the world the person has to face up to his you know how to be generous following witness: ‘in these own cross and every Christian witnesses to this love through days of illness I have had an is invited by Christ to go along the giving of your suffering, opportunity to understand bet- 54 ter the value of service that the Lord has called me to render to the Church as a priest, as a bishop, as the successor of Pe- ter: it also passes by way of the gift of suffering, by which it is possible to complete in one’s own flesh the debt which the afflictions of Christ still leave to be paid, for the sake of his body, the Church (Col 1:24)’ (13 October 1996). John Paul II was a Pope who spoke on many occasions about suffering, who visited a large number of sick people, but his strength and witness lay in having suffered a great deal. He was a Pope who has great experience of suffering. ‘The pain of the Pope, a symbol of our time’, wrote Rocco Buttiglione in a fine article (Il Tempo, 19 September 1996).

f) Suffering and love: a two-lane path: the lane of which can do so much for the 18 a fertile encounter taking on and sharing with him salvation of mankind’. his pain, and that of generosity Yes, it is really the case that The statement of Paul VI to in helping other people to carry the examples of witness in re- 16 be found in his apostolic ex- their cross. It is for this reason lation to suffering are innu- hortation Evangelii Nuntiandi that the world of health and ill- merable; one need only go to is a great reality: ‘contempo- ness is a privileged terrain of hospitals or enter many homes rary man listens more willing- witness for the new evangeli- where a large number of family to witnesses than to teach- sation, and this is because, and lies have for years looked after ers, or if he listens to teachers I will repeat the point employ- a sick loved one in order to re- he does so because they are ing the same words as those of alise the strength of suffering witnesses’ (n. 41). Pope John Paul II, it has no in changing and transforming This was true of the early other purpose than ‘to release people, in providing witness Christians because of their love, in order to give birth to and saying to other people that alive and working faith, and it works of love towards neigh- the Lord is good and the is true, it must be true, of to- bour, in order to transform the strength of a human being day’s Church, above all whole of human civilisation in- does not always coincide with 17 through suffering, as a privi- to a ‘civilisation of love’. good health but that in weak- leged field to create witness, ‘Dearest sick people, in love ness, in illness, a human being to evangelise. may you know how to find the can express great strength.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 55

Practical life abounds with many countries are frequented realism, and to see the truth of such examples which are at by more people than our our society in a better way. times hidden and the literature parishes and where the pres- …There are many of us, we that narrates these lives in ence of Christ who wants rec- are worth a great deal, but written form is no less copi- onciliation is present’. He fin- what we are and what we are 19 ous. ished his talk in the following worth is based upon some- Some phrases taken for the way: ‘let us not forget that one thing that does not depend on witness of sick people reveals day all of us will belong to the us, which precedes us and es- to us this dynamic of suffering people of the sick and the dy- capes us. Health, life, every- not only for those who experi- ing, even us; it will be an in- thing that we are is a gift.…Ill- ence it but also as an evange- escapable way of encounter- ness makes us appreciate what lising force: ing Christ who reconciles us we receive from others as ‘Never, pain, will you be and invites us to his Easter’. well. Somebody must be at able to shut me up…I can love your side to help you to live… on the rack of torture’ (Martin • The second voice: the life During days of illness you Descalzo). and death of Anania (+2003) pray more, you feel nearer to She died at the age of two, the presence of God who con- troubled by pain. ‘They never His body died but his life soles us and makes us strong, saw her tire of suffering’ did not. He knew about tears and the words of St. Paul be- (Maria Teresa). and suffering but he always come clearer: ‘my grace is ‘I thank God for having giv- bore them with tenacity and enough for you’. ‘The strength en me the strength to see my courage. He was a light that il- of God is manifested in our reality’ (Maria Dolores). luminated without offending, weakness’. The acceptance of ‘I knew you, because people that warmed without burning. one’s own weakness helps one 55 talked about you, but now my He died in the style of a cham- to appreciate more the possi- eyes see you’ (Gb 42:2-6) pion. He was given only a bilities of others, and above all ‘In my illness I felt closer to temporal farewell. A cross of else the great strength of the the fatherhood of God and Je- stone, and there was the si- love of God which is never ab- sus as a friend and compan- lence of wise words, and life sent. Illness is a time of deep ion’ (Martin Descalzo). sublimated by death, and love insight. One understands bet- ‘I am happy even though stronger than death, and God ter the mystery of pain, the my son is still ill. The hospital to embrace after ninety-three strength of love, necessary has been a surprise’ (a father). years, and to love for always. solidarity, the definitive wis- Thus lived and thus passed dom of the cross of Christ, in- away our brother Anania, fa- nocent love realised in the A Final Reflection ther of our friend, Rude. His love of the path of freedom death was full of life. His wit- and salvation. My experience To conclude this paper I will ness fills us with joy and hope. was strengthened by the ill- give space to four friendly ness and death of two friends voices. Each one of them went • The third voice: a bishop and brothers of mine, both of through personal experiences relates his experience (D. Fer- whom were very close to me: of suffering or of nearness to nando Sebastián, the Bishop Bishop Congret and Bishop those who suffer. Their voices of Pamplona. Cf. La verdad Osés. They went to the depths and their ways of living were del Evangelio, Ed. Sígueme, of their experience and passed also a place of encounter and pp. 793-4). through the narrow door of of evangelisation. death to reach the glorious en- ‘Your bishop was ill; it was counter with the God of love • The first voice: Rev. Pier- nothing serious but long and and life. We learnt from them luigi Marchesi (+2002) complicated… The first lesson to die and to live near to this illness gives you is to realise God who awaits us with pa- He was a great defender of that our lives are provisional tience and mercy’. the sick, a man of the frontier and fragile. Illness is always and a man with a great something unforeseen. It does • The fourth voice: Jesús prophetic vision. Twenty years not belong to our agenda. Burgaleta offers the following ago, at the Synod on Reconcil- When we are well we take it reflection: iation of 1983, in front of the for granted that we will al- Holy Father and the Synod Fa- ways be healthy and strong. In Christ suffering is ‘joined thers, he expressed himself in But that day comes when our to love’ (SD, 18). the following terms: ‘it is al- bodies do not respond and we And because suffering is a ways edifying to bring sick realise that our apparent fact it is possible to live it out people to sanctuaries, at least strength is based upon a hill, a humanly and positively. those that are capable of going pyramid of wonders, which The evangelisation of the even though it is not always we do not control and we sick person must help him to they who have greatest need know very little about. This live his experience of pain in a of doing so. Today, it is neces- fragility as well is a part of the constructive way. sary, above all else, for the truth of our lives and for this How? By becoming aware Church to engage in a pilgrim- reason illness helps us to of our limitations and finitude; age to hospitals which in know ourselves with greater by preparing oneself for the

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 56

encounter with God as a silent ELIZONDO V. ET AL, La via della – n. 195: Un año de la carta Salvificis croce. La Passione di Cristo nelle doloris. companion; by preparing to Americhe (Queriniana, 1992). – n. 235: Enero-Febrero-Marzo 1995. take on death, that is to say to FRANKL V.E., Homo patiens. Inter- N. Monografico. El sufrimiento y la en- finish one’s life as an act of pretazione umanistica della sofferenza fermedad. (preface and translation by E. FIZZOTTI, Review “MISSIONE E SALUTE” n. self-giving, of total trust, of Varese, 1972). 5/96 – La sofferenza è parte della vita. fusion with others God. GONZALEZ FAUS J.L., Vicarios de Review “DOLENTIUM HOMI- Cristo (Ed. Rotta. Madrid, 1991). NUM”. various reflections on the mean- Only love experienced in GRANDI V., Al servicio de los enfer- ing of suffering in n. 27/1994. illness can give illness mean- mos con amor (Ed. Selare, Bogotà, ROJAS E., Una teoria della felicità ing and only love, SELF-giv- 1997). (Ed. Paoline, Rome, 1988). HARING B., La Fe, fuente de salud. SALVADORI M., Fede e malattia (Ed. ing, can give death a meaning, Canto a los profesiones sanitarias (Ed. Carroccio. PD, 1986). which can be transformed into Paulinas, 1990). TETTAMANZI D., L’annuncio del Van- a ‘vital act par excellence’: ‘he ILARI A., Il dolore non è mai vano, gelo al mondo della sofferenza. Anime e mai inutile. La croce della sofferenza è Corpi 61 (1975), 523-538. loved me and gave himself for fonte di grazia e di salvezza. Anime e VICO PEINADO, Profetas en el dolor me’ (Gal 2:20). Love is also corpi, 90 (1980), 307-313. (Ed. Paulinas, Madrid, 1981). the richest source there is on JAN RYN Z., El dolor tiene mil rostros VIRGULIN S., La croce come potenza – Juan Pablo II y los enfermos (Ed. Uni- di Dio in I Cor, 18-24 in La sapienza the meaning of suffering, versitaria, Santiago de Chile, 1993). della croce oggi. Atti del Congresso In- which is always a mystery. ternazionale: Roma, 13-18 ottobre 1975 This answer was given by God (I, Leumann, Turin, 1976), pp. 144-150. to man in the cross of Jesus Christ (SD, 13). Notes H.E. Msgr. JOSÉ L. REDRADO, 1 GIANFRANCO RAVASI ‘Fino a quan- O.H. do, Signore? Un itinerario nel mistero Secretary of the Pontifical Council 56 del2la sofferenza e del dolore’, p. 21 for Health Pastoral Care, MATEO BAUTISTA, Para mi amigo The Holy See. infermo (San Pablo, Buenos Aires,

19934), pp. 7-9. JOHN PAUL II, Omelia durante la celebrazione della Parola, Viedma (Ar- gentina), 7.4.1987. Bibliography 4 5 Salvificis doloris, n. 27 REDRADO JOSÉ L., Evangelizzazione JOHN PAUL II, Apostolic Letter Salvi- e mondo sanitario: una sfida ai religiosi ficis doloris, 11.2.1984. della sanità in Curate infirmos e la vita JOHN PAUL II, Motu Proprio Dolen- consacrata (Pontificio Consiglio della tium Hominum, 11.2.1985. Pastorale per la Salute, Vatican City, NGELINI A F., L’uomo delle beatitudi- 19964). ni (Tipographia Vaticana, Vatican City, Cf,. Labor Hospitalaria, n. 1986). 235/1995, ‘Cartas sobre el dolor’, pp. NGELINI A F., Quel soffio sulla creta 52-756. (Tipographia Vaticana, Vatican City, LUKAS E., Dare un senso alla sof- RICCARDA LAZZARI, Testimoni della 1986). ferenza (Cittadella editrice, Assisi, croce e della gioia (Ed. Camilliane, NGELINI A F., El Evangelio del sufrim- 1983). Tur8in, 1997). iento y la primiera evangelización en MAGRASSI M., Gesù e il malato (Ed. Cfr. ‘Un ejemplo concreto’, Eccle-

Chile. Address given at the Ponifical La Scala, Noci, 1996). sia,9 Madrid, 7 September 1996. University of Chile, 25 September 1992. MARTINI C.M., Farsi prossimo (Piani José L. REDRADO, Curate infirmos, NGELINI A F., L’amore per i sofferenti, pastorali, Milan, 1985-86). p. 11021. ARTINI chiave dell’evangelizzazione. L’Osser- M C.M., Parlo al tuo cuore. 11 O.c., p. 119. vatore Romano, 9 October 1992, p. 5. (Centro Ambrosiano. Milan, 1996). FIORENZO ANGELINI, L’eremo e la NGELINI ATTAI A F., All’occasione del cente- M G., Teologia della croce e foll1a2 , p. 111.

nario del primo annuncio del Vangelo pastorale della sofferenza. Anime e 13 Dolentium Hominum, n. 35 nel Nuovo Mondo, Vatican City, 23 Sep- Corpi, 63 (1976), 81-91. Pontificio Consiglio per la Pas- tember 1993. MONGILLO D., La croce di Gesù torale della Salute, Giovanni Paolo II e ANGELINI F., Ero infermo … (Ed. Cristo, fondazione di vita morale in La la sofferenza (Ed. Velar. Bergamo,

Velar, Bergamo, 1996). Sapienza della croce oggi. Atti del Con- 199145). AA.VV., Il significato della sofferen- gresso Internazionale: Roma, 13-18 ot- FIORENZO ANGELINI, Quel soffio

za umana (Atti del I Congresso Stauròs, tobre 1975(I, Leumann, Turin, 1976), sull1a5 creta, p. 148.

Ed. Stauròs. Pescara, 1983). pp. 276-283. 16 Ibid., p. 160. AA.VV., Vivir sanamente el sufrim- MOLANN, El Dios crucificado (Ed. Christ at the same time taught man iento. Reflexiones a la luz de esperien- Sígueme, Salamanca, 1975). to do good with suffering and to do good cias de enfermos (Conferencia Episco- MOTICELLI I., La sofferenza nella rif- to those who suffer. He unveiled to the pal Española, Madrid, 1994). lessione teologica italiana dopo il Vati- full the meaning of suffering with these

AA.VV., La spiritualità nel tempo cano II (Ed. Salcom, 1984). two17 observations: SD, 30. AVONE della malattia (Quaderni di Camil- N , Teologia del fallimento (Ed. 18 Ibid, 30. lianum, n. 1. Rome, 1990). Pont. Univer. Gregoriana, Rome, 1988). JOHN PAUL II, Message for the AUTISTA AVASI B M., Para mi amigo infermo R G., Fino a quando Signore? Wo1r9 ld Day of the Sick, 1997, n. 4. (Ed. San Pablo, Buenos Aires, 1994). La sofferenza secondo la Bibbia (Ed. Cf. JOSÉ VICO PEINADO, Profetas en CANONICI C., Dolore che salva. La Fatebenefratelli. Spiritualità n. 40. Cer- el dolor (Ed. Paulines, Madrid, 1981). sofferenza umana e le missioni (Ed. nusco sul Naviglio (MI), 1995). José L. REDRADO, ‘Evangelización y Porziuncola, Assisi, 1992). REDRADO J.L., Presencia cristiana mundo sanitario: un reto a los religiosos CINÀ G., Sofferenza e salvezza (Sus- en las clínicas y hospitales (Ed. PPC, de la sanidad’, in Curate infirmos (Pon- sidi. Camillianum, Rome, 1995). Madrid, 1969). tificio Consiglio per la Pastorale della CONFERENCIA EPISCOPAL ESPAÑOLA, REDRADO J.L., Dolore e morte in Salute), pp. 113-115. AA.VV.: Vivir Los 10 días del enfermo en la Iglesia es- conflitto con noi: alla ricerca di un sen- sanamente el sufrimiento – Reflexiones pañola (Conf. Ep. Esp. Past. Salud, so. Congresso Internazionale di Psicolo- a la luz de experiencias de enfermos, Madrid, 1994). gia e Scienze Umane “La Bussola”, Spanish Bishops’ Conferenc. Depart- CONGAR Y., RAHNER K., Sulla malat- Veroli (Fr), 16-18 maggio 1996. ment of Pastoral Care in Health, , Col. tia (Brescia, 1976, Meditaciones, 28). Review “CONCILIUM” n. 119 – Iglesia y Mundo de la salud, n. 3. RIC- DE LA CALLE, Respuesta bíblica al Sufrimiento y fe cristiana. CARDA LAZZARI: Testimoni della croce e dolor de los hombres (Ed. Fax. Madrid, Review “LABOR HOSPITALAR- della gioia (Ed. Camilliane, Turin, 1974). IA”: 1997). ENRICO AITINI and SANDRO EVELY L., El sufrimiento (Ed. Estela, – n. 190: Presenzia de los enfermos BARNI “Caro maledetto dottore” (una Barcelona, 1966). en el Sínodo de obispos, 1983. lettera sul cancro)

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 57

Health Care and Utopia. Is the Humanisation of Health Care a Utopia?

1. The Treatment of Man need heartfelt concern’ (Bene- increase in discrimination in in- and Lack of Humanity dict XVI, Deus caritas est, n. ter-professional relationships, 31, Rome, 2005) and perhaps because of this, the The French philosopher Em- This illuminating statement dehumanisation of the service manuel Hirsch, the current di- on the ineluctable alliance be- is also intensifying. Indeed, to- rector of the ‘ethical space’ of tween science and humanisa- day the only question bran- the public hospitals of Paris, tion allows us to assess the con- dished in the debate on health has declared that ‘our duty to texts of dehumanisation that care is that of economic-finan- hospitals is the duty owed to a are still present in health-care cial sustainability. utopia’. Health-care systems services. The Italian Bishops’ This question, which is of that still have hospitals as their Conference has no hesitation in great importance for the sur- strong point must take into con- acknowledging the existence of vival of health-care and social sideration the questions of the a system which by now has be- systems, has generated a cas- humanisation of pain, depen- come unacceptable, not only cade of claims that are increas- dency, the increase in the num- for believers but also for those ingly short sighted and lacking ber of patients with dementia, people who live in society and in humanity. Indeed, the cen- and the invasion of the most so- expect a fair system and one trality of the sick person and 57 phisticated technologies. If we that respects human dignity his needs, which deserve a dif- do not allow encounter be- We will now see in how ferent approach, have been tween the humanity of medical many ways dehumanisation is made of secondary importance. doctors, nurses, technicians and described on a ladder that goes ‘The Church believes that patients, hospitals will be trans- from ‘lack of humanity’ to the humanisation of the health- formed into anonymous busi- ‘degradation of humanity’. care world is an urgent task and nesses that run the risk of be- These words are like stones thus includes it within the field traying their humanistic voca- and they should make us re- her pastoral action, convinced, tion. flect: ‘The analysis of the lack as she is, of the evangelising Without having recourse to of humanity in the service pro- value of every initiative de- the various appeals, which are vided to sick people is far from signed to give a more human often alarming, of the various being over. A profound need is face to assistance and care for public or private observers of perceived to personalise the ap- sick people’ (n. 26). the social/health care system, proach, to move from treating One notices here the strong one must become aware of the to taking care of, to seeing the appeal of an ethical character to situation in which hospitals person in the totality of his be- recognise and promote, find themselves. This is done ing’ (Pastoral Note of the Ital- through gestures of care and as- with a lucid and accurate analy- ian Bishops’ Conference, n. sistance, the inherent dignity of sis by the official Pastoral Note 14). sick people who, even with the of the Italian Bishops’ Confer- The context of reference is decline of their bodies, main- ence, Predicate il Vangelo e cu- the current crisis in assistance tain their value as children of rate i malati (Rome, 2006; to people in conditions of men- God. All the gestures that are ‘Preach the Gospel and Heal tal fragility, responsibility for engaged in with this motivation the Sick’), which in this part of whom must not be reduced to have an interior charge that ris- this paper is the text of refer- the mere administration of es above them and allows the ence because of its faithfulness pharmaceuticals. Real care posing of questions about to reality and its evident objec- must be entrusted to listening meaning and the opening up of tivity and neutrality. I would and to the acceptance of the spaces of comprehension that like to begin with the vast hori- whole person by health-care facilitate access to the Gospel zon of statements contained in workers who are motivated, of life. the encyclical Deus Caritas est solidarity-inspired and well-di- ‘In reading the disquieting on the due characteristics of rected by a specific training. ‘It phenomenon of the decline of health-care workers as taken up is within the perspective of humanity that is present in ser- by the Italian Bishops’ Confer- hospitality that the initiatives vices for the sick – such as the ence: ‘Individuals who care for directed towards making ser- prevailing of political and eco- those in need must first be pro- vice to the sick more human nomic interests, excessive bu- fessionally competent…Yet, acquire meaning. In a context reaucratisation, administrative while professional competence in which there are tensions, inefficiency, the deterioration is a primary, fundamental re- conflict, difficulties in dialogue of the scale of values, the quirement, it is not of itself suf- and communication between scarce respect for the patient as ficient. We are dealing with hu- people who are new to caring a person – the Church invites man beings, and human beings for sick people’ (n. 25). people to see the root of dehu- always need something more In this case, the context of manisation as sin’ (n. 27). than technically proper care. reference is present-day hospi- This decisive invitation of They need humanity. They tals in which, together with an the Italian Bishops’ Confer-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 58

ence, an echo of the stronger would appear to be difficult, Medical doctors, who are in- reference to structures of sin to with the de facto disjunction creasingly fascinated by these be found in the encyclical that occurs between the needs techniques because of their Evangelium vitae, directed to- of man and the needs of tech- success and the impression wards all people in important nology, to achieve the defence they give of omnipotence, do positions, is an invitation to and the safeguarding of the dig- not put man but the action at reconcile the apparent oppo- nity of man because of the fas- the centre of things. The tri- sites of ethics and efficiency. cination wielded by the perfor- umph of technology thus pro- The appeal to the conversion of mances of the technical. A pa- duces a certain fall in the hu- hearts so as to think in a ‘differ- tient is afraid of the very large manistic meaning of medicine ent’ way about social and number of machines for diag- which overvalues itself to the health-care reforms imposes an nosis and treatment which point of taking the place of na- adherence to values and an in- seem to reduce him to an artifi- ture: the artificial tends to sub- tention to adhere to project cial instrument to be analysed, stitute the nature by construct- where the rule of life is charity diagnosed and treated according a world that can be totally so that a possible civilisation of ing to the laws of physics and manipulated. love can be achieved. chemistry alone. But technologised medical It is forgotten, as unfortu- science that places such a trust nately is borne out by certain in its own power over nature to 2. The Challenges economic theories of certain the point of promising the heal- of Modernity 1 health-care models, that man is ing of ill-health for everyone to Humanisation not a machine that can function and almost victory over death with varying degrees of effi- comes to call for more power- 58 It is well known that the culture of modernity is based upon the discovery of the individual – the subject of philosophers – and on the pre-eminence of the scientific method created with the establishment of the technical-scientific company. In this way there has arisen a materialist civilisation/culture that identifies development with scientific and technical development and neglects the ‘growth’ of humanity because it is not a commodity that can be bought and sold. Health-care culture has run the risk of being dehumanised because it mystifies or makes technical the vital problems of man by limiting the relationship between medical doctors and sick people to an encounter of roles – healers and patients. ciency, he is not the chance ful ‘miracles’ in the name of Hence the technological inva- product of evolution: he is a the right to enjoy everything sion which even seems to re- gift of God who should be re- that can be done at a technical place human decisions with au- spected and defended in his level. The question of the tomatic, robotic ones. spiritual and corporeal dignity. meaning and vocation of man Indeed, nobody can deny to- Biomedical technology is not becomes completely expelled day that the technical-scientific initially neutral – that is to say to the point of the upholding of company has imposed a trans- good or bad – but must be seen recourse to euthanasia when formation both in health-care as an instrument and potential the remedies that can be techni- organisation and in the perfor- action that in itself can also be cally effected no longer exist. mance of medical services in- directed towards good. Certain Together with the ‘fall’ of the side and outside hospitals. modern techniques, for exam- noble meaning of medicine, However, this development ple in vitro fertilisation, the there is thus produced also a has led to a dominance of tech- cloning of embryos, the pro- ‘fall’ in the ethical value of the nology which is in a certain duction of embryos to be used medical profession which be- tension with the humanistic ap- solely for the production of comes reducible simply to the proach of classic medicine. stem cells and anti-procreative use by this professional catego- This dialectic opposition be- techniques themselves, envis- ry of the technical of the tech- tween the exaltation of technol- age from the outset actions niques that are available: with- ogy and medical ethics appears which are in themselves unac- out seeing the real welfare of today to constitute the real and ceptable from a bioethical point the patient and the relativity or authentic challenge to the hu- of view and from the point of partiality of the technical means manisation of technology. It view of Catholic morality. themselves that are employed.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 59

The greatest damage is clared: ‘the field of health care In the view of P.L. Marchesi, specifically that of the transfor- and health… offers innumer- humanisation must become the mation of man the person into a able confirmations of the con- ideal of politics and rise above pure object of technocratic crete possibility of a fertile in- financial calculation and mere power or perhaps into an un- teraction of reason and faith to management of budgets in or- aware instrument for a transfor- construct, in freedom and full der to propose itself anew with- mation directed towards the respect for the human person in political ethics in a world manipulation of the human the civilisation of life which, in such as ours which has perhaps identity itself. order to be truly such, must also lost from sight the fundamental In my view we here en- be a civilisation of love’ (Do- objective of the promotion of counter the greatest challenge lentium Hominum, ibid. p. 8). the human. In doing this he us- of modernity for medicine es the hammer of words in or- which involves, on the one der to place ethical reasoning in hand, seeing man solely as a 3. The Strong Points of each one of his papers or material composite, and, on the a Prophetic Message that speeches. other, the production of the de- Should be Implemented We may quote some pas- humanisation of relationships. sages from the anthology The temptation and the risk An opportunity to go deeper which contains these texts in that men will regress towards a into our subject is offered to us chronological order as points of condition of inhumanity is pre- by the recent publication of a reference for the implementa-

sent in human history and daily volume entitled Umanità. Sto- tion 2of a project of humanisa- social life. The words of the en- ria e utopia (‘Humanity. Histo- tion. cyclical Evangelium Vitae ry and Utopia’) which is a col- (1995) still sound out in the lection of the writings of Fra a. Humanisation: an Alliance 59 spirit of contemporaries: Pope Pierluigi Marchesi, a man who with Man (1981) John Paul II warned people was defined by his contempo- about the culture of death that raries as the ‘prophet of hu- The proposal of ‘humanisa- pervades certain spheres of our manisation’. tion’ is not an ideology, it is not civilisation, producing a false Beneath the apparent ease of a philosophy. It represents, in- culture of human rights and de- his writings are hidden, similar stead, a process of retrieval of sire to eliminate persons who to the material to be found un- our alliance with suffering are not productive within soci- der the tip of an iceberg, an im- man, an alliance that runs the ety: premature babies, disabled mensity and depth of thought risk of being lost perhaps be- people or the elderly, with the and passion that will shake cause we have lost our introduction of euthanasia and anyone who attempts to im- covenant with God. abortion as a right. merse themselves so as to bring We who believe in mystery, Specifically against the neg- them to the surface. We are who believe in God out of faith ative tendencies of separation dealing with thought and pas- and not because of a conformist into races, discrimination into sion that come from afar; they or ritualistic adherence, must opposed social categories and involved the life and the action admit that our ‘service out of the prevailing of economic in- of the author and forced his re- love for our neighbour’ comes terests over the search for the ligious brothers and the secular from our being Christians in the common good, the cultural health-care world to change full sense. Now, in the footsteps movement for humanisation their mental and emotional ap- of our Founder, our neighbour appears as a proposal for a new proach first of all, and then is directly and at the level of vision of man-in-society which their approach at the level of priorities men who suffer. Our wants to permeate knowledge practice, so as to move towards lives therefore have a precise and operational techniques that a renewed understanding and direction given that we chose to are able to change the utilitari- healthy relationship with pa- enter the religious life of the an culture that dominates con- tients. Fatebenefratelli. We have to ad- temporary models of social These writings cover diffi- mit that this direction is ardu- life. cult years for health care and ous to maintain and if we have Indeed, health-care services, bear witness to the torment of a in part lost it, its regaining will necessarily integrated into so- hospital religious who saw the also be arduous. But this alone cio-economic dynamics regu- gap and at the times the lack of is what we must do. It is this re- lated by laws and administered coherence between prophecy gaining, it is this tie ‘of blood’ by politics, cannot be seen as and reality, with all the accom- between us and our patients that highly humanising realities if panying difficulties of planting I call ‘humanisation’. respect for every man and the the values of humanisation in The Church, to the extent whole man is not placed at the the daily experience of health- that we are living limbs of it, centre of every social institu- care realities. encourages us to ensure that tion. His message provokes us to our works and activities ‘con- It was along these lines that leave the limited and often base tinue to be privileged places of Pope John Paul II prophetically field of the circle of works, reli- evangelisation, witness to au- pushed us in 1996, when, in gious families and institutions thentic charity and the promo- opening the proceedings of the to which they belong and to dition of the human’ (from the Tenth International Conference rect a 360 degree gaze at the address of the Pope to Brazilian of the Pontifical Council for new and different needs of our religious) (Umanizzazione. Sto- Health Pastoral Care, he de- sick brothers. ria e utopia, p. 44).

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 60

b. Humanity: c. Humanisation: human law has not yet reached, a Pharmaceutical an Act of Justice and in order to protect man in his to be Used of Humanity (1981) needs and to point out the way, indicate, and foster the arrival The company hospital is im- When speaking about hu- of justice. This charity becomes mediately perceived: in it ref- manisation one cannot confine an instrument of justice that is erence is made to profit, to the oneself to saying simply that much more effective that any quantity of patients, to levels side by side with our hospitali- reform or social revolution of pay, to equipped rooms, to ty we must place love, Human- (op.cit., p. 100). carpets in offices, to economic itas: we have to remember that concerns: reference is never our hospitality is designed to d. Humanising Oneself made to patients, unless as ob- welcome those who are afflict- to Humanise (1981) jects which have to assure eco- ed by tribulations as well as by nomic satisfaction at the level a lack of food and medicines; Humanising hospitals cer- of the budgets of the concern. that humanisation has its most tainly means the modification One should not be opposed authentic placement in the of structures. Above all it to the modernisation of hospi- charism of hospitality and this means the modification of our tals. Indeed, it is a positive fact belongs to that more, or better relationship with workers, rela- that many hospitals have giv- to that something else, as a re- tives, and lastly with patients. en due importance to moderni- sult of which our hospital must We must learn to take on our ty, efficiency, and to the tech- not be just a clinic, a hotel, an humanity in order to offer it to nological and spatial efficacy office, but a warm place full of the patient and to identify our of our works. Efficiency is ‘affection’ and where a sick inhumanity in order to contain 60 certainly a value; indeed, a person sees that his moral, spirit, to reduce it, with the help of great value. But it is not the itual, supernatural needs are a life of prayer, of study, of on- only value. met in addition to his psycho- going training which, and I re- What distinguishes a com- logical and social needs. In our peat the point, contemplates pany from a hospital? The fact works – which are often fi- not only our knowledge but al- that a hospital produces health nanced by civil laws as result so our being. and not only economic results. of which corporeal and techni- Our focal point is that of try- It wants to produce wellbeing cal aid is assured – we will ing with determination to relate for a man who is not well. The commit a very grave sin if we in a new may to patients so as dehumanisation of a compa- limit ourselves merely to hav- to place them at the centre of ny-hospital is very difficult to ing a sick person in our custody hospitals and of the care of all perceive at first sight. In gen- (a prison function) or to assur- workers. It may appear not eral a hospital is fine, modern, ing him sound efficiency (a very much to state and to sup- recently built, rich in patients. company function). It would be port at a practical level the cen- But where is the humanity? a sin against justice and against trality of the patient but I am Where is humanity if hours charity. Our task is to assure sure that in many of our hospi- are dedicated to drawing up justice to the sick person with tals this centrality is obscured. accounts and a few minutes treatment that is full of exper- Well, if this diagnosis were to are dedicated to patients, to tise. But it is also our task, be confirmed, we could not their problems, their problems quite apart from human laws, sleep soundly until patients re- at the level of care and treat- to respect the sacred right of turned to their place, that place ment as well? The company- people who suffer to obtain re- that St. John of God identified. hospital is not our model; it is spect, dedication, love, under- And we, his followers, coura- a partial model, an insufficient standing, transparency and sol- geously, ready to transgress old model, and thus it should not idarity. It is for man that we habits as well, and forms of be- be accepted. The highest level must inflame ourselves; it is not haviour no longer directed to- of efficiency should never, re- for the conservation of power wards a good end, can, must, ally never, become a pretext to or the obtaining diplomas that every day, renew our ancient deny a patient our personal we should strive. alliance with the man who care and the care of our co- At times we grow heated turns to us, well aware that he workers. over things and we grow cold can receive from us that central As a contemporary slogan over man. We must not give location which he would only has it: ‘one can die of moder- only bread. We should also with difficulty find elsewhere. nity’. Instead, one can live, give our own persons. To the The humanisation of hospi- hope and get better through question of whether humanisa- tals is not possible outside our humanity. And when one can- tion is an act of justice or of humanisation. A medicine that not recover, one dies in peace. charity, I would reply immedi- can humanises hospitals is still This is because humanity is ately: today it is an act of both. not for sale! Although it is true not only something that is It is an act of justice because that a humanised hospital is a good and to be given in a pa- we respect in this way the right different hospital, one that is ternalistic way. It is a resource, of man upheld by human laws; radically different at the level it is a skill that has a therapeu- it is an act of charity because of communications, power, de- tic value, it is a ‘pharmaceuti- we respect a need, that for care, cision-making styles, affective cal’; indeed, at times that best that no law can regulate or im- life etc., it is equally true that to that is available to a hospital pose. Charity, charitable love, become different it needs men (op.cit., p. 61). must come to the rescue where who have in their turn changed.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 61

It needs, in particular, mature ject. Here I would like, instead, g. The Humanisation of Death religious, or religious who are to stress the fact that today the (1986) committed to becoming ma- tendency is to have excessive ture, and a rich community al- confidence in the technical re- But let us dwell upon a third ways ready to engage in human sources that (and not always for aspect, to which reference has growth, in spiritual growth humanitarian reasons) are made already been made. In the pres- (op.cit., p.110). available to the health-care ence of a gravely ill person we, world. This also explains the fa- too, often lose hope; we feel e. Hospitality Incarnated cility with which certain gov- useless and we abandon him in History (1986) ernments and parliaments have while awaiting the inexorable passed laws relating to abor- moment. This impoverished vi- Our charism, therefore, in- tion, euthanasia and manipula- sion of life and death, as a re- vites us to enter the temple of tive interventions upon genetic duction to the role of technical the concrete man of today. It al- structures. These tendencies workers, forgets that the term so tells us that we have to should be opposed. But to do ‘health’ also means ‘salvation’, change according to the temple this in an effective way it is that is to say the life of the and the man without assuring necessary to be abreast of the soul! For this reason today hos- ourselves that such a change is times, to know about the vari- pitals have become a place of painless. Perhaps it is easier to ous subjects at a deep level, and lonely death. A heart that stops address the risks of a savannah to avoid sterile accusations or does not make a noise; and yet or a desert than proclaim our abstractly rigid positions of de- in us it should provoke a vast charism to educated people, fence. And above all when we echo. Death, like life, is not an with notable critical faculties, see that the sacredness of man act that is exclusively individ- but with new needs to meet. is threatened, whatever may be ual. The life of other people al- 61 ‘In the technical and con- the source of that threat, we so touches us closely, after a sumeristic context of modern must have the human and reli- certain fashion. society in which every day new gious courage to intervene. It is up to us, within our hu- forms of marginalisation and man limits, which, it is certain- suffering are discovered, our ly the case, cannot change des- hospital apostolate is fully rele- tinies, to eliminate that sense of vant’. We read this in our con- ‘the savage’ in the image of stitutions. We, dear brothers, solitary death with tubes of are those who will run the risk plastic which dramatically re- of not being relevant if we do vives the ancient horror of the not fix our gaze on the forms of rotten corpse abandoned in the marginalisation and suffering countryside. of contemporary man. What civilisation would we Let us therefore ally our- have in which the forms of hor- selves with those people – sec- ror changed, but not its sub- ular co-workers as well – who stance? (op.cit., p. 211). want to grow at our side and often walk ahead of us. Together h. The Humanisation of we will respond better to our Hospitals (1988) call, to the new culture of Man, We cannot keep quiet in the of Time and Life, an endeavour face of injustices, betrayals, A sick person who is admit- of research and experimenta- forms of laziness, and solutions ted to hospital expects to get tion which perhaps our Order not in line with what humanity better, hoping that modern has never before had to address and faith suggest to us. What is medicine will deal with the ‘re- with so much urgency (op.cit., at stake is our vocation, our role covery’ of his health. He ex- p.127). as allies of suffering humanity. pects information that is acces- To keep silent in such cases sible to his understanding and f. Religious in Health Care: means to consent. But once not concealed behind indeci- Leadership and Critical again to speak, to point out new pherable terminology. He does Awareness and just paths, we must have not want to see himself treated adequate training and be up to as an anonymous number, as In addition to being witness- the task. Unfortunately, such is pathological case ‘XY’, but as es and moral guides, we must not always the case. And here an individual who suffers be- also act critically in the world we come back to indispensable cause of a specific illness, as a of health care. Indeed, it is not co-operation with secular peo- never to be repeated person enough to work hard within our ple. In order to take up in victo- who is respected in his illness. hospitals; we should also dedi- rious fashion the challenges of A patient wants to be accepted cate time to the study of phe- our time we need connections, into an atmosphere permeated nomena connected with assiduous exchange, with ex- with human warmth. progress in health care in order perts in various fields: profes- At this point we may be al- to direct them towards the sionals of the medical, biologi- lowed to ask: to what extent are greatest wellbeing of the per- cal and human sciences who medical doctors, health-care son. In the previous document are able to assure us that train- workers, and patients them- on humanisation I tried to ex- ing which today cannot be dis- selves subjected to the fascina- press certain ideas on the sub- pensed with (op.cit., p.170). tion of mechanical medicine; to

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 62

what extent are they slave of the human body which by now of the personal experience of a the belief that postulates health has no limits. Matching this sick person. It means to enter as feasibility; to what extent is scission between what is said into his madness, to struggle to- the body abused by reducing it and what is done, mechanical gether with the sick person to a machine and seeing human medicine denies the existence against his madness beginning organs as parts of this ma- of pre-existing boundaries to with his hallucinatory world chine? (from the Address of the science and the conscience. The and to place authentic meaning Holy Father to those Taking pre-existing boundaries acting against this world. Only in this Part in the Second International to defend the dignity of the hu- way is it also possible to re- Conference of Secular Collab- man person and the inviolabili- spond to his need to see his own orators, Rome, March 1988). ty of the mystery of his body mental illness as something that How should health be ‘de- and his soul are violated in a can be healed, as an illness with fined’? And who should define brutal way. Inexorably impris- which (and not against which) it. Health, a feasible thing – this oned in the ‘mask’ of the scien- one can live. As is the case with is the idea which is (not) pro- tist, a medical doctor is never physical illnesses, in the field of nounced by medical doctors able to openly admit his own mental illnesses, too, there are who on the one hand seem to powerlessness understood in a forms that can be healed and be increasingly moved by the positive sense (op.cit., p. 260). forms that cannot be healed, invisible strings of technology even though when we consider in medicine and, on the other, i. Humanisation and the concept of ‘an individual’ are increasingly less aware of Psychiatry (1988) (which means to be invisible) how much they pose as God. there is neither pure physical The ‘modern’ medical doc- A person afflicted by a men- illness nor illness that is exclu- 62 tor, who is completely ab- tal illness needs to be recog- sively mental. The patients sorbed in the application of his nised as a sick person, as a pa- needs his environment to accept mechanical medicine to the or- tient, as a tormented human be- his illness without ‘ifs’ and gan, body or man as object ing, and as a person who feels without buts’, without mystifi- runs the risk of handing him- pain. A mentally ill person of- cations (obsessed, possessed by self over to the ‘pressure to ten ‘experiences’ the night- a spirit, possessed by a devil) conform himself to God’ (the mares, the anxieties and the and without stigmatisations (he deserved it, I have no pity for him, he does not want to be helped…). Once he is better, rehabilitated, once again in possession of his health, the illness must not become a brand for the person concerned or for his family (op.cit., p. 270).

l. The Humanisation of Professionals (1996)

Over the last thirty years, we have striven, perhaps with great success, to define ourselves in relation to all the kinds of workers who populate the city and have with hard work won the right to be represented officially in those places where the decisions about the political future of civil society are taken. If we want to look at the fu- concept comes from the torments of a cruel imaginary ture we must forgo the pride of philosopher Markquard). The world. As a patient he thus has definitions. We must adopt ap- dignity of the human person is a strong desire for love, care proaches and forms of behav- inviolable. But in repairing, and understanding. To his iour that will bring about new this medicine, which is re- ‘mad’ desire for understanding knowledge about illness, health duced to pure and simple ac- we can respond only when we and the life conditions of man. tions involving repair, ignores are ready to receive his torment We must impose upon our- the soul, the psyche, even if it in that dimension and that com- selves a new pathway of hu- often refers to the unity be- plexity that he communicates manisation where we ourselves tween the body and the soul, to us, and in a way that refrains become the object of our own even if it easily makes use of from any attempt to understand care. Humanising ourselves the term ‘psychosomatic’. rationally his experience from first of all and not humanising To speak about the unity of our point of view. only our professional forms of the body and the soul acts as a To have compassion thus practice. cover for the manipulation of means to draw near to the world The problem that poses itself

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 63

in post-modernity, that is to say n. Vocation at the Service of the science and the professions, when precise rules are absent Sick (1990) and between faith and activism for institutions and social bod- within institutions. To this rev- ies make the social fabric fluid, The restitution of a sense of olutionary process of synthesis for us involves seeing our- prophecy to activity to promote between theory and practice selves first of all as humans and vocations at the service of the one must link the search for fellows (op.cit., p. 342). sick must involve a radical peace and the integration of all overturning hitherto of the ap- men into an ecumenical move- m. Consecrated Women proach of far too many forms ment that constructs the unity at the Service of recruitment. We must have of mankind. We need adult of Humanisation (1990) the courage to no longer place Christians who are capable of the ‘economy’, the manage- planning the future (op.cit., p. Breaking with Jewish tradi- ment of individual religious in- 411). tions, Christ conferred on stitutes or the ‘survival’ of indi- women an important place in vidual religious families at the p. Pietas, Religion and the perception of his message centre of our activities: we Humanisation (1992). (Lk 1:42) and his transmission must finally place there the of prophecy (Jn 4:42). Women, new and various needs of our The term ‘pietas’ for us has a therefore, should have as a pri- sick brothers and sisters different meaning to that com- ority a charism of compassion (op.cit., p. 384). monly understood in Italian that should be recognised and which is often similar to com- practiced in the Church as a o. Humanisation and passion or commiseration. Its true ministry. In the early Challenges for the Future oldest root takes us back to the Church the deaconesses (Rom (1991) root itself of religion because it 63 16:l; l Tim 3:1l) took on first is the pious man who recognis- and foremost a service of It seems to me right to be- es that his divinity – his God – prayer and compassion for the come aware of the fact that one has a priority and a transcen- poor and the sick, and a liturgi- cannot reduce the future to dence to be venerated and in- cal role in the baptism of fracture with the present. This voked, to be propitiated and women. Mary of Nazareth represent should be experienced contacted, through religion. A mains that woman, a humble as a possible future. Thus the pious man, contrary to an impi- and eternal sign of that mother- challenges of the future are the ous man is he who attests that hood in the spirit whose fra- challenges of the present. his humanity is ‘meaningful grance filled the whole of the As regards service to the sick and significant’ because of his home of the King like small and those in need it is neces- relationship with God who is to rose bushes (Sir 24:14; Ct I:12). sary to see health-care systems be blessed and praised, to be According to St. Paul (I Cor as part of a broader socio-eco- acknowledged and loved. 12:4), a ministry and a charism nomic-political system. Indeed, In this reference to religious refer back respectively to the solutions to the problems of piety, humanitas acquires the Christ and the Spirit. The rela- health of a population can nev- characteristics not of a theoreti- tionship that exists between er be even remotely addressed cal abstraction but of an exis- them as a differentiated re- if there is not human solidarity tent, identifiable and palpable sponse to the same vocation in political projects and a co- set of human persons who are was expressed by Pope John herent use of economic and fi- autonomous but linked and Paul II during the vigil held in nancial plans (cf. John Paul II, sustained by transcendence. Paris in 1980: ‘the experience Centesimus Annus, 1991). If I say man and humanisa- of two millennia teaches us The struggle against AIDS tion my intention is to say tran- that in this fundamental work, constitutes today a significant scendence, intelligence and the mission of all of the people terrain of this inter-relation- spirituality, that is to say a of God, there is no essential ship that cannot be eliminated. structural connection with the difference between a man and And there will be no effective world of the divine. I cannot a woman. Each one in their solutions unless one constructs acknowledge a God if I do not own gender according to the a network that is capable of im- acknowledge the dignity of specific characteristics of mas- proving the conditions of life of man, above all the dignity of culinity and femininity be- people with deviant forms of man in need. comes almost a new man, that behaviour. You provoked me as a friar is to say a man for other peo- Addressing the complexity to remember that St. John of ple, and as man becomes the of systems is impossible with a God, the founder of the hospi- glory of God. If this is true, just dogmatic mentality and with tal friars, identified in this con- as it is true that the Church in mere good intentions. We need stituent link between humani- her hierarchy is led by the suc- new mentalities and new cul- tas and pietas the basis for a cessors of the Apostles and tures that give space to person- different kind of religious care thus by men, it is even truer al capacities and open up new for sick people and the motiva- that in the charismatic sense pathways of communication. tion for the building of is hospi- women guide the Church, as And in particular a strong com- tal. men do, and perhaps even munication between ethics and The Gospel revolution, car- more so. I invite you to think scientific knowledge, between ried out by him to the most ex- often of Mary, the mother of humanisation and medical treme consequences, lies Christ’ (op.cit., p. 366). practice, between private con- specifically in identifying the

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 64

destinies of man, his needs, his creative human work and, as an rehabilitation are concretely errors and troubles, his wishes, essential part of that work, ini- implemented. Convinced that his plans, his healthy or sick tiative and entrepreneurial abil- health is a state of balance be- body, as objectives of a project ity becomes increasingly evi- tween the needs of the body in which God Himself is in- dent and decisive’ (Centesimus and the soul, we must educate volved. The love of God which Annus, n. 32). educators who are able to go is pietas that binds us to God It is enough to comment on beyond the technical and the and men. this text to see the value of the individual sciences so as to For me humanisation thus technical. But I believe that identify more complete educa- means pietas but it also means here, too, we can overturn the tional objectives (op.cit., p. mercy, the promotion of the hu- perspective and I would ask 455). manity of man in all the struc- whether there should be a rela- tures of the social and in organ- tionship between ethics and the s. Ideas for the Definition of ised civil life, the constant technical and thus whether we Humanisation (1992) transformation of structures at should speak about values in the service of the dignity of the technical. To try at this point to define man, above all when we are Indeed, if it is true that the ‘humanisation’ – something dealing with a man who is sick technical is a creative model very difficult at the level of and thus intrinsically in need. for the transformation of na- words but simpler at the level And this as ‘service’ to God ture, it must be true that the of action – one can at this point (op.cit., p. 433) world of the technical is im- attempt a first formulation putable to we technical workers among many. It involves a q. Humanisation and the Value at all levels. Faced with the ca- mental, affective and moral ap- 64 of Technologies (1992) pacities of the technical which proach that forces the worker are increasingly effective and to constantly rethink his mental Today nobody can deny that ‘invasive’, as is said in medi- schemata and to reshape his the technical-scientific compa- cine, we must realise that the habits of intervention, as well ny has radically transformed prediction of risks and the as therapeutic systems and sys- not only the organisation of memory of the future must be tems of assistance, so that they health care as a whole but ineluctably recognised as prin- will be directed towards the above all else the exercise of ciples that should be respected good of the sick person who is, individual medical services in medical-technological ac- and will always remain, a per- whether hospital services or tion. son in difficulty and thus vul- otherwise. At this point is identified the nerable, not least because he is The technical, which through role of politics in health care not always able to formulate in technology is joined with sci- with its capacity to compare the a correct and direct way his ence, has come into existence real needs of people through own authentic needs. as a set of autonomous systems the achievements of technical The definition offered by that establish themselves in a forms in order to attempt to es- Pope John Paul II at a famous way that is autonomous from tablish the existing responsibil- conference on ‘the humanisa- other systems such as social ities between technical-heath tion of medicine’ that was held systems, ethical systems, and care systems and anthropic-so- in Rome in 1987 is more de- economic systems. cial systems (op.cit., p. 438) tailed and stimulating: ‘a) with- The essence of the technical- in the context of the individual technological method is that of r. Being Educators for relationship, where humanisa- achieving the effect desired Humanisation (1992) tion means openness to every- with the greatest of efficacy. As thing that can lead to under- such we have to recognise that Well, we continue to preach standing man, his interiority, man brings into play the values the importance of humanisa- his world, and his culture. To of knowledge and creativity in tion but we begin to think at humanise this relationship in- inventions and applications of least of new models of forma- volves both a giving and a re- the technical. tion for we religious and for ceiving, creating, that is to say, When referring to the pres- health-care workers so that that communion that is total ence of humans in the field of valid strategies and methods ‘participation’. b) At the social the distribution of goods, the can be identified to change the level the request for humanisa- Pope wrote in Centesimus An- existence of sick people in hos- tion is translated into the direct nus: ‘In our time, in particular, pitals and society. commitment of all health there exists another form of A training that illuminates workers to promote, each with- ownership which is becoming necessary principles not only in his own sphere and accord- no less important than land: the helps the patient but also pro- ing to his skills and expertise, possession of know-how, tech- vides a positive role in the pro- suitable conditions for health, nology and skill… Organising tection of health; it provides to improve inadequate struc- such a productive effort, plan- training for the day before not tures, to foster the right distrib- ning its duration in time, mak- the day after. ution of health-care resources, ing sure that it corresponds in a We must design new profes- and to ensure that health-care positive way to the demands sional profiles so that within policy in the world has as its which it must satisfy, and tak- and outside hospitals initia- end only the good of the human ing the necessary risks… In this tives, actions and programmes person’. way, the role of disciplined and of education, prevention and In this way, the intelligence

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 65

and the rationality of the people a tangible sign of the soul of by following individual devia- of God are called to implement the charism of hospitality. tions more than our own tech- humanisation as a way of relat- The Gospel revolution, car- nical-scientific approaches. ing to sick people. The best ried out by him to the most ex- Man, and a mad man as well, way to humanise medicine lies, treme consequences, lies is made in the image of God to express the point in sum- specifically in identifying the and must be respected precisely marising fashion, in treating destinies of man, his needs, his because of the extreme weak- patients as persons, in respect- errors and troubles, his wishes, ness that makes up his vulnera- ing their dignity, in making his plans, his healthy or sick ble originality. them participants in the deci- body, as objectives of a project Man is always made in the sions that concern their lives in which God Himself is in- image of God, above all when and their health (op.cit., p. volved. The love of God which the physical and spiritual traces 462) is pietas that binds us to God of that sublime intelligence that and men. created us specifically ad imag- t. Catholic Hospitals and a inem et simulitudinem suam Style of Service (1999) have retreated. I would dare to say that if Catholic health-care profes- this faith in weak and wounded sionals and hospital volunteers God, who is able to suffer in his must take on the task of re- creatures, is absent, then the designing a new pact of soli- very premise of equality and darity between institutions and solidarity between men also citizens if we do not want to disappears. run the risk of destroying the I would like to be allowed to 65 unity of human society. make a final appeal to men of In conclusion, I cannot keep science and those politicians silent about what should be in interested in this subject. I the near future the role of would like to say that mentally Catholic hospitals: ‘catholic’ sick people today need first and hospitals, that is to say univer- foremost this recognition as sal hospitals because of their wounded God who walks vocation. In our tradition, therefore, amongst us. Our hospitals must find the humanisation means pietas, Let us form human persons way to express the uniqueness mercy, the promotion of hu- who are able to understand and originality of their voca- manity in man, the direction of their cries and understand their tion. A Catholic hospital, in- institutions towards the promo- gestures. God is amongst us in spired by God’s charity for tion of human dignity, with mad people, in the disinherited man, must then recognise that everything as a ‘service’ to poor, in suffering, as He is style of communion which in God. amongst us in science and the treating bodies is concerned al- My reflection wants to be a joy of living (op.cit., p.554). so with the salvation of people logically directed method in the in order to construct the com- form of a reflection of a reli- Is the humanisation of health munity of the saved. gious kind. care a utopia? Yes, it really is. Hence we must be encour- St. John of God was inspired But only men of courage, of aged to find common lines of by a precise way of serving prophecy and of love, as was action which, taking up certain God in the sick; he proposed a this religious of the Fatebene- reflections on Catholic identity coherent model of hospitality fratelli, Pierluigi Marchesi, can developed in other sectors, I that was able to inspire other turn it into reality. would like to sum up as fol- models of humanisation but a lows: the catholicity of a struc- model that is inexplicable with- Prof. PIETRO QUATTROCCHI ture centres in a critical fashion out reference to God ‘the Fa- Head of the Service of Bioethics, around the commitment of its ther of Our Lord Jesus Christ’ The Fatebenefratelli Hospital, staff to seeing health care as a (op.cit., p. 516). The Tiber Island, ministry. In this perspective three factors are vital: care for v. Humanisation and Faith in quality, the search for social God (1997) justice; and care for the poor (op.cit., p. 511). In taking up the therapeutic model, which was described by Notes

u. John of God, a Model of historians as the ‘sweetness 1 For a greater understanding of these Humanisation (1995) method’, we have reinterpreted questions and issues see ‘From Hip- rehabilitation as an instrument pocrates to the Good Samaritan’, Dolen-

John of God, the founder of of true humanisation and not tium2 Hominum, n. 31, 1996, 1. Fra Pier Luigi Marchesi, born the hospital religious, identified only a technical carrying out of Valentino, (1929-2002). Religious of the in this constitutive link between protocols… Dominated by the Fatebenefratelli from 1947 onwards, he humanitas and pietas the basis theoretical beliefs of models of became Prior General of the Order from 1976 to 1988. The volume from which for a different religious care for rehabilitation we must avoid these passages are taken is entitled: the sick and the motivation for homogenising all patients in Umanizzazione. Storia e utopia (Elledici- the construction of his hospital, parallels or matching histories Velar, 2006).

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 66

Gynaecologists and Obstetricians Called to Service to Life AT THE OPENING OF THE PROCEEDINGS OF THE FOURTH INTERNATIONAL CONFERENCE OF CATHOLIC GYNAECOLOGISTS AND OBSTETRICIANS OF MATER CARE INTERNATIONAL, WHICH TOOK PLACE IN ROME ON 11-14 OCTOBER 2006, MSGR. JEAN-MARIE MPENDAWATU, AN OFFICIAL OF THE PONTIFICAL COUNCIL FOR HEALTH PASTORAL CARE, MADE THE FOLLOWING SPEECH ON BEHALF OF THE PONTIFICAL COUNCIL.

1. Gynaecologists and indeed, a culture that is aggres- ma at the end of their studies. I Medical Doctors at the sive in relation to life at its dif- believe that you Catholic gy- Service of the Lives of ferent stages and in its various naecologists and obstetricians Mothers and Children expressions is becoming in- must react and find modalities creasingly established. In ma- of appropriate dissent in order The Charter for Health Care nipulating life some scientists to uphold the right of conscien- Workers of the Pontifical banalise it and devalue it, tious objection and work so Council for Health Pastoral thereby helping to create psy- that in our universities a prima- Care defines a medical doctor chological, social and cultural ry example is made. 66 as a worker at the service of conditions not only for the de- I thus invite you, dear doc- life; here one is, of course, criminalisation of crimes such tors, gynaecologists and obste- dealing with life, that great gift as abortion and euthanasia but tricians: of God, given to man, of which also for the promotion of laws – not to submit yourselves to he is only a responsible stew- that are clearly favourable to forms of blackmail of any ard, and whose life embraces abortion and euthanasia and kind; the whole arc of human exis- which are often held up in – not to practice your profes- tence from conception to its modern societies as measures sion in line with the interests of natural sunset: gynaecologists of civilisation. the strong or social reward; and medical doctors have as 2. Today, in some circles – not to become corrupt their profession the mission to favourable to abortion, there is mercenaries without a sense of attend to life from its begin- the increasing affirmation of a responsibility; ning, during the arc of its nat- pseudo-right that bestows upon – not to forgo the Hypocratic ural growth until its blooming a mother the power of life or character of your profession at the moment of child birth. death over her unborn child be- that always and in all situations Dear medical doctors, my cause of the simple reason that commits you to not contribut- friends, you have received this the unborn child depends on ing to bringing about the great gift of God of helping the woman who carries it in deaths of innocent people but, families and in particular her womb or the pretext of the instead, commits you to re- mothers with your professional difference of the corporeal de- specting them unconditionally expertise and skill and your velopment of the unborn child. from conception until the nat- medical knowledge; of ad- In this way an attempt is made ural epilogue of their exis- vancing this great and wonder- to establish an inequality of tence. ful gift of providence, human rights that is so radical as to at- life, a fascinating mystery, the tribute to the mother discre- life of each one of us and tional power over her own 2. The Contribution of mankind yesterday, today and child. I believe that it is perti- Gynaecologists and tomorrow. As health-care nent to state once again that the Obstetricians in Favour of workers you strive to serve life freedom of the mother is limit- Unborn Life within the with intelligence and dedica- ed by the specific rights of the Framework of the tion, in particular when it is at individual that she bears in her Programme for the risk because of pathologies and womb and public authorities Prevention of the Vertical various threats that can com- should uphold. Transmission of HIV/AIDS promise the wellbeing of both 3. One cannot keep silent the mother and the unborn about the situation of many gy- 1. HIV/AIDS is a planetary child. What an honour but also naecologists who are ‘morally emergency. In twenty years it what a responsibility for you forced’ to carry out an abortion has become the first cause of gynaecologists and obstetri- so as not to run the risk of los- death in Africa, In 2005, ac- cians, who are called to work ing their jobs, or the situations cording to the statistics of UN- with such a great and mysteri- of students engaging in work AIDS, out of 40.3 HIV positive ous human and divine event! placements who have to do the children sick with AIDS in the 1. The cultural context in same thing, unfortunately in world, about 1.2 million were which you practice your pro- very many clinics in order to Africans. I could go on and de- fession is not, unfortunately, avoid the risk of being exclud- scribe the dramatic context of favourable to respect for life; ed from receiving their diplo- the situation of HIV/AIDS in

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 67

the world and in particular in many mothers, above all in de- reproductive health in order to the continent of Africa, but I veloping countries, in your refer to an authentic concept of will stop here. However, I programmes. reproductive health side by side would like to provide a signifi- with a series of connected cant statistic: in Botswana, rights. Everything is defined as 35% of adults are HIV positive. 3. Catholic Gynaecologists a new feature of the panorama In Abidjan, in the Ivory Coast, and Obstetricians and the of human rights and correlated AIDS has become the first Ideology of Reproductive rights. In the international con- cause of death and South Africa Health text, reproductive health is has the highest number of HIV linked to procreation and to positive people in the world, Today in the international other strongly debated areas that is to say five million peo- context there is a serious ideo- such as, for example, gender ple. logical question which was ad- perspective or sexual orienta- 2. We are all invited to make vanced in particular at the in- tion. In other words, reproduc- a contribution to combating ternational conferences held in tive health is connected with a this terrible pandemic; the field Cairo and Peking. I am refer- profile of the equality and de- where you as gynaecologists ring here to the question of so- marginalisation of women, and and obstetricians could do a called ‘reproductive health’. associated with the educational great deal is that of the vertical The famous Millennium Decla- realities of young people and transmission of the virus, that ration gives a great deal of adolescents, and this has in- is to say from the mother to the space to this creeping ideology; creased elements that generate child, where one can signifi- I am also happy that this matter conflict between the genera- cantly reduce the number of will be studied by you. Of the tions (the rights/duties of par- children who are born with the eight millennium goals for de- ents as against the rights of 67 HIV virus thanks to simple and velopment, three relate to adolescents). inexpensive measures at a health: the reduction of infant 2. I invite you dear medical medical and pharmacological mortality (goal 4), the improve- doctors to explore this problem level. In the young mission ment of the health of mothers and to provide information to churches there are major and (goal 5), and combating your profession so as to prevent impelling needs and the local HIV/AIDS, malaria and other you from unconsciously serv- bishops asked to be helped to diseases (goal 6). It is increasing the merchants of death who respond to such an important ingly the case that services re- are certainly not absent in your emergency which in definitive garding the health of mothers field. Catholic gynaecologists terms allows the avoidance of and their children are offered and obstetricians cannot be the risk of further abortions be- by governments, and above all passive in relation to this ideol- cause of the fear of mothers university clinics, which in- ogy which is infecting many of that they will give birth to chil- clude, in addition to the tradi- our structures and also many dren with HIV. This is a matter, tional and ordinary services of health-care workers in the as you can see of being, here gynaecology and obstetrics, al- world. too, at the service of life, en- so services connected with the My best wishes to you and suring that life from concep- instruments and means of con- your work. tion is, and is born, healthy. I traceptives and abortions Msgr. JEAN-MARIE believe that you could do a framed within the ideology of MPENDAWATU great deal with very little if you population control. Official of the Pontifical Council for were to include this noble ini- 1. In this field increasing ref- Health Pastoral Care, tiative, which directly affects erence is made to the right to the Holy See.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 68

The Anchor of Life HOPE TO HOLD DEARLY—THE ROAD TO OVERCOME SUFFERING (HEB 6:19)

CVS: A Mission apostolic action showing that prove false, we who have fled which Begins at the Foot love which saves. for refuge might have strong of the Cross Every person, by under- encouragement to seize the standing the implication of his hope set before us. We have The CVS (Volunteers of Suf- own baptismal vows, becomes this as a sure and steadfast an- fering Center) is an interna- an active, responsible member chor of the soul,...” (Heb 6:17- tional confederation com- in all of the CVS’ activities. 19). posed of diocesan Associa- This letter to the Hebrews tions founded by Msgr. Luigi defines hope as the anchor of Novarese in 1947. These As- Holding onto Hope our lives, the symbol which sociations have lay persons gives security and stability. and clergy who live the apos- “...God desired to show This biblical image evokes a tolate through the total in- more convincingly to the heirs shipwreck scene, or at least volvement of the suffering in of the promise the unchange- the picture of a ship being all aspects of life. The pas- able character of his purpose, bounced about in a stormy 68 toral and social activities of he interposed with an oath, so sea. Christian hope is like an the associations place the dis- that through two unchange- anchor of salvation which can abled in a prominent position. able things, in which it is im- be grasped in times of crisis or The CVS Apostolate came possible that God should turmoil. about as a response to the dra- Christian hope, which over- ma of the suffering, as well as comes and surmounts this pic- providing a concrete answer to ture, is Jesus Himself resur- the requests for prayer and rected. penitence of the Blessed Vir- Inevitably, human suffering gin in her apparitions at Lour- is the beginning of a time of des and Fatima. It gives a crisis, a stormy sea which af- sense to suffering which be- fects human fragility and gan at the foot of Jesus’ cross shakes the very foundations of where the Evangelist, John, the individual. The Christian, described the Blessed Virgin however, even when he feels and Christ’s beloved disciple lost and shipwrecked in that (John 19:25-27). Jesus’ death profound sea of his existence, and resurrection, His gift for does not let himself be beaten the salvation of the world, by the fury of the storm. He give a reason for His mother becomes strong as that anchor and his disciple to go on liv- through his trials and tribula- ing while trusting one another. tions. His strength lies in Only through communion Man’s dignity throughout holding Jesus Christ is his with Christ can pain, fatigue, heart while being in commu- suffering have meaning and all of his life, nion with Him in the person’s give hope. At the foot of the Christian duty daily life. This is the only way cross, the CVS Apostolate to understand a Christian can affront suffer- finds its identity by looking at and to follow, ing. the world of the suffering as a Christ the Savior, The CVS Apostolate em- “place” for its particular mis- phasizes the baptismal voca- sion, giving to each member a bringing with Him, tion of every Christian. In life based upon salvation. beside Blessed Mary, particular, the CVS asks all From the union with Christ our spiritual mother, those whose lives are directly crucified and resurrected, our own cross, touched by suffering to hold there is not only a reason, a on to hope as a response to for the betterment hope, a consolation in the lives their own pain. Each member, of those who suffer, but also a of the entire world according to his baptismal missionary dimension in every are the basic precepts vows, must profess and pro- member’s life. upon which claim Jesus resurrected the Each baptized person has our apostolic work hope of the world. the obligation to announce the As Jesus who was beside Gospel to the world and this is based. his disciples at Emmaus (Luke becomes a “free” choice in the Msgr. Luigi Novarese 24, 13-35), all who belong to CVS – each member openly the CVS are near those who offering his own life through suffer, accompanying and sus-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 69

taining them. In the same The founder of the organization, Msgr. Luigi Novarese, manner, the Immaculate Vir- gin, as mother and sister, has was born at Casale Monferrato on July 27, 1914. Following appeared at Lourdes and Fati- a personal illness, he saw the necessity to overcome that ma numerous times. God’s sense of futility and uselessness which the suffering felt Mother shows the way to salvation by guiding and sustain- many times. From his childhood, Msgr. Novarese was very ing each person down life’s devoted to the Blessed Virgin; and his entire spiritual growth road leading to her Son. was characterized by her presence. Thus in 1947 with the birth of the CVS, he and Sister Myriam Psorulla Overcoming Suffering emphasized the central role of Christ’s mother in each person’s life. Illness, isolation, exclusion find meaning only in Jesus In 1931, Luigi Novarese completely recovered from a life- Christ. Those who have felt threatening illness after a Novena to the Blessed Virgin Who these experiences in their own Aids and Saint John Bosco. Then he decided to study lives are living examples for all. The CVS’s apostolic ac- medicine to help the ill. The death of his mother in 1935 tion is transmitted by a pre- brought him to another path. He discovered his priestly ciously patient “keeping close vocation as a better way of helping those who suffer; and in to one another during life’s journey.” It is founded upon 1938 he was ordained. From 1942 until 1970, he was a “reciprocal understanding” part of the Vatican Department of State. He directed the 69 through brotherly relation- Italian Hospital Chaplains office from 1964 until 1977. ships. The CVS’s apostolic action He died at Rocca Priora (Rome), Italy on July 20, 1984. directly and actively involves both the suffering and the healthy. The CVS recognizes the important vocation of the The ‘Silent Workers of the Cross’ are a private disabled as role models of the international association of the faithful recognised by the Gospel through their concrete actions both on a social and Pontifical Council for the Laity to which can adhere pastoral level. members of the laity of both sexes and priests. In the All CVS members place im- imitation of Christ ‘called and sent’ by the Father (cf. Heb portance on the spiritual aspect of their lives and focus 10:58) to carry out His will for the life and salvation of the their apostolic action within world, the Silent Workers of the Cross live the total giving their small group activities of themselves as a response to the baptismal whose aim is to fully utilize social and ecclesiastical re- consecration in the practice of gospel advice. sources for the promotion of In the broad and intricate world of suffering, the Silent the individual’s dignity. Workers of the Cross actuate in themselves and share The fundamental organiza- tional element is the small with everyone a pathway of growth and maturation in the group present in each parish. faith so that in the light of Easter everyone will discover This teaches and co-ordinates that they are called to encounter and proclaim the all activities for an active integration of the suffering in the meaning of their suffering and the joy of salvation. Church, family, and society. The Silent Workers of the Cross act personally and Group activities focus on the directly with concrete actions of service to the person spiritual growth of each member for a fuller life of joy in Je- and pursue their own goals through all the means of the sus Christ, our Lord. apostolate that are required by different socio-cultural To facilitate this, the associ- and environmental situations. They engage in pastoral ation is organized into different groups: children, adoles- activities (animation, publishing, study), socio- cents, young adults, and ma- rehabilitative activities and activities involving assistance ture adults. and care. In particular, they co-ordinate the International Each diocesan association has Spiritual Retreats, Days of Confederation CVS which brings together all diocesan Meditation and Workshops. associations of the Centre of Volunteers of Suffering with In addition, it focuses on all the aim of working for the overall promotion of the facets of the suffering – from their role in the workplace to suffering person. recreation. CVS

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 70

The Journey of the Office for Pastoral Care in Health of the Archdiocese of Bari-Bitonto under the Banner of Creativity (1986-2006: TWENTY YEARS AT THE SERVICE OF THE LOCAL CHURCH)

INTRODUCTION: bishop said to me: ‘well, this health care (the Camillians, the Two Illuminating Phrases year the pioneering stage of the Minor Capuchin Friars, the of Two Pastors office will come to an end: now Fatebenefratelli, and the Minor of the Local Church pastoral care in health must be- Friars, who in November 1986 come a dimension of the ordi- came together in the creation of The memory of the meeting nary pastoral care of every an association that is today with Msgr. Mariano Magrassi, community’. It seems to me called the ‘Italian Association the Archbishop of our local that this indication can become for Pastoral Care in Health 3 church of Bari/Binto, which the best pathway by which to (A.I.Pa.S.). In 1987 it began took place in the late morning continue with our journey of its teaching activity at the of a festive day during the sec- service to the diocesan church. ‘Camillianum’ International In- ond part of September 1985, is stitute of the Theology of Pas- 70 still fresh in my mind. Without toral Care in Health in Rome, frills and with extreme imme- THE CONTEXT: affiliated to the ‘Teresianum’, diacy the pastor said to me: ‘I the Birth of the Office with a which conferred the academic thought I would entrust you Real Prophetic Intuition qualifications of the licence with responsibility for pastoral and doctorate in this discipline. care in health in the diocese be- I wanted to recall these ob- In the 1980s there were only cause for many years you have servations of our two pastors a few diocesan and regional been involved in this field’. In who have contributed in a de- consultative committees for the face of my perplexity be- termining way to the life of the pastoral care in health that has cause of my inadequacy in re- Office because they help to already been created and were lation to the task, when taking place the birth and the develop- already operating. The name leave of me he added in pater- ment of this Office in its most ‘office’ was not employed. An nal fashion: ‘do what you can accurate context. evident sign of this fact was and choose valid people to When this Office was creat- that in the Note of the Italian work with you’. The letter ap- ed in our archdiocese the apos- Bishops’ Conference entitled pointing me to this post arrived tolic letter Salvifici doloris (11 ‘Pastoral Care in Health in the at the end of May the following February 1984) of John Paul II Italian Church’ (1989) offices year because in the curia they on the Christian meaning of were not envisaged amongst had forgotten to add this legal human suffering had already the bodies responsible for com- 1 ratification. Twenty years later been published and the body munion and animation. Refer- I can state with all conscience that is now called the Pontifical ence was only made to consul- 4 that in this position ‘I have Council for Health Pastoral tative committees. Care and done what I could’ and I have Care had just been brought into activity for sick people were in had the grace to find many being by the motu proprio Do- the hands of Caritas. Indeed, ‘valid people to work with me’ lentium Hominum (11 February our diocese, before the creation who have allowed our diocese 1985). of the Office, from the 1970s to engage in a long deaconal In Italy the National Consul- until the first half of the 1980s, journey in the field of pastoral tative Committee for Pastoral was very active in providing a care in health, supported by the Care in Health had been active service to sick people and dis- help and the light of the Holy during the 1960s, engaging in abled people through the wor- Spirit. periodic meetings and the or- thy initiatives first of Msgr. The meeting with Msgr. ganisation of its own national Giuseppe Natale and then, Francesco Cacucci, the current conferences. Many years later above all else, of Don Vito Di- pastor of our archdiocese, it would have a permanent ana. which took place at the ‘St. point of reference in the Na- Here it is necessary to recall Mary’ Oasis of Cassano Murge tional Office of the Italian not only the frequent journeys (BA), on the occasion of a Bishops’ Conference, which organised by UNITALSI to meeting of the directors of the had been created in September Lourdes but also the annual diocesan offices in the middle 1996, with a director and a diocesan day for the sick 2 of September 2005, is even head office in Rome. During placed within the celebrations clearer in my mind. During the same years (1984-85) the of St. Nicholas in the month of lunch, after communicating first contacts had been begun May; the promotion of that I had reached the point of for co-operation between the health/social care voluntary twenty years of life in the pas- four religious Orders involved work together with the OARI; toral office that I directed, the in the field of hospitals and the first unsuccessful attempts

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 71

to establish a consultative com- qualified in the sector of pas- proach allowed an examination mittee; initiatives involving the toral care in health should not of any possible errors that had training of pastoral workers; be under-emphasised. From the been made and to look to the the attempt to pay special at- outset they offered a strong immediate future with tention sick people on the occa- contribution to the implemen- hope.Within the horizon of sion of the visit of the Pope to tation of training for pastoral these constant lines of the path- Bari in February 1984, both workers in the diocese (one way of the Office, we discov- with a special place for them may mention the most promi- ered and followed with during the liturgical celebra- nent: Angelo Brusco, Arnaldo courage and constancy the fol- tions and through the visit of Pangrazzi, Rosario Messina, lowing principal paths of its this eminent Pastor to the poly- Giuseppe Cinà, Domenico growth. We could more appro- 5 clinic of the city. Casera, Luciano Sandrin). priately define them as ‘lanes’: Thus the proposal made by the strong belief of the need for Don Vito Diana (the tireless di- the training of pastoral work- rector of the diocesan Caritas ers, the importance of bodies for many years) to Msgr. Mari- involved in communion and ano Magrassi to create a new participation, the value of office for pastoral care for suf- health care/social voluntary fering and the sick, as it was work, and the utility of remem- usually called in those days, bering what was being con- should really be seen as a structed. prophetic insight and should be attributed to the merits of both of them. THE FIRST PATHWAY: 71 the Initial and On-going Training of the Pastoral WITHOUT A MODEL: Workers Under the Banner of Research and Creativity Our Office believed from the start in the importance of, and The first steps of the new Of- the need for, the initial and on- fice were always supported by Another important element going professional training of good will, by the practical was the active presence of peo- pastoral workers. It was no ac- sense of people, and by the in- ple in the life of the local cident that as soon as I was ap- sights that were expressed from Church, especially during the pointed director I felt the need time to time to the director and important and fundamental to take part, at the Camillian the first members of this body: moments of the diocesan com- Centre for Pastoral Care in it could not have been other- munity, of the parishes and of Verona, in an intensive month’s wise. Given that there was no the associations of, and for, course of clinical pastoral edu- model of reference and the sick people. This presence cation (CPE) in September practical directions of the ec- helped to make the existence of 1986. This training opportunity clesial magisterium did not yet this young body known about turned out to be providential exist, everything took place un- and helped the people involved and fundamental and its practi- der the banner of research and in it to make it grow. cal consequences were visible creativity, which also included Thirdly, the policy was cho- in the shaping of the general prayer, openness to the inspira- sen of small steps in planning organisation of the work of the tion of the Holy Spirit, discus- and drawing up projects: wis- Office, in the methodology to sion with other Offices that dom and care allowed the be used in annual planning, and were well consolidated at the proposing and implementation in the practical stages of the level of practice, and the first of initiatives that were propor- implementation of the projects shared initiatives that were en- tionate to the human capacities that had been identified. gaged in with them. and means that were available. The action of training for the However, it is advisable to Fourthly, the operational diocesan community took the recall certain initial and perma- horizon of the Office from the form of the study of Salvifici nent elements that charac- outset was to breath with two doloris with a course that last- terised the work of the whole lungs: with attention being paid ed for three years (1988-1990). journey taken over these twen- to, and involvement in, initia- The lectures of this course ty years. Firstly, the personal tives by the regional consulta- were entrusted to local lectur- enthusiasm and the youthful tive committees and those at a ers and had a surprisingly large curiosity that were present in national level it was possible to number of participants. At the building bridges of acquain- walk together with the other same time or in subsequent tance and friendship with qual- diocesan Churches and the Ital- years the following were also ified people who belonged to ian Church. organised: a course on this sector and characterised Lastly, there was no absence bioethics (November-Decem- pastoral and organisational of personal and communal re- ber 1988), intended principally action. Here the providential flection on the pastoral experi- for the students of the schools event of meeting certain ences that had been undergone for professional nurses (1989); Camillian fathers who were and their assessment. This ap- a course on ‘help relationships’

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 72

7 of the first, second and third assured the support and help of ments’. This policy continues levels (1988-1991), under the its most qualified lecturers, this today because on-going train- direction of Prof. A. Brusco; a school, which during the ing, together with the help of course on group animation; course of the years acquired the the Spirit, is the first premise and other numerous meetings name of ‘two-year course of for an effective and fertile ser- with the councils of the vicari- ethics and humanisation’, also vice by the ecclesial communi- ate to illustrate the cultural ini- offered health-care personnel ty to the men and communities tiatives of the Office. (medical doctors and nurses) of today. Then, during the early the opportunity of training in 1990s, the Office organised the field of ethics and humani- specific courses on ‘sacraments sation, which, indeed, are so THE SECOND PATHWAY: during illness’ (1991) and necessary to improve health- Bodies for Communion ‘evangelising and bearing wit- care service and places of care. and Participation ness to charity during illness’ What the Note of the Italian (1992). At the same time were Bishops’ Conference states Following the advice of our begun annual meetings for ex- about the hospital religious as- beloved pastor, Msgr, Mariano traordinary ministers of holy sistant in regard to training can Magrassi, the second pathway communion as on-going train- also be applied to the training followed by our office has been ing and to prepare for the of every pastoral worker: ‘to that of looking for people to World Day of the Sick. This was an initiative that was very much participated in by those for whom it was intended and 72 it still has the goal of exploring the subject of the World Day, suggesting a fan of initiatives for the event involving animation, and distributing relevant material to specific communities. The results have been excellent because the practical consequences of the celebration of this World Day have been seen in the written reports that are sent in to the Office. The Office has always offered its own contribution to the initial training of extraordinary ministers in the courses organised by the parishes or the vicariates, with papers on special subjects belonging to this area. For some years now annual meetings on pastoral care in health have been organised. In 2006 we are at our third such meeting. Our Archbishop is al- achieve an adequate perfor- work with us and to create so involved in these meetings mance of his mission at the those structures of pastoral care and he offers his own contribu- side of sick people, in addition in health, indicated in the Note tion at the level of reflection on to a profound spirituality the of the Italian Bishops’ Confer- the subject that is addressed. chaplain must possess profes- ence of 1989, that ‘are at the The proceedings of this train- sional competence and training service of pastoral workers, as- ing activity are written down that enable him both to have a sociations and institutions as an and made available by those deep knowledge of the psy- instrument of communion and involved. These proceedings chology of a sick person and to animation to achieve shared are conserved in the archive of establish with him a meaning- pastoral goals in the world of 6 8 the diocesan office. ful relationship and to engage health and health care’. In 1996, after a year of meet- in valid interdisciplinary co- For this reason, the creation ings and reflection on the sub- operation. It is upon the basis of the consultative committee ject with the consultative com- of a warm humanity that the was of primary importance in mittee, the project of a school pastoral accompanying of sick the initial concerns of the di- for pastoral care in health people finds its first support. In rector. In looking for heads of emerged. This year it has respecting the needs and the associations and sick people, in reached the achievement of ten rhythms of the patient, the inviting the chaplains of years of existence and activity chaplain will know how to pro- health-care institutions, in ani- with the diocesan committee. vide the comfort and the hope mating hospital sisters, and in Working with the Camillianum that comes from the word of asking the regional vicariates in Rome, which from the outset God, prayer and the sacra- to send their representatives, a

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 73

group was slowly formed of sary, when called upon, has and participation of the Office team members and animators never failed to produce the eco- are a valid instrument by which that shared in the first steps of nomic resources to sustain the to perform the tasks that are en- the pathway of the Office, cultural and training activities trusted to it: to animate the var- which was gradually develop- of the Office. ious ecclesial realities and ing on a larger scale. During the course of the health-care structures as re- In order to create a sense of years the staff of the Office gards questions and issues con- belonging on the part of the have been organised through nected with health and the members and to deepen togeth- the drawing up and approval of needs of sick people and their er knowledge of the pastoral the internal regulations of the families; to co-ordinate and sphere of their respective com- consultative committee. This foster common and shared ac- petence, the strategy of having helps to more clearly mark out tion on the part of the various a meeting of the consultative the identity of the Office, the associations, groups and bodies committee once a month was goals to be reached, the criteria that are active in the diocese: useful and productive. The of membership, the internal and to engage in initiatives in- meetings, which were preceded structure, and the distribution volving training and up-dating 9 by a letter inviting people to of tasks. Recently a special in this area. take part and by a specific committee composed of a re- agenda for the meeting, were stricted number of members always characterised by seri- who are convoked by the direc- THE THIRD PATHWAY: ousness and the practical char- tor whenever this is necessary Attention Paid to Voluntary 10 acter of the joint work. All the or urgent matters so require it Work and its Promotion reflections and the consequent has been created. And since the joint decisions taken during beginning of the new millenni- The Church has always 73 these monthly meetings were um, in response to a request of demonstrated its emphasis on written down by a secretary the director, the Archbishop voluntary work both through who produced minutes that has also appointed a vice-direc- statements of the Magisterium were distributed to, and read tor for the Office. For a year and through the promotion of by, the participants. In subse- now the Office has also been specific associations that as- quent years the meetings of the assigned a head office, which sure practical service during consultative committee took is located in the diocesan semi- times of physical, psychologi- place every two months, and nary, a building which also has cal and spiritual suffering. this is still the case, given that other offices. A daily presence Thanks to various kinds of the original purpose now by a volunteer of the consulta- voluntary work, John Paul II longer applies. tive committee is assured for observed, ‘the fundamental hu- The activity of every year anyone who may have need of man values, such as the value was then established in a pro- certain services. of human solidarity, the value gramme that included both the In following how it has de- of Christian love of neighbour, objectives and the principal ini- veloped, one may state that the form the framework of social tiatives by which these objec- Office today has its own staff life and interhuman relation- tives could be achieved. The and duties system which em- ships and combat on this front programme was printed and al- phasises that it is not to be the various forms of hatred, vi- ways sent to the members of identified with one individual olence, cruelty, contempt for the consultative committee. It but involves a multiplicity of others, or simple ‘insensitivi- recent years it has also been pastoral subjects at various lev- ty’, in other words, indiffer- sent to the parish priests. Every els and with different responsi- ence towards one’s neighbour 11 month the Office has always bilities. It has contacts with, and his sufferings’. had its regular space in the and assiduously takes part in, For their part, the Italian ‘Diocesan News Bulletin’ meetings of the regional con- bishops stated in the pastoral where its appointments and ini- sultative committee and the na- directions of the last decade tiatives are made known about. tional consultative committee, that ‘the increasingly wide- At the end of every pastoral and makes a practical contribu- spread experience of voluntary year an assessment is made of tion in the various contexts work is a further strong testi- the journey that has been trav- with which it is involved. It mony to the service of our elled, the delays that there have never fails to take part with a churches in response to various been and their causes, the ob- congruous number of pastoral forms of poverty and a sign of jectives that have been workers in meetings on pas- the ethical and social vitality of 12 achieved and a commitment al- toral care in health in Puglia the gospel of charity’. Look- ways to look forward to the and those organised by the Na- ing at the hospital world the na- next year. An annual written re- tional Office in Chianciano tional consultative committee port on the activities engaged (SI) or by the Italian Associa- for pastoral care in health of in has enabled the whole dioce- tion for Pastoral Care in Health the Italian Bishops’ Conference san community to know about (A.I.Pa.S.), in which certain emphasised that ‘in addition to what has been achieved and members of our local Church integrating Christians more di- this is published in the dioce- are involved with different re- rectly into the social context, san Bulletin. It should also in sponsibilities. voluntary work implicitly car- all honesty be recognised that To conclude, we may state ries out work of pre-evangeli- 13 the diocese, through its bur- that the bodies for communion sation and evangelisation’.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 74

On these theological and ec- nity to enter into dialogue and that has been lived through and clesiological foundations the to enrich each other, to become leaving a cultural legacy to diocesan Office has been in- involved in the pastoral jour- those who come afterwards so volved in a direct way in the ney of the diocesan church, and that the journey engaged in can world of voluntary work in or- to become bridges of commu- be continued in faithfulness to der to respond at a practical nion with the various parish, tradition and with attention level to the explicit invitation family and social realities. paid to new signs. made by our Archbishop, Ms- Towards the end of the Ever since the beginning of gr. Mariano Magrassi, in his 1990s the diocesan Office ac- its activities the Office has had Easter message ‘Let us give cepted the challenge of the ex- an archive looked after by an Life to Life – the Health-Care perience of the Mixed Hospital archivist. It is certainly the case Reality in the Land of Bari’, Chaplaincy (COM), a new pas- that the cataloguing has been which called on the ecclesial toral body of the hospital world done in an amateur way but at community ‘to promote and which, although it has been of- the right moment and with train voluntary workers who ficially recognised by the Ital- qualified people a survey of the act in conformity with free giv- ian Church since 1989, still en- documentation can be carried ing as a sign of the Church counters difficulties in becom- out. In this way that which is which serves amongst our ing established in the various considered most valuable and brethren’. In December 2005 individual dioceses. It belongs suitable will be conserved. the ‘Volunteers of Bethesda’ to the world of pastoral volun- There are over twenty boxes association was created which tary work. in the archive of the Office, is based on Christian principles In the polyclinic of Bari the two for each pastoral year. and seeks to work within pub- experience of the hospital These are divided into folders 74 lic hospital structures by offer- chaplaincy was begun in 1997 on the various sectors of activi- ing its own specific contribu- with the co-ordination of the ty: meetings of the consultative tion to the humanisation of the director of the diocesan Office committee, annual planning, world of health care and al- who works as a chaplain within monthly appointments, incom- 14 ways putting the sick person, this structure. After this other ing and outgoing correspon- with his physical, psychologi- health-care or hospital struc- dence, the school for pastoral cal and spiritual needs at the tures have arisen, albeit with care in health, papers by the di- centre of every programme, their own specific and different rector, material of the World and working in harmony with individual physiognomy. In Day of the Sick, the meetings hospital staff but always main- November 2005 we had the at Collevalenza etc. Copies of taining the specificity of its first meeting of the pastoral the proceedings of courses and own actions. workers of the hospital chap- conferences held in the diocese It has been led by the direc- laincies of our diocese. are drawn up and conserved, tor of the Office as its president In order to have a better idea and the director has been re- who in this role has been able of the importance of the experi- sponsible for a section of the to locate the development of ence of the COM it is helpful to provincial library of the Minor this association within the remember that it is based and Capuchin Friars of St. Fara in pathway of the local church founded on the ecclesiology of Bari, a section limited to pas- and has striven to embody the communion that was devel- toral care in health, which has values of faith and charity both oped by the Second Vatican about a thousand volumes that through the basic and on-going Council which defined the have been published during the training of the voluntary work- Church primarily as a mystery course of these twenty years. ers and through a working and as a people of God. These have been arranged into presence in wards at the side of The hospital chaplaincies, in sections. sick people, their family rela- the light of the path that has An internet site in the name tives, and pastoral workers. been hitherto followed, may be of the hospital chaplaincy of At the present time the ‘Vol- really defined as laboratories of the polyclinic has been created unteers of Bethesda’ are over ecclesial community where in (www.cappellaniapoliclinico- 170 in number and are present an original way pastoral ser- bari.it), within which is placed and work in the three great vice is experienced with the in- the pastoral work of the Office. health-care institutions of the volvement and the commit- We are also waiting to open a capital city of Puglia (Policlini- ment of all the component section of the office in the site co-Consorziale, Giovanni members of the people of God, of our archdiocese (www.ode- XXIII and Di Venere), enjoy each one according to their gitria.bari.it). In this will be good relations with the pastoral own specific charism. placed the links of every hospi- workers of the religious ser- tal chaplaincy. vice, and some of them are practising Christians or extra- THE FOURTH PATHWAY: ordinary ministers of holy the Conservation LOOKING AHEAD: communion. of Memory (the Archive) Towards the Future Naturally, the experiences of other associations of Catholic Conserving the memory of a At the end of this survey voluntary work flow into the body and thus of a community which has allowed me to trace consultative committee of our means not dispersing the multi- and communicate the history Office. These have an opportu- form richness of an experience of our Office, it is necessary to

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 75

look to the future and to refer charisms. His passion should bodies of health-care institu- to the new pathways of pas- move charisms from co-opera- tions are known about: hospital toral care in health that lie tion to co-responsibility, from chaplains and hospital pastoral ahead of the church of di Bari- figures who help to presences councils. Thus it is of indis- Bitonto. that think together and walk pensable importance to convert 1. The development of the within a shared pastoral pro- at a practical level to being a missionary dimension of pas- ject. His specific ministry of Church as ‘communion’ which toral care in health. Care for leading the parish community gives primary emphasis to the sick people and the promotion should be exercised bringing dignity of every baptised per- of overall health cannot be lim- together the threads of mission son and the mission received ited to health-care institutions and services: it is not possible from sacramental grace of con- 16 but must involve the role of to be a parish on one’s own’. tributing to the gospel mandate parish ecclesial communities We may refer by way of exam- of evangelisation and human with the animation of the local ple to certain ministries that promotion. In simple words, to area. In this way pastoral care should be established after a live the communion Church in health, like other forms of suitable period of experimenta- means to see the uniqueness pastoral care, must be trans- tion: the ministry of comfort, and wealth of every richness formed into a daily dimension pastoral care for the elderly, the who belongs to it, to recognise of ordinary pastoral care. This accompanying of the dying, the specific contribution that path was previously indicated and pastoral care of mourning. every component member by the Italian bishops in the 3. The greater professional- makes to it, and to grow in the pastoral Note ‘The Missionary ism of the providers of pastoral awareness of working together Face of Parishes in a Changing care in health. This is obtained for a common objective. It also 15 World’. In this document through the basic and on-going means being convinced that the 75 there are various suggestions training both of priests and of primary effective witness that along these lines. For example, all pastoral workers. Today the the Christian community can the welcoming of everyone (n. health-care and hospital world offer contemporary society is 4), answering the basic ques- is very complex and diversi- specifically that of being one in tions of the human heart (n. 6), fied; the problems are multi- the Trinity and being ‘one heart care for our weakest brethren plying in a disproportionate and one soul’. From commu- (n. 9), and care and concern for way and the requests of sick nion should then spring the co- the least amongst us (n. 10). people have become more de- operation and co-responsibility manding and more profound. of the pastoral team: the pas- For these reasons, priests and toral workers are not mere car- pastoral workers should feel riers out of commands but ma- the need to qualify their actions ture and responsible Christians in a professional sense in order who contribute, each in line to acquire ‘relevance’ and ‘sig- with their own specific voca- nificance’ in the health-care tion, to the shared mission of community. The more they are the ecclesial community. trained in their sector the more their pastoral service will be effective and fecund. For that CONCLUSION matter, pastoral workers cannot justify their presence simply In concluding we can state through the distribution of holy that in a descriptive way the communion but are called to Office for Pastoral Care in live that pastoral care in health Health can be defined as being that Pope John Paul II defined ‘a body that expresses the lov- as activity ‘capable of sustain- ing care and concern and the 2. The new ministerial forms ing and fostering attention, operating presence of the of pastoral care in health. The nearness, presence, listening, Church in relation to the sick, document of the Italian Bish- dialogue, sharing, and real help the world of health and health ops’ Conference cited above toward individuals in moments care, and the question and is- has an illuminating phrase in when sickness and suffering sues of health and illness, so as relation to this question: sorely test not only faith in life to bring the light and the grace ‘Priests should always see but also faith in God and his of the Lord with the gospel of 17 themselves as being inside a love as Father’. If we are in life, of suffering and charity. presbytery and within a sym- Europe at a political and eco- For this reason, it is dedicated phony of ministries and initia- nomic level, one should also to ordinary pastoral care of the tives: in the parish, in the dio- begin to think at a European healing community in the cese and in its expressions. The level in the field of pastoral health-care structures and the parish priest should be less a care in health as well, which in local area based upon the sick man of doing and direct action some countries already in- and the suffering, as active and and more a man of volves training standards for responsible subjects of the communion; and thus he pastoral workers. work of evangelisation and sal- should be concerned to pro- 4. The promotion of pastoral vation; upon the Christian illu- mote vocations, ministries and bodies for communion. Such mination of the problems of the

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 76

health-care world (training, hu- Notes tives that were engaged in during that pe- 1 riod. Unfortunately, a scarce amount of manisation, scientific re- Cf. the letter of Archbishop Msgr. written documentation was given to the Mariano Magrassi to Nunzio Leonardo search…) and the animation of dire6ctor of the new Office. Di Taranto on the appointment of some- The building of the diocesan office the local area as regards the one to be head of pastoral care in health in for pastoral care in health is located at the questions and issues of health the archdiocese of Bari (prot. n. 20/86, 26 diocesan seminary in Corso A. De care (the dignity of the human May 1986). Amongst other things the Gasperi, 274/A, Bari. Archbishop wrote: ‘The work is great be- 7 8 PSCI, n. 40. person, respect for and defence cause suffering makes men nearer to God, Ibidem, n. 65. of life, the promotion of more similar to Jesus and more detached 9 10Cf. PSCI, n. 78. health); upon the sensitisation from the world. The world of health care In this part of my papare I draw upon will make you meet all the social classes, L.N. DI TARANTO, ‘L’Ufficio per la Pas- of the Christian community and and in various circumstances. With great torale della Salute per la Promozione del- in particular parishes, groups, goodness direct everyone to the smile of la Vita nell’Arcidiocesi di Bari-BItonto’, associations, pastoral bodies, human and divine grace and continue in in CAMILLIANUM, review of the Inter- and holistic care for sick peo- the diocese that work that you have al- national Institute for the Theology of Pas- 18 ready engaged in with the chaplains of toral Care in Health - CAMILLIANUM, ple and their families’. your Order’ (in ‘Archive of the Diocesan year V, first quarter 2005, number 13, Office for Pastoral Care in Health’, I fal- new series, pp. 163-173. In a word, the primary and 11 done 1986/87). OHN AUL 2 12 J P II, Salvifici doloris, n. 29. fundamental commitment of Cf. G. GHILARDI I, ‘La Consulta CEI, Evangelizzazione e testimoni- the Office is to promote the Nazionale per la Pastorale Sanitaria’, pp. anza della carità - Orientamenti pastorali value of life and the dignity of 55-62, in Insieme per servire, the review dell’Episcopato italiano per gli anni ’90, of the Italian Association for Pastoral 8 December 1990, n. 48. the person both in health and in Care in Health, year XX, n. 1, January- 13 14 PSCI, n. 59. suffering, from the moment of March 1996, proceedings of the national L.N. DI TARANTO, La Cappellania conception until its natural end, conference of the AIPaS on ‘three faces ospedaliera mista - Una novità ecclesiale of hope: reflection, co-operation, plan- nelle istituzioni sanitarie (Camilliane, in the Christian vision pro- ning’, Collevalenza (PG), 9-13 October Tur1i5n, 1999). posed by the Church through 1995; L.N. DI TARANTO, La chiesa nel CONFERENZA EPISCOPALE 76 her history and her Magisteri- mondo della sanità che cambia (Camil- ITALIANA, Il volto missionario delle lian3e, Turin, 2002), pp.11-19. parrocchie in un mondo che cambia, 30 um. The local Church of Bari- Cf. L.N. DI TARANTO, ‘A.N.C.R.O. May 2004. Un’associazione nuova per un servizio 16 Bitonto has had the grace of 17 Ibidem, n. 12. enjoying the service of this Of- antico’, in Insieme per servire, year I, n. JOHN PAUL II, , Christifideles laici 1, p4p. 3-12. –Post-synodal Apostolic Exhortation on fice for twenty years: may God Cf. CONSULTA NAZIONALE CEI the ‘Vocation and Mission of the Lay be praised and thanked! PER LA PASTORALE DELLA SANI- Faithful in the Church and the World’ (30 TA’, La pastorale della salute nella Dec18ember 1988), n. 54. I ARANTO chie5 sa italiana: PSCI, pp. 65-78. Cf. L.N. D T , La Chiesa nel Rev. LEONARDO NUNZIO Cf. The diocesan bulletins of that mondo della Sanità che cambia (Camil- DI TARANTO years report the principal pastoral initia- liane, Turin, 2002), pp. 40-41.

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 77

Pastoral Care in Health in Poland

I would like to express my After making this premise, I of the Church. One has to re- gratitude to the heads of the will now describe certain of the spond to the deepest questions Pontifical Council for Health most relevant aspects of the of man that bear upon the Pastoral Care and to those who vast activity engaged in by our essence of human life and of work most closely with it in or- Commission for Pastoral Care Christian faith, and this is not der to express the pastoral care in Health possible with a solid and pro- and concern of the Church for found theological reflection. the sick, helping all those who In addition to this meeting provide service to the sick and 1. On-going Training there are other meetings and suffering so that the apostolate conferences devoted to up-dat- of mercy can respond in an in- Training occupies a privi- ing and to the examination of creasingly better way to the leged place in our activities be- documents drawn up by the challenges of the third millen- cause we are aware that illness Pontifical Council for Health nium. In taking part as a mem- and suffering are phenomena Pastoral Care or to specific ber of this Pontifical Council in which, if looked at in depth, subjects that today involve the two of its general assemblies, I raise questions that always go conscience of Christians, for have been able to observe per- beyond medicine to touch the example: abortion, euthanasia, sonally how important pastoral essence of the human condition AIDS, and drugs. These con- care in health is in today’s in this world (cf. Dolentium ferences involve the participa- world, which wants to promote Hominum, n. 2). To this end, tion of all those who work in 77 the civilisation of death by in- every year, on the first Sunday the field of health and suffer- creasingly opposing itself to of Easter, in Niepokalanow ing. the culture of life, which was (which is near to Warsaw), a In addition, I would like to so much called for by our un- course of training for a large emphasise that of notable im- forgettable and beloved Pope, number of priests (sixty in all) portance in the on-going train- the Servant of God John Paul responsible for pastoral care in ing promoted by our Episcopal II. In addition to the great docu- health in their dioceses is or- Commission are also spiritual ments of the Magisterium of ganised. The bishop responsi- exercises and the national pil- the Church, in the promotion of ble for pastoral care in health grimage of health-care work- pastoral care in health in our always takes part in this meet- ers. This initiative by now con- churches the experiences of the stitutes a long-standing tradi- meetings, as a well as the tion, indeed it goes back over ‘Work Plan 2002-2007’, of the sixty years, and thus also exist- Pontifical Council for Health ed under the communist Pastoral Care have been of regimes. At the feet of the great help. Black Madonna, during the last week of May of every year, Pastoral Care in Health in health-care workers (medical Poland is Organised in the fol- doctors, pharmacists, nurses, lowing way: and women and men religious involved in the field of health At a national level: and health care) engage in a The Commission of the pilgrimage and about five thou- Bishops’ Conference for Pas- sand people take part in this. toral Care in Health, which About one thousand health- promotes, co-ordinates and di- care workers take part in the rects all the sectors of pastoral spiritual retreat. care in health in Poland: The bishop responsible for ing. This meeting, to which are pastoral care in health, support- invited the best speakers and 2. The World Day of the Sick ed by a group of close helpers: specialists in various disci- The National Director for plines ranging from theology to The World Day of the Sick in Pastoral Assistance to Health bioethics, helps those attending Poland is celebrated in a very Care Workers. to understand that pastoral care solemn way. It is a moment of The National Director for the in health is not possible without particular significance and im- Apostolate of the Sick. a theological grounding and portance for pastoral care in The National Director for that pastoral care in health sep- health. It is celebrated in a Hospices. arated from Christ who is solemn way in the parishes, in Health and Salvation, too, is the hospitals and in the various At a diocesan level: not possible. Priests during Catholic and non-Catholic A diocesan office for pas- these days of training can ob- places of care. Chaplains and toral care in health, chaired by serve that compassionate and pastors of souls organise in an a priest, now exists in each dio- philanthropic love is not effective way moments of cese in Poland. enough. This is not the mission prayer, reflection and study in

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 78

these local areas and health- 4. Catholic Medical Doctors close contact with the diocesan care workers, sick people and delegates for pastoral care in their family relatives take part The immediate outcome of health. This association is very in these initiatives. the celebration of the Second active in the professional, reli- At a national level one of the World Day of the Sick at the gious and human fields. tasks of the Episcopal Com- sanctuary of the Black Madon- mission is to prepare for this na of Częstochowa on 11 Feb- World Day, to disseminate the ruary 1993 was the creation of 6. Catholic Hospital Message of the Pope and vari- the Association of Polish Chaplains ous kinds of material, and to Catholic Doctors. Three thou- engage in other initiatives as sand doctors now belong to this Since the fall of the commu- well. For some years now the association and its president is nist regime in 1989 a new situ- mass media, the TV channels Dr. Anna Gręziak of Warsaw. ation has arisen for the organi- and various Catholic and non- This association has branches sation of spiritual care for pa- Catholic radio channels have in nearly every diocese of the tients and health-care workers given a great deal of space to country. In recent years it has in hospitals and other places of the celebration of the World promoted a series of pro-life care. At the present time the Day of the Sick. We are respon- initiatives. There have also status of a chaplain is recog- sible for ensuring that the offi- been symposiums on the en- nised by the state and thus cial celebrations promoted by cyclical Evangelium Vitae and chaplain priests are employed the Pontifical Council for on the Charter for Health Care in Catholic and non-Catholic Health Pastoral Care also have Workers of the Pontifical health-care structures. They a delegation from Poland. The Council for Health Pastoral work full time or short time ac- 78 celebration of the World Day of Care. I may add that this asso- cording to the agreements that the Sick does not finish with 11 ciation closely follows, through are made. As regards spiritual February: an attempt is made to the participation of its repre- care for sick people in the put what has been said into sentatives, the annual interna- parishes, this is organised by practice throughout the year. tional conferences or other spe- the pastors. In every parish, on cific meetings promoted by the the first Friday or Saturday of Pontifical Council for Health the month priests visit the sick 3. The Apostolate of the Sick Pastoral Care. A representative and elderly people in their of this association took part in homes and bring them holy Within our Episcopal Com- the tenth congress of the communion or administer the mission there is a Sector for the FEAMC which was held in sacrament of the anointing of Apostolate of the Sick, and this Bratislava in Slovakia on 1-4 the sick to them. One may say has a director at a national lev- July, when Your Eminence that in a few years we have el. This body was founded on gave a magisterial lecture on managed to achieve good co- 12 May 1930 by the Metropoli- the subject ‘New Challenges ordination amongst Catholic tan-Archbishop of Lviv, H.E. for Medicine and Health-Care hospital chaplains. Amongst Msgr. Bolesław Twardowski. Workers in Europe’. the various initiatives engaged The national secretariat pro- Naturally, their activity is in, there are training and up- motes prayer by sick people carried out in close contact dating courses. Cardinal Javier and with sick people, and this with the Episcopal Commis- Lozano Barragán took part in is both liturgical and non-litur- sion for Pastoral Care in one of these training meetings gical prayer. It is also responsi- Health. We hope that many in Danzig in 1999 and gave a ble for the publication of the Polish medical doctors who are magisterial prolusion on Fides monthly review ‘The Aposto- excellent professionals and et Ratio. It is to be hoped that in late of the Sick’. In addition, Christians will join our associa- the future a Union of Catholic pilgrimages to Marian sanctu- tion. Hospital Chaplains will be cre- aries, spiritual exercises, and ated at a national level (over other initiatives are also pro- 1,500 chaplains provide spiri- moted and organised by this 5. Catholic Nurses tual care in hospitals and other body. Of primary importance is and Obstetricians places of care) and this could the pilgrimage to the sanctuary form a part of a Union of Hos- of Częstochowa on 6 July on The association that was cre- pital Chaplains at an interna- the occasion of the Feast of Our ated on 27 May 1995 has tional level, an initiative much Lady Health of the Sick. There amongst its goals that of the called for by the Pontifical is also the lively spiritual and Christian and ethical formation Council for Health Pastoral physical participation in the of its members and the promo- Care. World Day of the Sick or other tion of encounter and commu- difficult moments experienced nication between them. Its head by individual nations. The offices are in Warsaw. The 7. Catholic Hospitals, members of this Apostolate of- president of this association, Hospices, Nursing Homes fer their prayers and the gift of which has seven hundred nurs- and Rest Homes etc. their suffering most willingly es and obstetricians as its mem- to the petrine ministry of the bers, is Dr. Iwona Stanis. This As has been the case with Holy Father and to the univer- association already has nine- hospital chaplains, after 1989 sal Church. teen branches and they are in the Church in Poland has grad-

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 79

ually been organising itself in Catholic structures and in the lotinum. At the present time in this field as well. At the present Caritas of the Catholic Poland we have five reviews time there are five Catholic Church. The World Sympo- that help to promote pastoral hospitals and these are the sium on Catholic Voluntary care in health and the pastoral property of religious orders: of Work in Health Care, which care of illness at a national lev- the Fatebene fratelli, of the was held in the Vatican on 30 el: The Apostolate of the Sick, Camillians, of the Sisters of St. November and 1 December The Patient, The Anchor, Letter Elizabeth and of the Sisters of 2001, was of great help in pro- to the Sick and Rise Up! St. Charles Boromeo. These moting voluntary work. The structures, and their medical proceedings of the symposium and paramedical staff, bear wit- and other material that was Conclusion ness to the Gospel of suffering sent to us by the Pontifical in this field. As a part of our Council for Health Pastoral The data and information field of responsibilities we are Care were distributed by our that I have just presented on also organising their union at a Episcopal Commission. How- pastoral care in health in national level in order to ever, voluntary work is a new Poland give us great satisfac- achieve effective co-operation reality and a great deal has still tion and joy because since 1989 with the AISAC. to be learnt in this field. What everything has really been done In addition to these hospital we hope is that the associa- to promote, co-ordinate and structures, at the present time tions really implement Christ- guide pastoral care in health. the Church also has thirty-eight ian values in their service and However, the Polish prelates hospices. These are well organ- also that they are non-profit are aware that we cannot halt ised from an organisational making associations. because there are very many point of view and above all else challenges and very many dan- 79 in them spiritual, human and gers, above all against life, professional care for the dying 9. Publications and the which is sacred, and as such and for their family relatives is Distribution of Specialist must be defended from concep- assured. Overall in Poland Material tion until its natural end. there are more than a hundred Thus in the future we want to hospices. The Church also has The subjects and the ques- continue with fervour along the thirty-four homes for elderly tions and issues addressed by path that has been followed, people, single mothers and the the review of the Pontifical and which so far has borne homeless; ninety-seven insti- Council for Health Pastoral good fruit, in order to bear wit- tutes of care and rehabilitation; Care, Dolentium Hominum. ness in an ever stronger way to and about seventy non-public Church and Health in the the Gospel of Suffering, of health-care centres. World, are communicated to which our most beloved Pope, those who are responsible for the Servant of God John Paul this area and then communicat- II, was the icon. 8. Catholic Voluntary ed at a national level. The text- Health-Care Workers book of the Pontifical Council, H.E. Msgr. WŁADYSŁAW ZIOŁEK The Church, Drugs and Drug- Metropolitan-Archbishop of Łódź, Catholic voluntary work in Addiction, has been translated Bishop Responsible for health care is becoming in- into Polish and will be pub- Pastoral Care in Health, creasingly present, above all in lished in the near future by Pal- Poland

DOLENTIUM HOMINUM N. 63-2006 DH n.63 ing 1-80 16-01-2006 17:14 Pagina 80