DOLENTIUM HOMINUM N. 71 – Year XXIV – No. 2, 2009

JOURNAL OF THE PONTIFICAL COUNCIL FOR HEALTH CARE WORKERS (FOR HEALTH PASTORAL CARE)

ARCHBISHOP ZYGMUNT ZIMOWSKI,,Editor-in-Chief CORRESPONDENTS BISHOP JOSÉ L. REDRADO, O.H., Executive Editor REV.MATEO BAUTISTA, Bolivia MONSIGNOR J. JAMES CASSIDY, U.S.A. REV.RUDE DELGADO, 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. 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

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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 Contents

4 Speech of the Holy See Delegation 26 Human Resources to the 62nd World Health Assembly in Catholic Health-Care Structures: S.E. Msgr. Zygmunt Zimowski What Sustainability for the Future The Pontifical Council for Health Care Workers THE XVII WORLD DAY OF THE SICK 11 FEBRUARY 2009 34 Hospitals as Settings for the Exploration and Practice of Hope 6 Account H.E. Msgr. José Luis Redrado, O.H. Msgr. Dariusz Giers 40 The Mental Capacity Act 2005: 8 Angelus Bioethical Assessments Benedict XVI Rev. Bonifacio Honings, O.C.D.

9 Address of the Holy Father 43 Prior Decisions Concerning Life: Benedict XVI a Guide for Catholics Rev. Bonifacio Honings, O.C.D. 11 The World Day of the Sick 2 in the Spanish Church 46 Accompanying the Family The Department for Pastoral Care in Health, Rev. Arnaldo Pangrazzi, M.I. the Spanish Bishops’Conference

12 The World Day of the Sick in Bolivia TESTIMONIES Msgr. Walter Pérez Villamonte 50 Physician and Apostle: 12 The World Day of the Sick, a Survey of the Life and Virtues Iraq, Baghdad of the Pedro Herrero Rubio 13 Taiwan, the World Day of the Sick H.E. Msgr. Rafael Palmero Ramos

16 Australia 55 Spain: the Association of Christian H.E. Msgr. Philip Wilson, DD JGI Health-Care Workers Rev. Rudesindo Delgado

TOPICS 61 Suffering, a School of Life: the Servant of God 20 The Faith of Priests in Limit Situations Manuel Lozano Garrido Rev. Rudesindo Delgado H.E. Msgr. José Luis Redrado, O.H.

Appointment of the Under-Secretary of the Pontifical Council for Health Care Workers

On 31 July 2009 the Holy Father appointed Rev. Msgr. Jean-Marie Musivi Mpendawatu Under-Secretary of the Pontifical Council for Health Care Workers for a five-year period. He replaces Rev. Fr. Felice Ruffini M.I., who finishes his service for reasons of age.

So many thanks to Fr. Ruffini for the service that he has rendered over the last twenty-four years as Under-Secretary of the Pontifical Council for Health Care Workers

The illustrations in this edition are taken from the book: L’amore di Dio per noi, il Vangelo published by Editrice Velar, Gorle (BG)

DOLENTIUM HOMINUM N. 71-2009

Speech of the Holy See Delegation to the 62nd World Health Assembly 18-27 MAY 2009, GENEVA, SWITZERLAND

Mr/Mme Chair: bility that is carried by faith-based organisa- I wish to present the Holy See’s sincere tions and thousands of Church-sponsored congratulations and good wishes on your ap- health-care institutions in the provision of pointment to this important office. support and treatment to those living in Recently appointed by His Holiness poverty. The increasing financial burden Benedict XVI as the President of the Pontifi- placed on governments during this economic cal Council for Health Care Workers, I con- crisis is felt even more acutely by the Church sider it a great honour to share with the dele- – sponsored institutions that are often de- gates at this 62nd World Health Assembly prived of access to governmental or interna- some of the reflections and concerns of the tional funding and yet persevere in the strug- Holy See. In relation to the impact on health gle to serve those most in need. The values 4 and health-care during this period of global that motivate such service on the part of faith- economic crisis, the Holy See shares the pre- based organizations, in addition to the over- occupation already expressed by other dele- riding value of the sacredness and dignity of gates. human life, include some of the same princi- The current crisis has raised the specter of ples articulated in the Resolution on Primary the cancellation or drastic reduction of exter- Health Care being considered by this Assem- nal assistance programs, especially for less bly. I refer to principles such as “equity, soli- developed countries. This will dramatically darity, social justice and universal access to jeopardize the state of their health systems, services.”2 which are already overburdened by endemic, epidemic and viral diseases. Pope Benedict Mr/Mme Chair, XVI in his message to the G-20 observed that In 1998 the Pontifical Council – prompted “the way out of the current global crisis can by the World Health Organization – conduct- only be reached together, avoiding solutions ed a research in local Churches on the chal- marked by any nationalistic selfishness or lenges faced by the international community protectionism.” He therefore calls for “a in the attainment of health for all. The results courageous and generous strengthening of in- of this inquiry showed that one of the greatest ternational co-operation, capable of promot- challenges was the implementation of the ing a truly humane and integral develop- principle of equity.3 A decade later, I am ment.”1 afraid to note that this challenge still holds in My delegation also wishes to point out the most countries. My delegation therefore notes high importance and the particular responsi- with great attention the resolution concerning the Social Determinants of Health that is pro- posed for passage by this Assembly and is particularly interested in the urgent plea con- tained therein for governments “to develop and implement goals and strategies to im- prove public health with a focus on health in- equities.” 4 Furthermore, there is a shared concern for the millions of children globally who do not reach their full potential due to the serious gaps in health equity. This same concern was addressed by Pope Benedict XVI to the par- ticipants at the 2008 International Conference of the Pontifical Council for Health Care Workers, when he called for “a decisive ac- tion aimed at preventing illnesses as far as possible” among these children and when they are present, treating them “by means of

DOLENTIUM HOMINUM N. 71-2009 the most modern discoveries of medical sci- nomic models, necessary though they are. ence as well as by promoting better standards Justice is achieved only if there are upright of hygiene and sanitation, especially in the people.”7 less fortunate countries” 5 Thank you, Mr/Mme Chair.

Mr/Mme Chair, H.E. Msgr. ZYGMUNT ZIMOWSKI We cannot allow such defenseless children, President of the Pontifical Council for Health Care Workers, their parents and other adults in low-income the Holy See communities throughout this world to be- come even more vulnerable as a result of the Notes global economic crisis, which is largely fu- 1 BENEDICT XVI, Letter to Mr. Gordon Brown ahead of the elled by selfishness and greed. Thus the Holy G20 Summit, 30 March 2009. Father insists that we “need a strong sense of 2 http://www.who.int/gb/ebwha/pdf_files/EB124/B124_R8- en.pdf. global solidarity between rich and poor coun- 3 Pontifical Council for Health Pastoral Care, Research on tries, as well as within individual countries, “Project de document de consultation pour l’actualisation de la stratégie mondial de la santé pour tous”, Rome 1998, (un- including affluent ones. A common code of published text). ethics is also needed, consisting of norms 4 http://www.who.int/gb/ebwha/pdf_files/EB124/B124_R8- en.pdf. based not upon mere consensus, but rooted in 5 BENEDICT XVI, Address to Participants in the 23rd Inter- national Congress on the Pastoral Care in the Treatment of the natural law inscribed by the Creator on Sick Children, 5 November 2008, Rome. the conscience of every human being (cf. 6 BENEDICT XVI, Message for the Celebration of the World 6 Day of Peace, 1 January 2009, n. 8. Rom 2:14-15)”. Because, “justice cannot be 7 BENEDICT XVI, Address to the Parish Priests and Clergy 5 created in the world solely through good eco- of the Diocese of Rome, 26 February 2009.

DOLENTIUM HOMINUM N. 71-2009 The XVII World Day of the Sick 11 February 2009

6

Account

The Holy Father Benedict of God, would thereby be mul- There are tiny human beings XVI expressed in his Message tiplied The same hope applies who bear in their bodies the the following wish: ‘I therefore to health-care centres and to consequences of incapacitating hope that the World Day of the groups responsible for pastoral diseases, and others who are Sick will offer the parish and care in hospitals throughout the fighting illnesses that are still diocesan communities an op- world. incurable today, despite the portunity to be ever more aware progress of and the that they are the “family of assistance of qualified re- God” and will encourage them A Summary of the Message searchers and health-care pro- to make the love of the Lord, fessionals. There are children who asks that “within the eccle- ‘Human life is beautiful and injured in body and in mind, sial family no member should should be lived to the full, even subsequent to conflicts and suffer through being in need”, when it is weak and enveloped wars, and other innocent vic- visible in villages, neighbour- in the mystery of suffering’. ‘At tims of the insensate hatred of hoods and cities’. In order to the same time, I address a adults’. put into practice this wish of the heartfelt appeal to the leaders of Pope it would be appropriate if nations that they will strengthen the above-mentioned Message the laws and provisions for sick The Solemn Concelebration and the speech of greetings that children and their families’. ‘In in St. Peter’s Basilica the Pope offered to sick people fact, it is necessary to assert during the solemn celebration vigorously the absolute and On 11 February, the liturgical in the Basilica of St. Peter’s on supreme dignity of every human memorial of the Immaculate 11Februaryofthisyearbe- life’ which ‘is beautiful and of Lourdes, a celebration came the subject of continual should be lived to the full, even of the Eucharist took place in reflection, in each parish in when it is weak and enveloped the Vatican basilica presided particular, in whose area there in the mystery of suffering’. over by Cardinal Javier Lozano exist so many invisible wards, ‘This year our attention focuses Barragán. Together with the with the hope that the dea- in particular on children, the President of the Pontifical conate of charity, an inex- weakest and most defenceless Council for Health Care Work- haustible source of spiritual life creatures, and on those of them ers, the other concelebrants and a sign of the merciful love who are sick and suffering. were Cardinal Agostino Vallini,

DOLENTIUM HOMINUM N. 71-2009 Cardinak Ivan Dìas, Cardinal trade and involved in wars, call Immaculate Virgin of Lourdes. Antonio Cañizares Llovera and on all of us to pray for and im- In that sacred place, our heav- Cardinal Bernard F. Law. plore the mercy of God towards enly Mother came to remind us Amongst the bishops present mankind. that on this earth we are only there were the Secretary of the During the celebration of the passing through and that the hu- Pontifical Council, José Luis Eucharist, the sacrament of the man being’s true and definitive Redrado, and Rino Fisichella, anointing of the sick was ad- dwelling place is Heaven. We the President of the Pontifical ministered to ten people. must all strive for this goal’. Academy for Life. Around the After the address of the Pope altar of the confession were the lights went out and the gathered a large number of The Meeting of faithful, after lighting candles, priests of the Pontifical Coun- Benedict XVI with the Sick sung the Ave Maria of Lourdes. cil, of the diocese of Rome, and in the Vatican Basilicata This was a very beautiful and numerous spiritual assistants of atmospheric moment which theUNITALSIandtheOpera The Holy Father Benedict evoked the atmosphere of the Romana Pellegrinaggi, the two XVI, who arrived in the basilica Marian sanctuary with its torch- organisations which were re- at the end of the Eucharist, of- light processions. The Holy Fa- sponsible for the preparations fered those present a profound ther, visibly moved by the at- for this event. reflection on the inestimable mosphere that had been created In his introduction to the value of life. during his meeting with the Holy , Cardinal Javier ‘Human life is not a dispos- sick, blessed them and stopped Lozano Barragán, after greeting able good but a precious coffer to personally greet about twen- the distinguished figures pre- to be preserved and looked af- ty people in wheelchairs, to- sent, greeted the large number ter’; ‘faith helps us to consider gether with very many other 7 of sick people, disabled people, human life beautiful and wor- sick people who were present volunteers and agents of pas- thy of living to the full, even with those who accompanied toral care in health who had when it is undermined by evil’; them, who that evening joined come to the basilica from Rome ‘With his passion and his death in prayer with the successor to and other parts of Italy. The [Christ] took our weakness up- St. Peter. prelate observed that pain and on himself and totally trans- suffering, especially in the most formed it’; ‘My venerable Pre- Msgr. DARIUSZ GIERS innocent and the youngest, who decessor John Paul II wished Official of the Pontifical Council are afflicted by illnesses, ex- the World Day of the Sick to for Health Care Workers, ploited, the victims of the sex coincide with the Feast of the the Holy See.

DOLENTIUM HOMINUM N. 71-2009 Angelus

SAINT PETER’S SQUARE, SUNDAY, 8 FEBRUARY 2009

Dear Brothers and Sisters, ple, in today’s passage we read that The Gospel today (cf. Mk 1: 29-39) in “healed many who were sick with various close continuity with last Sunday’s presents diseases, and cast out many demons” (Mk 1: to us Jesus who, after preaching on the Sab- 34); in another passage from St Matthew it bath in the synagogue of Capernaum, heals says that Jesus “went about all Galilee, teach- many sick people, beginning with Simon’s ing in their synagogues and preaching the mother-in-law. Upon entering Simon’s house, Gospel of the Kingdom and healing every he finds her lying in bed with a fever and, by disease and every infirmity among the peo- taking her hand, immediately heals her and ple” (Mt 4: 23). Jesus leaves no room for has her get up. After sunset, he heals a multi- doubt: God whose Face he himself revealed tude of people afflicted with ailments of is the God of life, who frees us from every every kind. The experience of healing the sick evil. The signs of his power of love are the occupied a large part of Christ’s public mis- healings he performed. He thus shows that 8 sion and invites us once again to reflect on the the Kingdom of God is close at hand by meaning and value of illness, in every human restoring men and women to their full spiritu- situation. This opportunity is also offered to al and physical integrity. I maintain that these us by the World Day of the Sick which we cures are signs: they are not complete in shall be celebrating next Wednesday, 11 Feb- themselves but guide us towards Christ’s ruary, the liturgical Memorial of Our Lady of message, they guide us towards God and Lourdes. make us understand that man’s truest and Despite the fact that illness is part of human deepest illness is the absence of God, who is experience, we do not succeed in becoming the source of truth and love. Only reconcilia- accustomed to it, not only because it is some- tion with God can give us true healing, true times truly burdensome and grave, but also life, because a life without love and without essentially because we are made for life, for a truth would not be life. The Kingdom of God full life. Our “internal instinct” rightly makes is precisely the presence of truth and love and us think of God as fullness of life indeed, as thus is healing in the depths of our being. One eternal and perfect Life. When we are tried by therefore understands why his preaching and evil and our prayers seem to be in vain, then the cures he works always go together: in doubt besets us and we ask ourselves in an- fact, they form one message of hope and sal- guish: what is God’s will? We find the answer vation. to this very question in the Gospel. For exam- Thanks to the action of the Holy Spirit, Je- sus’ work is extended in the Church’s mis- sion. Through the sacraments it is Christ who communicates his life to multitudes of broth- ers and sisters, while he heals and comforts innumerable sick people through the many activities of health-care assistance that Chris- tian communities promote with fraternal charity. Thus they reveal the true Face of God, his love. It is true: very many Christians around the world priests, religious and lay people – have lent and continue to lend their hands, eyes and hearts to Christ, true physi- cian of bodies and souls! Let us pray for all sick people, especially those who are most se- riously ill, who can in no way provide for themselves but depend entirely on the care of others. May each one of them experience, in the solicitude of those who are beside them, the power and love of God and the richness of his saving grace. Mary, health of the sick, pray for us!

DOLENTIUM HOMINUM N. 71-2009 Address of His Holiness Benedict XVI to the Sick, at the End of the Eucharistic Celebration Presided over by Cardinal Javier Lozano Barragán, in St. Peter’s Basilica, on the XVII World Day of the Sick, Memorial of Our Lady of Lourdes

WEDNESDAY, 11 FEBRUARY 2009

Dear Sick People, and most defenceless of creatures. It is true! If Dear Brothers and Sisters, we are left speechless before an adult who is Our meeting has a special value and signif- suffering, what can we say when illness af- icance: it is taking place on the occasion of fects an innocent child? the World Day of the Sick which occurs to- How is it possible to perceive the merciful day, the Memorial of Our Lady of Lourdes. love of God, who never abandons his children My thoughts turn to that Shrine which I too in trial, even in these difficult situations? 9 visited on the occasion of the 150th anniver- Such questions are frequent and at times dis- sary of the Apparitions to St Bernadette. And turbing. Truly, they find no adequate answers I have kept a vivid memory of that pilgrim- on the merely human level since the meaning age which was focused in particular on the of pain, illness and death remains incompre- contact I had with the sick gathered at the hensible to the human mind. However, the Grotto of Massabielle. I have come very glad- light of faith comes to our aid. The Word of ly to greet you at the end of the Eucharistic God reveals to us that even these ills are mys- celebration at which Cardinal Javier Lozano teriously “embraced” by the divine plan of Barragán, President of the Pontifical Council salvation; faith helps us to consider human for Health Care Workers, has presided. I ad- life beautiful and worthy of living to the full, dress a cordial thought to him. Together with even when it is undermined by evil. God cre- him I greet the Prelates present and the ated the human being for happiness and for priests, men and women religious, volunteers, life, while illness and death entered the world pilgrims and especially the beloved sick peo- as a consequence of sin. However, the Lord ple and those who care for them daily. It is al- has not left us to ourselves. He, the Father of ways moving to relive in this circumstance, life, is the physician of man par excellence here, in St Peter’s Basilica, that typical at- who ever lovingly bends over suffering hu- mosphere of prayer and Marian spirituality manity. The Gospel shows Jesus who “cast which characterizes the Shrine of Lourdes. Thank you, therefore, for this expression of your faith and love for Mary; I thank all those who have sponsored and organized this event, especially UNITALSI [the Italian National Union for Transporting the Sick to Lourdes and International Shrines] and the Opera Ro- mana Pellegrinaggi [Roman Society for Pil- grimages]. This Day invites us to feel with greater in- tensity the spiritual closeness to the Church’s sick which, as I wrote in the Encyclical Deus caritas est, is the family of God in the world within which no one must go without the ne- cessities of life (cf. n. 25b). At the same time, today we are given the opportunity to reflect on the experience of illness, suffering, and more generally, on the meaning of life to be lived to the full even in suffering. In the Mes- sage for today’s event, I wished to focus at- tention on sick children who are the weakest

DOLENTIUM HOMINUM N. 71-2009 out the spirits... and healed all who were sick” tery of his death and Resurrection. Every Eu- (Mt 8: 16), pointing out the way of conver- charistic celebration is the perennial memori- sion and faith as conditions for obtaining al of the Crucified and Risen Christ, who de- healing of body and mind. With his passion feated the power of evil with the omnipotence and his death he took our weakness upon of his love. It is therefore at the “school” of himself and totally transformed it. This is the Eucharistic Christ that we are granted to why according to what the Servant of God learn and to love life always and to accept our John Paul II wrote in his Apostolic Letter apparent powerlessness in the face of illness Salvifici doloris “To suffer means to become and death. particularly susceptible, particularly open to My venerable Predecessor John Paul II the working of the salvific powers of God, of- wished the World Day of the Sick to coincide fered to humanity in Christ” (n. 23). with the Feast of the Immaculate Virgin of Dear brothers and sisters, we are increas- Lourdes. In that sacred place, our heavenly ingly realizing that human life is not a dispos- Mother came to remind us that on this earth able good but a precious coffer to be pre- we are only passing through and that the hu- served and looked after with every possible man being’s true and definitive dwelling attention, from the moment of its origin to its place is Heaven. We must all strive for this ultimate natural end. Life is a mystery that in goal. May the light that comes “from on itself demands responsibility, love, patience High” help us to understand and to give and charity, on the part of each and every one. meaning and value to the experience of suf- 10 It is especially necessary to surround those fering and death too! Let us ask Our Lady to who are sick and suffering with care and re- turn her motherly gaze on every sick person spect. This is not always easy; yet we know and on his or her family, to help each one to where to find the courage and patience to face carry the weight of the Cross with Christ! Let the vicissitudes of earthly existence, and in us entrust to her, the Mother of humanity, the particular sickness and every kind of suffer- poor, the suffering, the sick of the whole ing. For us Christians, it is in Christ that the world, with a special thought for suffering answer is found to the enigma of pain and children! With these sentiments, I encourage death. By participating in Holy Mass, as you you to trust in the Lord always and I warmly have just done, we are immersed in the mys- bless you all.

DOLENTIUM HOMINUM N. 71-2009 The World Day of the Sick in the Spanish Church

The world of pastoral care in inthefaceoftheirsickbrother 11 February is the date when health in Spain received the the Face of Christ who, in suf- the diocesan Church celebrates creation of the World Day of fering, dying and rising again, the World Day of the Sick to- the Sick with joy and satisfac- achieved the salvation of gether with the universal tion. Because of its own expe- mankind. In addition, it had to Church. Each diocese has its rience, it was convinced that be done in harmony with local own specific form of doing the celebration of this day needs and circumstances given this and its own specific plan- would be a very good thing for that one could not forget the ning for the occasion: a cycle sick people, for those who help importance of its target – the of conferences, a diocesan or them and treat them, for those People of God, the many inter-diocesan day, or presence who work in the sphere of pas- Catholic health-care institu- in the mass media (the press, toral care in health, and for the tions, and civil society. radio and television). A dioce- Church as a whole. The Day of the Sick thus san initiative presided over by Ever since 1985, on the came to be the culminating a bishop confers unity and sixth Sunday of Easter, the point of a campaign that begun solemnity on the celebration. World Day of the Sick has with the National Meeting of been celebrated and this cele- Delegates in the month of Sep- bration, which has been re- tember and included a large ceived with warmth and inter- number of initiatives, some at 11 est ever since it began, is with- a national level, some at a lo- out doubt one of the most sig- cal level, and yet others at a nificant and fecund activities diocesan level. of pastoral care in health. This Using the experience that celebration has acquired in- had been accumulated in the creasing relevance and has past and the results that had produced results: the recogni- been produced, an attempt was tion that sick people are active made to link the World Day of individuals; the impulse given the Sick with the beginning to pastoral care in health in and the middle of the Cam- parishes; initiatives taken in paign for the Sick. The Nation- many dioceses based upon this al Days of the Delegates, at the day; an abundance of liturgical end of September, are the be- and doctrinal material produce ginning of the course and the for catechesis; the work of co- moment to begin: once a spe- operation and coordination be- cific subject has been decided tween delegations and various and the general orientation has kinds of agents of pastoral been settled, initial work in- care: and an increasing appre- volving study, analysis and the This is the first important ciation of pastoral care in creation of documents begins. action of a campaign that con- health within the whole of the The World Day of the Sick tinues over the next months Spanish Church, etc. is the central point of the until Easter with the celebra- When John Paul II estab- course and the campaign. tion of the Easter of the Sick. lished the World Day of the There is a first stage of work Both these celebrations, name- Sick as an official appointment involving study and reflection, ly the World Day of the Sick to be celebrated on 11 Febru- and the drawing up of materi- and the Easter of the Sick, con- ary, the feast of Our Lady of als and documents, which goes stitute the solemn inauguration Lourdes, the Episcopal Com- from September to February, of the campaign and its closure mission for Pastoral Care and which allows the World or termination. The activities thought it necessary for the Day of the Sick to be the be- that each diocese engages in Department for Pastoral Care ginning and the solemn inau- during this period and from in Health to analyse together guration of the whole of the one date to another are many with the diocesan delegations campaign. The Message of the in number and varied in char- how the celebration of the Day Holy Father constitutes the acter. 11 February, for many of the Sick in Spain could be point of reference and, togeth- dioceses, is a diocesan celebra- integrated with the World Day er with the material drawn up tion. The period of Easter, the of the Sick without losing its by the Department for Pastoral Easter of the Sick, is a more enormous riches. Care in Health and the dioce- specific celebration and takes We were aware that the day san delegations, it makes up place in a parish context, in was to be an intense moment the preparatory terrain for pas- hospital centres or in rest of prayer, of communion, of toral work that takes place in homes. the offering up of pain for the every diocese and in parish The Department good of the Church, and an ap- and hospital Christian commu- for Pastoral Care in Health, peal to everybody to recognise nities. the Spanish Bishops’ Conference.

DOLENTIUM HOMINUM N. 71-2009 The World Day of the Sick in Bolivia

On 11 February is celebrat- We sincerely thank all those of recognising that every per- ed the World Day of the Sick, who work in pastoral care in son deserves to be cared for a suitable opportunity to re- health because through their and treated in the best way flect on human pain and our generous devotion they im- possible given that this is a hu- solidarity towards our brothers press a more human and man right. and sisters who are in a situa- gospel face on care and assis- We recognise the role of tion of need. tance for the sick. Their free large numbers of medical doc- Illness brings out the whole and humble presence, which is tors, nurses and auxiliaries of human frailty and places the marked by commitment, who through their devotion person who suffers in a world makes present Christ the Good and their generosity work to full of questions. As disci- Shepherd who gives life to humanise health-care centres ples/missionaries of Jesus those who suffer, in body and and to ensure that patients are Christ we must bring hope and spirit, the signs of human treated as people and even care to the weak because only frailty. more as children of God who in this way do we sincerely strive for their fulfilment de- show that we love Jesus. The spite illness and pain. Gospel of Matthew reads: The letter of James tells us: ‘‘Lord when did we see thee ‘Is any one among you suffer- 12 sick or in prison and visit thee? ing? Let him pray. Is any cheer- And the King will answer ful? Let him sing praise. Is them, ‘Truly, I say to you, as there any among you sick? Let you did it to one of the least of him call for the elders of the brethren here, you did it to church, and let them pray over me’’ (25:39-40). him, anointing him with oil in We wish to express our the name of the Lord; and the nearness to our sick brethren prayer of faith will save the and to say that we pray for sick man’ (Jm 5:13-15) them. We know that commu- Thanks to everyone for the nal prayer is effective because solidarity, fraternity and faith the Lord assured us that that they share with their sick ‘where two or three are gath- brethren. May the Lord Jesus, ered together in my name, I am We appeal to all men and who passed by doing good and amongst them’ (Mt 18:20). women of good will to work to healing all kinds of illness, When we are sick we find achieve the overall health of bless you with abundant ourselves immersed in wor- people because pastoral care in graces! ries, in intentions and in mem- health is not something that re- ories but we also manage to gards only voluntary workers Msgr. WALTER PÉREZ find the strength that comes but is something that concerns VILLAMONTE, from other people and which is the whole population of Bo- Bishop of the Diocese of Potosi, manifested in the discovery of livia. One is not dealing with President of the Department brothers and sisters who pray mere assistance to those who of Health, and invoke help for us. are injured in their health but the Bishops’ Conference of Bolivia.

The World Day of the Sick, Iraq, Baghdad

Uniting itself to the appeal of With the blessing of the in the Church of Mary of the Holy Father, Pope John apostolic nunciatures in Iraq the Syriac Catholics. Paul II, which was launched in and His Excellency Msgr. Mat- This day began with a pro- his speech of 11 February 1992 ti Shaba Matoka, the Archbish- cession of the most holy Eu- when he called for a day to be op of the Syriac Catholics and charist, preceded by all the par- dedicated to the sick, the the various Catholic bishops of ticipants and children dressed Church in Iraq every year cele- the diocese of Baghdad, and a as angels in the cathedral, brates the World Day of the large number of relatives, where the of the Sick with all the associations friends and acquaintances, this Chaldeans and other bishops, and communities that care for year the World Day of the Sick the representative of the apos- the sick and the handicapped. was celebrated on 14 February tolic nunciatures Don Matteo

DOLENTIUM HOMINUM N. 71-2009 de Mori, and other priests, be at one with the whole of suf- and the exchange of good monks and sisters belonging to fering humanity. The interces- wishes and greetings, with various congregations, were sions of the people of God thanks being offered to the waiting prayed for peace and prosperity Lord our God for giving us the The Mass was presided over inthecountryandtheendingof grace of being Christians and by Fr. Thaer Saad Allah with all violence in Iraq. During the ex- of suffering with Him, and be- the concelebrating priests and change of the peace of Christ ing redeemed by the cross. representatives of the various some sick people began to go churches of Baghdad. Fr. Philip amongst the congregation and Domenicano presented the of- to distribute ‘red hearts’ made ferings brought to the altar (the specially for the occasion to Bible, bread, wine, small celebrate this day of love and to stones), accompanied by the say that the sacrifice of Christ song ‘Children of a Church’. on the cross is great love. The liturgy of the word con- At the end of the celebration tained a long reading of the the queen of the year was cho- first letter of St. Paul to the sen. A (handicapped) girl aged Corinthians (1 Cor 12: 12-31) twelve called Farah (joy) was and a passage from the Gospel chosen to be the queen of 2009. of John (Jn 5: 1-9). The sermon She was crowned by last year’s concentrated on the salvific queen to the great joy of every- value of faith and love which one. enable us to bear our pains and The day finished with songs 13

Taiwan, the World Day of the Sick

1. A Mass that touched deep Bau Ju, Camillian brothers and to raise up the consciousness inside the heart sisters, sisters of the Francis- of the ‘family of God’. The can Missionary Sisters of Our Church herself is a family and In order to put into practice Lady of Sorrows, the Mission- she should imitate the spirit of what the Pope had said about ary Sisters of Providence, the the Good Samaritan by bearing concern for the poor and weak Missionary Sisters Servants of suffering in common and bear- of the world, a solemn Mass on the Holy Spirit, the Sisters of ing witness to charity. the World Day of the Sick was Providence of Portieux, and The readings at the Mass de- celebrated in St. John’s parish the Missionary Sisters Oblates scribed the redeeming love of of Panchìao on 15 February of the Holy Family. Mr. Thad- God, encouraged us to imitate (Sunday), organized by the deus Jao, President of the Jesus and love one another, Taipei Archdiocese, together Taipei Archdiocesan Council and reminded us of the need to with the Camillians, the Asso- of the Lay Apostolate, and his share sufferings with poor and ciation of the Friends of the team raised up their hearts dur- sad people. The Gospel point- Camillians, and the Catholic ing the nearly two hours of ed out the greatest command- Friends of the Sick Associa- thanksgiving, Mass and bene- ments: one is to love God and tion. The main celebrant was diction of the Holy Eucharist. the other is to love others as Fr. Raimondo Yang MI, Spiri- The participants were com- you would like to be loved. Fr. tual Director of the Friends of pletely immersed in prayer, in Yang in his homily observed: the Sick of the Taipei Archdio- the grace of praising God for “God wants us to love, God is cese. The Mass was concele- His love. the first one to love us, only brated by Fr. Antonio Lin, The World Day of the Sick love can heal the body, soul Spiritual Director of the Na- was inaugurated by Pope John and heart.” Selfish desire and tional Catholic Friends of the Paul Il in 1993 on the Feast sin creates division between Sick Association, Fr. Giovanni Day of Our Lady of Lourdes, men and God and with others, Rizzi MI, and Fr. Francis Hsu on 11 February, of every year. so we can be healed only with SJ. The choir of St. John Bosco The Pope advised the sick to God’s love and forgiveness. Church, with its very fine voic- pray for health through the in- This means that if we want to es, was invited to be responsi- tercession of Our Lady and he be healthy, first of all our spiri- ble for the liturgical music. invited the faithful of the tual “leprosy” should be puri- Nearly 350 participants, in- whole world to be united in fied. There is no other way; we cluding Fr. Lin Chih Nan, caring for the poor and the can rely only on Jesus. Spiritual Director of the Prayer sick. This year Pope Benedict As regards the question that Room of Minsheng Hospital of XVI affirmed the absolute dig- is often asked, “why is there Taoyuan, Director Sr. Chen nity of human life. He wished sickness?”, Fr. Yang explained

DOLENTIUM HOMINUM N. 71-2009 that God created us healthy “Come you who are blessed by Matutina Social Welfare Foun- and at peace; sickness was not my Father! Receive the king- dation, the St. Mary Social the original will of God “be- dom prepared for you since the Welfare Foundation, and the cause men accepted erroneous beginning of creation! Because Third Order of Dominicans, thoughts and mentalities, their when I was sick, you came to more than four hundred people capacity for recovery is con- visit me.” He reminded us that who long for both physical and strained; sin blocks life energy, the spirit of serving the sick is spiritual peace carne from the so sickness has space to come not limited only to the World St. Coletta Training Center for out.” But the mercy of God Day of the Sick – we should Exceptional Youth, the sent his loving Son to become implement it in our daily lives. Catholic Chih Ai Mercy Hos- man, who redeemed us on the This grace of the Sacrament pice and the St. Mary Center. cross; man’s suffering is trans- will fill the life of the faithful They all received superlative formed into the strength of continuously; we share and blessings from God. hope. This strength is the love bear witness by “serving the At the beginning of the rite of God, it manifests the grace Lord ardently with joy in our of blessing, Bishop Su sprin- of redemption, so “an answer hearts.” kled holy water on everybody, for sickness and suffering can Mr. Pan Chung Ching, the praying for a healing of hearts be found only in Jesus Christ.” Chairman of the Catholic through holy water. The bishop The Blessed Sacrament was Friends of the Sick Associa- encouraged those present with exposed immediately after the tion, addressed those present the theme of the message of Mass. Four priests knelt in after the ceremony. He thanked the Holy Father for the World front of the altar; they led the the Archdiocese of Taipei for Day of the Sick, emphasizing faithful in adoring the presence their big effort in making the the “absolute highest dignity of 14 of Christ. At the same time, Day known about and for the human life”, awareness of the they offered prayers and comprehensive planning car- needs of others and especially hymnsforsickpeople—those ried out jointly by different of children. If an adult feels suffering physically and spiri- groups. He also thanked the helpless when confronted with tually, sinners in families, volunteers for everything they suffering, how about these health-care workers and volun- had done and expressed his children faced with incurable teers who care for the sick, thanks for the generous sup- illnesses, physically and spiri- asking that they be healed and port of Fr. Ngoc Diep Nguyen tually hurt by war, homeless, released, pleading God to man- and the parishioners of St. without the warmth of family, ifest His glory, to grant John’s parish, as well as all the living by themselves, hungry strength both to those who face priests, seminarians, sisters and lacking medical care, and suffering and to those who and faithful. May they enjoy forced to leave their own coun- serveChristinthosewhoare peace in all senses with the tries? Addressing the unfortu- suffering. Everyone in the abundant blessing of God. See nate situations of innumerable whole church seemed to be you next year! children, the Pope had thanked consoled and enlightened by the organizations of the our Lord Jesus Christ through Church dedicated to lessening the presence of the Holy Sacra- 2. Rite of Blessings on the the sufferings of these chil- ment. It was solemn, warm and World Day of the Sick dren, as well as the many peo- calm; many of the faithful had in the Diocese of Taichung ple who serve the sick. These tears in their eyes. are examples of the valuable In order to bestow a special To celebrate the World Day witness of the Church to love blessing on the participants, Fr. of the Sick of 11 February, a of life, especially the lives of Yang blessed them with the rite of blessing was held on 14 the weak. Blessed Sacrament in the mon- February at the cathedral of the Many persons go to Lourdes strance, The other three priests diocese of Taichung. We hoped continuously. This is because prayed for them by a laying on that through prayer and bless- the intercession of Our Lady, of hands. A long line of the ing those who are suffering besides bringing the healing of sick went forward to receive from illness and their families physical sufferings, more im- this special grace, accompa- would gain spiritual health and portantly brings reconciliation nied by harmonious hymns. peace. with God and a change of life. One member of both the Le- Beginning at 1.00 pm on We can see that many people gion of Mary and the Camil- that same day, health-care per- dedicate themselves to charita- lian Friends said that at the sonnel from the clinics of the ble services because they have moment when his forehead mid-west areas, the Jen Ai experienced the true value of was touched by the mon- Hospital, etc., provided various life. This is a very great gift strance he was consoled by the medical services and consulta- which comes from heaven. So, lightofGod;hefeltthathe tions. Then Bishop Su presided do not refuse the invitation of was very warmly embraced by over the rite of blessing at 2.30 Our Lady to unite your suffer- a father, his wound was healed, pm. As a result of the publicity ings to those of Jesus! Through he felt very little but the grace and assistance provided by the our faith and conversion there and love of God were im- Chung Sheng Broadcasting will be strength to help us to be mensely great! Station, the Catholic Service reborn again and to live out the Fr. Yang encouraged every- Group in the Veterans’ General beauty of life. We also offered body with the words of Jesus: Hospital (Taichung), the Stella prayer cards of intercession for

DOLENTIUM HOMINUM N. 71-2009 those who were not able to Thomas Chung and other consider what we, as normal come. We engaged in an ado- priests who gave blessings people, can do for them. This ration of the Holy Eucharist through the laying on of hands. activity was very effective. accompanied by the statue of This was followed by eleven The second station, a house Our Lady of Lourdes. Jesus stations of activities. Smiling for an Alzheimer’s’ communi- came to us through the sacra- faces of satisfaction and joy ty, was organized for ment of the Eucharist — how could be seen both on the orga- Alzheimer’s patients, showing precious it was to be nurtured nizers and the participants. how they can live in a commu- by our spiritual food! We can The first activity was songs nity and fight the disease. This beatpeaceonlywhenweopen performed by the young people allowed guests to know how to our hearts to welcome Jesus. of the diocese; these warmed accompany patients and create After guiding everybody in up the atmosphere. Then there a community life for them. The prayer in front of the statue of were hymns sung by the volun- third station gave information our Lady, Bishop Su blessed teers and the staff of the Pas- on the Our Lady of China So- those present with the laying toral Care Department of the cial Welfare Charitable Works on of hands. He wished that hospital. The bishop and the di- Foundation and the Huang they would have hope and de- rector of the hospital addressed Ting Social Welfare Charitable sire, concern for the “littlest those present with warm feel- Works Foundation. The fourth brothers” generously and with- ings. They made everyone rec- station was a health appoint- out self-interest by imitating ognize their mission more ment. The Center for Health Jesus, and learn how to shoul- clearly, especially the need to Control advised those present der together the painful situa- be concerned about our little on how to maintain good tion of their families in order to brothers and sisters who are health, on how to love one’s let them experience the sick and weak. This was fol- own health before concerning 15 strength of God’s love and lowed with a rite of prayer for oneself with the health of oth- abundant graces through these all those present. We also ers. It described health educa- instruments of help. prayed for all the sick. This was tion, the activities of the “120 very touching and a beautiful Club” (for friends of diabet- gift from God. We were con- ics), health care for kidneys, 3. The St. Martin de Porres vinced that we were filled by the “club of loving your liver”, Hospital: Concern and the Holy Spirit. We also prayed the “club of loving always” Blessing for Health for the guidance of the Holy (friends with cancer of the Spirit to fill up what is lacking large intestine), the “club of The activities of prayer for in every person. The last activi- dawn” (friends with breast the World Day of the Sick ty was the “health stations”. At cancer), the “loving club” 2009 of the Chiayi Diocese the first station the animators (friends with cancer of the were organized by the St. Mar- had participants wear eye- mouth), etc. Through these tin de Porres Hospital, support- glasses, creating poor sight, games, led by the communities ed by the Diocesan Council for and had them try to walk or to of the friends of the sick and the Lay Apostolate, together make a chain with beads in or- personal sharing, volunteers with members of the faithful der to let them experience the made an appeal to everybody and catechumens. The activi- difficulties of being an aged to pay attention to the impor- ties were begun by Bishop person, inviting participants to tance of their own health

DOLENTIUM HOMINUM N. 71-2009 Australia LETTER OF THE ARCHBISHOP OF ADELAIDE TO H.E. MSGR. ZYGMUNT ZIMOWSKI

Your Excellency, part of church, government, report into Mental Health, Following your appoint- and civil society. “Stepping Up: A Social Inclu- ment by Pope Benedict XVI The resulting attention and sion Action Plan for Mental as President of the Pontifical action following the celebra- Health Reform”. The report, Council for Health Pastoral tion of XIV World Day of the which followed extensive Care, let me take this opportu- Sick in Adelaide can be con- public consultation, offered 41 nity to congratulate you on sidered under four key head- recommendations for change your appointment, and to send ings and themes: in this area, and proposed a you greetings and best wishes – Medical Care five-year action plan for the from the Church and Catholic – Pastoral Care for Individ- period 2007-2012. people of Adelaide, South uals and Families The South Australian Gov- Australia. This also affords an – Education and Training ernment drafted new legisla- opportunity to briefly report – Media and Public Advo- tion on mental health and after on the various local actions cacy. public consultation presented and developments which have the Mental Health Bill in June taken place since Adelaide had Many of the themes and 2008. Key reforms in the leg- 16 the great honour of hosting the recommendations which arose islation include: a clear articu- XIV World Day of the Sick in during the formal sessions at lation of the rights of mental February 2006, organized the Adelaide Convention Cen- health service consumers and around the theme: “Mental tre have resonated with the ap- carers; greater emphasis on Health and Human Dignity”. proach and actions at the level community care beyond hos- We have many warm mem- of Government on the part of pital and institutional care; the ories of the presence of your the South Australian Govern- recognition of the particular predecessor, His Eminence ment’s Social Inclusion Unit, circumstances of children, and Javier Cardinal Lozano Bar- under the leadership of Mon- acknowledging the unique ragán, who visited our city as signor Cappo. In this cultural perspective of Aborig- the Papal Legate for the cele- way, the celebration of World inal and Torres Strait Islander bration of the XIV World Day Day of the Sick provided an people. of the Sick. We recall with opportunity for individuals, Important changes identi- gratitude that, along with other families and experts to raise fied during consultations for members of the Pontifical their voices, and for some of the XIV World Day of the Council, he was able to en- their key concerns to become Sick 2006 have been included gage in pastoral visitation of the focus for Government and in the draft legislation: some of our health care facili- community action. – Family access to informa- ties, and especially to visit the tion that seeks to balance the Hutt Street Centre for Home- rights of the individual and the less People in the heart of our 1. Medical Care need for those caring for their city. We remember, too, the family member. important contribution of Car- During the Pastoral Day, – Recognition of the specif- dinal Lozano Barragán and the medical care emerged as a ic needs of Aboriginal South message he delivered during very significant area for con- Australians and people from the formal discussions at the cern and change. While there different cultural back- Adelaide Convention Centre, was a degree of sympathy for grounds; culminating in the profoundly those charged with administra- –Servicesthatbettermeet moving solemn Eucharistic tion of the health system, and the needs of those living in concelebration in our Adelaide an understanding of the great rural communities; Cathedral on 11 February. pressures on that system, ur- – Recognition of the vital The celebration of the XIV gent changes were recom- importance of family mem- World Day of the Sick in Ade- mended and improvements bers and carers and their needs laide, together with the pres- called for in relation to the in balance with the needs of ence of and interchange be- critical areas of coordination the individual. tween members of the Pontifi- and integration of services; cial Council for Health Care balancing needs for patient Workers, health care con- privacy with constructive en- 2. Pastoral Care sumers, workers, professionals gagement with families ad for Individuals and experts from across Aus- carers; and skills development and Families tralia and the world, provided for medical professionals. not only a focus for attention In the period since the The major issue most com- to issues of mental health and World Day of the Sick, the monly raised during our cele- human dignity, but was also a South Australian Social Inclu- brations of XIV World Day of timely spur to action on the sion Board has presented its the Sick was the urgent sup-

DOLENTIUM HOMINUM N. 71-2009 port required for families deal- regular meeting and conversa- programs include services for ing with mental illness. tion. Through the Society of personal helpers and mentors, One parish, in the city sub- St. Vincent de Paul, this pro- support for day-to-day living urb of Norwood, has respond- gram draws volunteers from and better access to psychia- ed directly to the World Day parishes and the local commu- trists, psychologists and gen- of the Sick Pastoral Day by es- nity. Training, ongoing super- eral practitioners through the tablishing the Norwood Parish vision and continuing support Government’s Medicare Ben- Companions program to re- is provided by Compeer to efits Scheme. spond to the personal and pas- prepare volunteers and enable At the level of our local toral needs of people living them to function effectively in Church, both the Compeer and with a mental illness and their their role. Norwood parish programs of- families. The aim of the initia- fer initial training and ongoing tive is to care for the physical, formation for individuals who mental, emotional, social and 3. Education and Training provide personal support and spiritual wellbeing of every in- companionship to people liv- dividual within the parish The need for education and ing with a mental illness. through the provision of care training for specific groups al- and information. It is intended so emerged as another com- that this initiative will fill the mon recommendation for ac- 4. Media and Public gaps left by existing social ser- tion in discussions during the Advocacy vices and will complement the XIV World Day of the Sick. excellent work already being In line with the State Social The need for public educa- done by existing groups in the Inclusion Board’s Action Plan tion, awareness-raising, in- parish. It is a grass-roots initia- for Mental Health Reform creasing understanding and 17 tive, run by parishioners, for 2007-2012, the State Govern- de-stigmatising mental illness the local community. ment has announced a training were all repeatedly raised in sessions during the XIV World Day of the Sick. The Church was recognised as having a key role to play in presenting a positive image of people suf- fering with mental illness. Many spoke of the need for the Church to be active as an advocate on behalf of con- sumers, carers and their fami- lies, and to make use of its own networks to help with ed- ucation and awareness-raising. Our diocesan newspaper, The Southern Cross, has car- ried a series of articles over the last two years, highlighting the situation and challenges faced by people living with At the level of the Archdio- initiative for the non-govern- mental illness, and some of the cese, I was happy to launch ment mental health sector to ways in which the Church and the Compeer program in No- support the development of its local community are respond- vember 2007, in conjuction workforce and build up its ca- ing to these needs and chal- with the State Council of the pacity to deliver high quality lenges. Society of St Vincent de Paul services. The Government has Monsignor David Cappo in South Australia. The Com- also provided funding to non- has taken strong leadership peer program is conducted government organisations to role in the State of South Aus- and coordinated by the Soci- enhance their governance tralia on mental health issues ety of St Vincent de Paul, with arrangements as part of a in the public forum, including the support of the Archdiocese broader capacity-building pro- in his capacity as the South through Diocesan agencies gram aimed at improving ser- Australian Commissioner for such as Centacare Catholic vicestopeoplewithmentalill- Social Inclusion. The Social Family Services and the Ade- ness. Inclusion Board was responsi- laide Catholic Justice and At the level of the National ble for proposing the State’s Peace Commission. The pro- Government, a number of Action Plan for Mental Health gram provides personal sup- Australian Government fund- Reform 2007-2012, and is port for individuals living with ed services arising from the now also responsible for over- a mental illness, by matching Council of Australian Govern- seeing the implementation of carefully selected individuals ments’ National Action Plan the Plan’s 41 recommenda- with trained and supervised on Mental Health 2006-2011 tions. volunteers who offer compan- are now being delivered in The Adelaide Catholic Jus- ionship and support through South Australia. Some of these tice and Peace Commission

DOLENTIUM HOMINUM N. 71-2009 and the Society of St Vincent children, adolescents, the Again, congratulations on de Paul have both worked to aged, Indigenous Australians, your appointment, and God’s develop awareness of issues those who are socially and ge- blessings on the work of the relating to mental health in the ographically isolated, and Pontifical Council for Health Church and wider community. those incarcerated in State Care Workers. Please pass on In the lead-up to the last South prisons. my prayers and kindest re- Australian State Election in Of course, much remains to gards to Cardinal Lozano Bar- 2006, the Adelaide Catholic be done in relation to each of ragán. Please also pass on our Justice and Peace Commis- these areas to realize the digni- best wishes to your collabora- sion presented a series of ty of all people regardless of tors at the Pontifical Council, questions for all candidates their health status, but I am and assure them of our prayers concerning mental health and confident that the seeds plant- and encouragement as you human dignity, and asked ed by the celebration of the prepare for XVIII World Day them to commit themselves to XIV World Day of the Sick in of the Sick in 2010. providing adequate and ap- Adelaide in 2006 will be a propriate levels of care for spur to further action and H.E. Msgr. PHILIP WILSON thosewithmentalhealthprob- commitment, and that these DD JCL lems, particularly in relation initiatives will bear great fruit Archbishop of Adelaide, to vulnerable groups such as over time. Australia

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DOLENTIUM HOMINUM N. 71-2009 Topics

The Faith of Priests in Limit Situations Human Resources in Catholic Health-care Structures: what Sustainability for the Future? Hospitals as Settings for the Exploration and Practice of Hope

The Mental Capacity Act 2005: Bioethical Assessments Prior Decisions Concerning Life: a Guide for Catholics Accompanying the Family The Faith of Priests in Limit Situations

I was asked to write on the The experience of illness and ‘Losing my health’, says faith of priests in the limit situ- death challenges our freedom Edilio Mosteo of Saragozza, ations of life. I will do this not and severely tests our faith:it ‘allowed me to engage in a vi- with a theoretical analysis but can destroy us or help us to tal rediscovery of faith. It was through the testimonies of a grow and to mature, to bend in like a rebirth of something that number of brothers that they on ourselves or to open our- was inside me, or expressed themselves wrote and which selves more deeply to other better, of Someone who dwelt were transmitted by people people, to distance ourselves in me. With , once again, near to them who received the form God or to draw near to I feel led to confess, with a cry, gift of accompanying them and Him and to purify the image on the stone of my illness: of listening to their inner that we have of Him. In our ‘Certainly, the Lord is in this thoughts and feelings. First, hands there is the gift and the place and I did not know it!’ however, I will briefly describe task of living our illness well or The Lord took advantage of my the experiences that human ill- badly, transforming it into gen- illness, granting me the prayer ness and death involve. erous wine and not vinegar, of the Psalm: ‘You will teach Almost always illness is a drawing from its bitter flowers me the pathway of life’. Where painful surprise that provokes – as Antonio Machado says in it seemed that everything was 20 an obligatory and forced stop in his poem 86 of Soledades –a finishing, a new pathway, a the flow of life. We have to ad- white wax as the bees do, so new life, was beginning, His dress in the first person some- that it becomes a time of grace work, in which I cooperated thing that we did not expect for us and for others. with a great deal of difficulty, at and which threatens to change It is not easy to live illness times in an inopportune and at our lives. and death in a human way. And times in a bad way… Begin- Illness provokes a profound it is not easy to live faith in ill- ning with illness, with suffer- change.Ourbodies are no ness and death either. But it is ing, one also sees God in an- longer our silent and obedient possible and this is demonstrat- other way. Sick people provide companions. Instead they be- ed to us by the testimony of so us with a privileged and far come troublesome and rebel- many priests that we have sighted outlook on the mystery lious, unknown and threaten- known and that we know and of God, His infinite beauty, ing. We find ourselves forced of those to whom I will only re- even if beginning with His ab- to pay attention to our body in a fer briefly. To all of them goes sence’.2 waythatisfullofworryandwe my gratitude and may the Fa- ‘Many times’, wrote have physical pain that is at ther be praised who works so Miguel, a priest of Tenerife, times very intense, or pain that many wonders in those chil- who was ill with cancer, ‘I invades everything. dren of His who place trust in have thanked God for my ill- Illness gives us an experi- His hands. ness. Because He took advan- ence of our own frailty. ‘How difficult it is’, writes tage of the presence of Christ It also strikes our relation- Fr. Congar, ‘to put faith and in my life to encourage other ships and communication with hope (during illness) into prac- sick people and even the faith other people: our families, our tice when there is nothing else, of other healthy people. I was friends, our work… this feeling when daily bread becomes hard very impressed when one of dependence profoundly for us, without butter or jam! morning they brought me changes our relationships and The difficult thing is to hope some young people that I did often causes us great affliction and believe when one has noth- not know who said to me: “the and suffering. ing. One day things will be teacher of religion spoke of the Illness creates a great inner filled with light. Then we will fact that faith in Jesus Christ is silence from which spring see their meaning when we abletopreserveserenityina thoughts, feelings and questions were living them during the person threatened by cancer that search for a reason for what night. And then without doubt and we have come to become has happened but to which it is we will discover that in the fi- aware of this”. What pleasant not easy to give an answer: why nal analysis the test was short- moments I spent with them! I has this happened to me? Why lived and it will burden us to saw on their faces the impact this illness? Why now? have doubted for one moment that produced something that Illness and death constitute a alone, to have longed for evi- is not frequent. I said to them: singular experience that afflicts dence or a solution and thus to “It is true, it is true… What in what is most intimate and sa- have wanted to leave faith and our lessons they told us about cred in a person. They belong hope. On the contrary! The faith in Jesus Christ is true. to the limit situations of life that memory of having been solidly The fact is that we had not make us touch the bottom, supported in faith will leave drawn near to him truly inter- make us encounter the truth of with us a taste of incredible ested”.3 ourselves, of other people and sweetness that will end in an ‘I try to evangelise as much of God. action of grace’.1 as I can beginning with this sit-

DOLENTIUM HOMINUM N. 71-2009 uation’, said Maximino Bar- Huesca: “I offer up my life for this in any way, and despite rero a few days before his priests and for the citizens of everything we give ourselves to death. ‘First I did it with my Huesca. I thank you, Lord, for Him with all our being. His life, with my health, with my having carried me with you… I word is silence, a great and voice… now I do it with pain, have great peace and joy. God deep silence that no sound can welcoming, suffering… with is Love and Peace… Always fill. God grants to me the possi- these thousand ways by which search for God and His will. bility to live and to grow, even one can evangelise from a hos- Live for Him. Be concerned in pain. From God I ask for the pital bed. I enjoy great peace. about other people and allow same thing that He gives me What I wish most is to live and life to go forward. My life has and wants to give me: to be a die in peace. I am on the cross been in God. I have lived for person in sickness and in of Christ and with him I want Him and now He is taking me health. I ask Him to have com- to rise again. I am going with Him. I am happy”.6 munion with Him, with myself through truly difficult mo- and with other people. May His ments but I am always full of will be done’.7 peace and with an acceptance ‘Now’, writes Iñaki Ká- of the will of God’.4 mara’, ‘it falls to me to live the ‘I experienced the fact’, priesthood in this other situa- writes D. Javier Osés, ‘that in tion. You will ask yourselves that moment God is the deepest whether I am happy. I am not and most decisive help and that so misguided as to say that this health for a Christian is some- experience makes me happy. It thing more than not being is true that it is a severe situa- threatened by death and that our tion. Specifically in these mo- 21 God, Creator and Father, is tru- ments and in a situation of this ly the God of Life. Knowing kind one cries out, with hesitant that specifically in these mo- faith, as to why, and as a re- ments God wants to make the sponse one obtains a very deep experience of His love felt silence… In the middle of this more gave me a great deal of silence, gradually, with my peace. I did not want anything, ‘God’, writes Jesús Burgale- stammering faith, I discover the neither to pray nor to think nor ta, ‘is with man as he is; weak, response of God. God responds to speak. Only a few sponta- limited, alone, abandoned; if to me through my family which neous feelings connected with such was not the case, we from the very first moment has God, with my family, and with would be destroyed. God re- been near to me to the full and the staff that moved around the spects and loves the finitude of with great naturalness, a great ward, emerged. It was sufficient man with limits. God does not deal of affection and optimism formetoknowthatGodloved free man from being a man. He during their ups and downs. He meandthatIhadtoallowHim wants him to be a man. He responds to me through my to be a Father with me. My ill- helps him to be what he is. God companions and friends that ness and long convalescence became man and can be none come to visit me, and the many helped me to approach my life other than the happy God with Cyreneans and Veronicas who in a deeper way, to experience whom to be joyful, the suffer- day after day look after me, that illness and health are gifts ing God with whom to suffer’. clean me, comb my hair, wash of God, that illness reduces God in illness can but love us me and put me to bed. I must one’s mood and that in life by loving us and thus respect thank – because they help me there are things that continue to what we are. God does not only face up to this situation – both be primary and there are things suffer with me in my pain – my the nurses and those who work that are secondary or tertiary. pain is His pain. God walks in the kitchen and maintenance, God, His goodness and His down the whole of my path- Fernando and Felix, who offer kingdom, are of primary impor- way, His humanised pathway me not only their medical tance’.5 ‘His death was already until death. My death also takes knowledge but also their drawing near’, narrates Mar- place in Him. God is in the ex- friendship’.8 garita, the sister of Javier Osés, treme loneliness of my bed, not ‘I have the feeling’, writes D. ‘and with a great deal of as a simple ‘other’ who dries Fernando Sebastián, ‘of not courage and serenity he told us my sweat, but as the most radi- having been ‘away from work’ that he was dying and he cal and intimate part of me. during this period but, rather, moved all of us by telling us God sees this in my weakness. that the Lord wanted me to that the most important moment God embraces it in frailty even learn to serve in another way, of his life was arriving. He when one opens one’s arms and beginning with weakness, with asked for a crucifix, he kissed one has the feeling that one is prayer and with suffering, real- it, and with a clear and steady embracing nothing. Accepting ly acknowledging the value of voice thanked God for the fam- the destruction of all the por- His grace and the superiority of ily that he had had, for the fact trayals of God, even the most others. During days of illness that he was a Christian, because legitimate – Father – is the one prays more, one feels near- God had called him to the summit of faith, of love and of er to the presence of God who priesthood, and for having been hope. God shows that He is consoles us and strengthens us. the bishop of the diocese of God when one cannot grasp The words of Paul become

DOLENTIUM HOMINUM N. 71-2009 clearer: ‘My grace is enough from the psalms. I felt the joy in recent years that I have for you’. ‘The power of God is prayer of other people as I had never felt so loved. And I manifested in weakness’. Ac- never done before. They told would like to emphasise this ceptance of one’s own weak- me that they were praying for because I very well know that ness helps one to give greater me, and I really felt this ‘push’, many other sick people have value to the possibility of other this ‘force’, and I thought: if never had the good fortune in peoples and above all to the men are so close to me, how this sense that I have had. A great force of the love of God can God not be?’ family, a sister at your side, are which never disappears. Illness gifts that Providence has given is a time of looking far ahead. me, but not all sick people find One understands better the this. mystery of pain, the strength of I would not have been able to love, the need for solidarity, the be ill without the example of definitive wisdom of the cross Jesus. The good fortune that of Christ, innocent love was mine in knowing his jour- stressed in pain as a journey of ney was without doubt the thing freedom and salvation. that most provided light during My experience was strength- my illness. Thanks to him my ened by the illness and the illness illuminated my faith and deaths of two friends and at the same time my faith illu- brothers who were very near to minated my illness. This illumi- me – Bishop Conget and Bish- nated my faith because it made op Osés. They reached the it, perhaps for the first time, 22 depths of this experience and true. How easy it is to believe entered by the narrow door of and preach when everything is death to reach the glorious en- going well! My pain allowed counter with the God of love me to discover that I did not be- and life. We learnt from them lieve in many things that I how to die and live near to this thought I believed in. God who awaits us with pa- ‘By grace’, wrote José Luis But I should add that it was tience and mercy. We are weak Martín Descalzo,‘Ihaveal- much more than faith that illu- but we will live and triumph ways lived in faith and in love minated my illness… Discover- thanks to the power of God for God, and this was a ‘nor- ing that beginning with my ill- present in Christ. He is with us mal’ thing in my life. God was ness I took part in a more vital until the end of time’.9 truly my father and Jesus was and truer way in the passion of ‘Suffering’, says Fr. Häring, truly my friend and companion. Jesus for me was a primary ‘liberated me a little from ego- During my illness I felt this fa- source of hope and joy. I never centricity. I engaged in a pro- therliness and this companion- asked God to heal me because it found reflection on the paschal ship to be even closer to me. seemed to me to be an abuse of mystery, applying to myself Only the grace of God has been trust and above all because I what it says about the life, able to keep me happy in recent feared that if God had taken death and resurrection of years. And I confess that I have away my illness He would have Christ. In addition, I learnt to experienced this almost as a taken away one of the few good have trust in Providence: God hand that caressed me. God has things that I had: the opportuni- does not leave me alone and never been absent from me at ty to cooperate with Him more does not allow me to doubt His any moment. I know that it is intimately, more truly. I certain- presence, neither when faced not at all pleasant to be in the lyaskedHimtohelpmetobear with pain nor when faced with Garden of Olives, but at the my illness with joy and to help illness… nor when faced with same time there was no ab- me take advantage of it and not death’.10 sence of ‘angels who comfort- ruin it through my selfishness ‘As a Christian, as a religious ed me’ as was the case with the and my need for affection. To and as a hospitaller’, writes Ms- Lord. Angels that at times ex- be and love in the Garden is not gr. José Luis Redrado, of the pressed themselves simply apleasure.Insteaditisagift,a Hospitaller Order of St. John of through interior peace and at present, at times the only one God, ‘I can confess that during other times – many other times which at the end of life I will be my illness I saw God through – were clothed as people who able to place in His hands as very many ‘human mediations’, over these years have loved me my Father’.11 very many small and insignifi- and helped me a great deal. My ‘Praying beginning with cant things that at other mo- brothers, my friends and a large what I was experiencing’, ments pass by unobserved. My number of people that I did not writes Antonio López Baeza – illness helped me to trust God know supported me and I ‘transformed my illness into a more and to contextualise many would regard as miraculous the time of grace. A grace that the things that we seem to think are fact that in the darkest hours Lord granted me was to under- important but which in fact are there nearly always arrived a stand that the favour I asked not. Prayer is not easy, especial- letter, a telephone call, a chance Him and that He wanted to ly during the acute moments of encounter in the street that grant me involved above all an illness. My prayers were helped me to recover my peace else accepting the result of that simple exclamations or phrases of mind. I must confess with process, whatever it might be,

DOLENTIUM HOMINUM N. 71-2009 as the thing that was best for difficult moments. In speaking people. But the Lord has lov- me. To give life the same mean- to them about my interior ingly disposed otherwise. I can- ing or more meaning than be- peace, I hope that people see not see, I cannot move around, fore despite the loss of my fac- that in prayer and faith there is I cannot do anything. It is that ulties; to know that I can still be much more than mere words. after my service for the Church useful and work for other peo- God in reality helps us to live nothing remains for me to do. ple; to accept the changes in fully even during the worst mo- The end is drawing near. I suf- meaning which the results force ments. And the capacity to do fer a great deal, I have great onmeandtoacceptthemwith- this depends on the depth of pain, but I do not want others to out making of them a drama our relationship with Him be aware of this because I do that embitters my existence and through prayer. not want them to suffer as a re- the existence of those who sur- During my convalescence sult. Now I am only awaiting round me… this was the most the nights were particularly eternal life, and it will come in valuable miracle that the Lord long, they were a time when a few days. Despite my physi- wanted to grant me, or to ex- various fears came to the sur- cal suffering, I am serene and press the point better, that has face. At times I was surprised tranquil. I am going to the already been worked within to find myself weeping and this house of the Father’.14 me’.12 was something that rarely hap- ‘Before receiving the anoint- ‘The last three years’, writes pened to me before… During ing of the sick’, said Don Vech- Cardinal Bernadin, ‘have been those difficult moments, apart hi, the High Rector of the Sale- achallengeformeinawaythat from faith and trust in the Lord, sians, to the members of his has never occurred to me to I was constantly sustained by General Council, ‘I wish to ex- keep my beliefs steady and to awareness of the fact that thou- press my trust in the Father. I trust in the Lord. But my prin- sands of people were praying want to abandon myself to He 23 cipal goal was to place my faith for me… who has loved me with an eter- in action, to live according to It is clear that in the spring I nal love. I am ready to accept the principles that direct my will no longer be alive. But I His will. I express to Him my life. Above anything else, I will soon experience a new life gratitude for what He arranged want people to know that I am in another way. Although I do for me all the years of my life. walking with them as a brother not know what is awaiting me In this time of illness I have and as a friend. The decision to in the other life, I know that had an opportunity to think live my tumour in public was a just as God called me to serve anew about the situation of so decision to share a simple mes- Him with all my abilities dur- many brothers who in my con- sage: faith is truly important. ing the course of my life on dition. I have experienced in Thank you for supporting me earth, so now He is calling me the first person that to serve is a in the Lord, thank you for home’.13 great thing and that it is painful opening me to His will; I have ‘The Lord visits me with the to need to be served. I have re- been able to accept my illness cross’, said Cardinal Pironio. ‘I flected on the care which so and now my imminent death as have preached on the cross a many brothers and sisters have well… Suffering and pain have great deal but how different it is given me with so much delica- lost meaning for me without to experience it and live it. I cy. Not all my sick brothers re- God and my heart searches for suffer a great deal but I am hap- ceive the care that I do. I thank people who feel abandoned or py and at peace in the hands of the Lord for this. I feel con- alone in their moments of aFatherwholovesmeandin fused and glad at the same time greatest need. the heart of Mary my Mother… because of the love that God I have been a priest for forty- I want to live this moment of has made grow in all those who three years and a bishop for my life which the Lord has lov- live around me… I feel like a twenty-nine years. I have al- ingly prepared for me. I am man who goes down a pathway ways told other people to place serenely ready to help in every- between two wings of friends themselves in the hands of the thing that the Lord wants to de- and inside me is spontaneously Lord. I have given advice to a lineate along my pathway… born the wish to proclaim with large number of people who Now the Lord calls from me the psalm the joy of walking to- were addressing what I am ad- the ministry of prayer and si- wards the house of the Lord to dressing now. The moment for lence, the ministry of offering. praise His name. I profoundly me has arrived to practise what It is more difficult but it is more feel my membership of the I preach. fecund. The way I pray now is Church and feel that she is tru- During this period I have to suffer in silence and to offer ly accompanying me… My prayed to God to grant me the up. I have offered up every- thanks go to everybody for grace to overcome my opera- thing: for the Church, priests, everything that they have tion and the post-operation consecrated life, the lay faith- done… We always remain unit- treatment with faith, without ful, the Pope, the young, the re- ed in prayer. May God reward bitterness or undue worry. The demption of the world… I be- themandtheMostHolyMary special gift that God has given lieve that a few days of living bless them!’ me is a gift of peace. In turn, remain to me. I had dreamed ‘According to what Sister my special gift to other people despite my illness that when Maria Jesus who looked after has been to share the peace of this moment arrived I would him in hospital, Riccardo Al- God with them, to help them to have had time to read, to write, berdi asked to experience his overcome their illness and their to withdraw to pray, to listen to death in his own way, a death

DOLENTIUM HOMINUM N. 71-2009 which he had already accepted. will know how to ask you for Of groaning, at the doors of He took advantage of the day: the Spirit so that my life, in this death. reciting the rosary, reading, pilgrimage which one day will writing, and waiting for visits finish, and my death, will be in Give me strength. Lord, for which tired him out. She saw your Cross. Hold my hand so this leap that he was worried because in that with you, despite the dark- Where my love rises up high vast sectors of religious life a ness of the journey, I will have And the earth is transformed privatisation, a disassociation the simple certainty of opening into heaven. of faith, behaviour and com- my eyes one day and seeing mitment, was asserting itself. you at the right hand of the Fa- Rafael Matesanz, He asked to live for a little time ther with the Holy Spirit’. priest of Segovia. more, despite the situation in Many evenings, when sleep which he lived, in order to help, overcome me, I expected to from a wheelchair as well… meet you in the morning that Something that is life of life thosethatwereinneed.Hewas had no end. But only you, Lord Is changing within me. frightened and worried about of my life and illness, know the This life of mine is dying being able to reach a limit that day that will have no sunset. In And a new life is being born. would have impeded him from the meantime, ensure that I do being courageous and he de- not leave you and that I thank The castles of once upon a clared: my God, give me you because every moment is a time strength! And his gaze fixed on miracle while awaiting an even Are being transformed into the crucifix. His illness was not greater miracle: eternal life, liv- ruins easy to live through. His death ing with you. There are creases in the tree 24 was the creator of a spiritual re- I abandon myself, sick and Because the tree is becoming ality of love’.15 weak, to your hands, which old. ‘After this night of afflic- made me, and to those of my tion’, writes Joseph Breu, a brothers on my journey of pain The words are shorter missionary priest who died in who communicate your And the silences are longer. Medellin in 1987, ‘I want to warmth to me. Your hands are Iwalkdownmypathwith pray and this prayer alone full of mercy. In them I take calm. comes from me: ‘to your hands refuge and I hide with all those And say my prayers with more Lord I entrust my spirit. Father, who feel the proclamation that calm. if you want, distance this chal- earthly life is the beginning of ice from me! However not my another life where illness and Already many things weight will but your will be done’. Re- death will be defeated for ever. upon me bellion, protest, strong rejection Thank you, Lord of my life And I am offloading a part of of what we live are feelings and my illness, because you the burden that flower and which we must have taught me that your grace In my hours I live the urgency express without fear. Only is worth more than life, that the Of repeating what I hold. faith, the presence of the Lord, coldness of death will never al- His strength, His love and the low the fire of your Love to The empty furrow hurts me solidarity of other people help die’.17 And my wounds have opened us to go forward. My activity is I will end this paper with po- The sinning of sufficiency to abandon me to the hands of ems written by three priests a And praising myself sincerely. the good Lord who does not short time before their deaths. leave me and helps me at every I am cleaning the terrain moment. Illness is an experi- Of leaves of mud. ence that is a deep desert. One I am in your hands. My undone The seeds of pines, lives problems which in life I flesh Of violets and rosemary. lived more intensely and in a Continues to say: ‘Love, what deep sea of powerlessness, you want’. To learn humility mixed with great confusion to Happy I consecrate to you my And love for the littlest, obscurity. There remains aban- springs. I will sow some bushes donment to God in a powerless Happy I give you the peace of Of violets in the centre. and dark faith. Illness undress- my annihilation. es us, it makes us feel poor. To be ‘the good fragrance of Death can do nothing, any- This affection of my blood people’, thing, to life, it does not defeat springs The rosemary, and pines, it. Although I am dying, I feel From knowing that I am in When they grow, life and today more than ever your arms. Will make me look at the sky before I experience how death, Dying is not dying, if you wait more. illness, do not win; this cancer for me is not killing me, it undermines At the end of this hard failure. Something that is life of life my physical health but not my Is changing within me. life. Christ defeated death, I, I am in your hands. With you I Is it already spring? too, am called to defeat death live. Has winter really gone? with my life’.16 With you I die. I am not a ‘Lord, I ask you that in pain I prisoner Jesús Nieto, priest of Huelva

DOLENTIUM HOMINUM N. 71-2009 Testament Tell me if it is true that The night light after the dark of the Solitary Bird thinking of your name night Caterpillars become IV The Hopeful butterflies. José Luis Martín Descalzo18

I know that I will lose my life. I know that heaven will open Rev. RUDESINDO DELGADO Ecclesiastical Assistant But it does not matter. AndevenmoreopenwillIfind of the PROSAC I will go on, I continue life. (Association of Christian playing. We will no longer be Health-Care Workers), And even though I know that I prisoners. Spain am breaking down Notes I will go on hoping, I continue We will win, losing the match. hoping, I hope. And given that we have lived 1 Y. CONGAR, A mis hermanos (Sígueme, Salamanca, 1969). being dead, 2 Labor Hospitalaria nº Orar en la Where was my heart Dying in the light we will malattia. 3 VICO PEINADO J., Profetas en el dolor beforehand? become alive. (Paulinas, , 1981). Where was the life that 4 Department for Pastoral Care in dawned whistling? Last News on the Death Health of the Spanish Bishops’ Confer- ence, Vivir el morir, photocopies dossier, Where the happy teenager? of the Author: V 1992. When did I change my soul 5 Bolletino Prosac Nº 14 (2000) into this garbage heap? Andsohesawthelight,The 6 Instituto Superior de Pastoral, La mis- ión sanante de la comunidad cristiana, light that came in Verbo Divino. But I want to continue in this Through all the windows of his 7 ALEMANY C. (ed.), 14 aprendizajes vi- mill of hope, life. tales (DDB, Bilbao, 1997). 25 8 Surge, El dolor del sacerdote. Stubborn, obstinate! He saw that pain hurried flight 9 ‘Después de la malattia’, letter of D. Prepare my bill of indictment! And understood that death was Fernando Sebastián, 30.10.2001. not. 10 SALVOLDI V., Häring (San Pablo, Madrid, 1998). Perhaps one day the knot will 11 MARTÍN DESCALZO J.L., ‘Reflexiones be broken. To die is only to die. Dying de un enfermo en torno al dolor y la malat- And if this does not happen it ends tia’, Congreso de las Hospitalidades Es- pañolas de Nª Sª de Lourdes (El Escorial, will be said: Dying is a fleeting beacon fire. November,1990). ‘He was not able to. But he It is to pass through a dying 12 LÓPEZ BAEZA A., Experiencia con la soledad (Narcea, Madrid, 1994) died at the gates of glory’. door 13 Cardinal Bernardin, El don de la paz And finding there what was so (Planeta/Testimonio, , 1998) First Presentiment looked for. 14 Testimony given by Teresa I, the reli- gious nurse who accompanied him during of Death: VII his illness, in La Escuela de Pastoral de la No longer weeping and asking Salud Nª Sª de la Esperanza de Madrid. I lived playing at other things. questions; 15 Department for Pastoral Care in Health of the Spanish Bishops’ Confer- Living, dreaming, being a man. Seeing Love without enigmas ence, ‘Vivir el morir’, dossier photocopied At times one is born when one or waste; in 1992. dies, but I ask myself Resting, living in tenderness 16 Department for Pastoral Care in Health of the Spanish Bishops’ Confer- How are roses born, dreaming? ence, ‘Vivir el morir’, dossier photocopied Having peace, light, home in 1992. Give me your merciful hands together 17 Alfa y Omega, 29.3.07 18 JOSÉ LUIS MARTÍN DESCALZO, Testa- So that my heart is freed of the And finding oneself, leaving mento del Pájaro Solitario (Verbo Divino, detritus. pain far off 1991)

DOLENTIUM HOMINUM N. 71-2009 Human Resources in Catholic Health-Care Structures: What Sustainability for the Future?*

The Pontifical Council for contexts in which Catholic 5,246 Catholic hospitals in the Health Care Workers, in the health-care realities work every five continents of the world; form of its section for statistics day. 17,224 clinics; and a flow of and the collection of data, car- We thank the following for patients treated or admitted ried out a survey on ‘human re- their valuable cooperation: the numbering respectively sources in Catholic health-care apostolic nuncios, who allowed 184,810,687 and 84,098,396. structures: what sustainability connections with the bishops of for the future’ in order to learn the offices responsible for pas- Given the evident reality of about the questions and issues toral care in health; the bishops the capillary presence and ac- connected with the limited responsible for pastoral care in tion of the Church in the health- availability of human resources health who offered their help care field in the world, an at- in Catholic health-care struc- during the preliminary stage of tempt was made to produce a tures as well as about the activ- the survey by identifying the studythatfocusedontheques- ities and programmes within most representative Catholic tion of the human resources that these structures. health-care centres in their are available, at least in relation This survey was begun at the countries; and the religious Or- to some of these realities. beginning of 2006 in 121 coun- ders and all those responsible 138 duly filled-in question- 26 tries belonging to the five conti- for Catholic health-care centres naires were sent in to the Pon- nental areas of the world who with efficiency and care tifical Council by Catholic (Africa, America, Asia, Europe, filled in the questionnaire al- health-care structures working Oceania) in which at that date lowing us thereby to learn in the following countries: at least one bishop responsible about the very many aspects of Australia for pastoral care in health was their service to suffering sick Burundi present. Thus an information- people. Chad gathering questionnaire was Lastly, it should be made Colombia sent to 1271 bishops responsible clear that this document does Korea for pastoral care in health in not seek to describe the whole Ecuador these countries. These bishops of the work of the Church in the Ethiopia in their turn then sent this ques- field of health and health care France tionnaire to the Catholic health- but it does allow us to learn Ghana care structures active in their re- about the contexts in which Guatemala spective countries. In addition Catholic health-care realities Iraq to these bishops, the Pontifical work, the questions and issues Ireland Council also sent this question- that they have to address, as Mauritius naire directly to the three major well as their daily commitment Italy Orders that work specifically in of an overall character to the Mexico the world of health care, name- person. Nigeria ly the Fatebenefratelli, the New Zealand Camillians and the Hospital Papua New Guinea Sisters of the Sacred Heart of Premiss Portugal Jesus, with an invitation to have The Czech Republic it filled in by their health-care The realities of the Catholic The Dominican Republic structures in the five continents world working in the field of Spain of the world. health care are many in number. Thailand The strategy of sampling that The data of the Office for Sta- Turkey was followed was of the snow- tistics of the Vatican City on 31 Uganda ball kind, that is to say the ap- December 2005 identified Zimbabwe proach was to create a non- probablistic sample. This is a Number of Catholic hospitals and clinics; number of patients sampling technique that most of treated or admitted by continental area of belonging the time allows the achieve- as of 31 December 2005 ment of satisfactory results (al- though ones that cannot be gen- Number of Centres Continental areas eralised to all the Catholic real- Hospital Clinics ities working in the world), in a Africa 1,046 5,292 logic, obviously enough, in- America 1,712 5,363 volving an exploration of the Asia 1,073 3,626 various subjects of research. Europe 1,257 2,755 This technique often allowed the acquisition of information Oceania 158 494 that was extremely useful for Total 5,246 17,530 gaining knowledge about the Source: Annuario Statistico della Chiesa 2005, Libreria Editrice Vaticana.

* Descriptive report on the result of a survey carried out by the Pontifical Council for Health Care Workers. Descriptive Analysis Tab. 1. Continental area of belonging of the country of the Data in which the structures were located Continental areas Abs. val. Val. % TABLE 1 America 32 35.6 At the present stage of re- Africa 18 20.0 search, the structures on which Asia 27 30.0 we have data are distributed Europe 10 11.1 equally between developing Oceania 3 3.3 countries and advantaged coun- Total 90 100.0 tries (developing countries – 50%). Tab. 2. Typology of the structures contacted (multiple answers) Answers TABLE 2 Typology of structure Abs. %of % of valid values answers cases The structures that filled in the questionnaire were largely Hospital 45 28.0% 52.3% hospitals but they also have the Clinic 19 11.8% 22.1% role of being dispensaries (28% Dispensary 43 26.7% 50.0% and 27%); residential centres Residential structure 24 14.9% 27.9% (15%); clinics and consultancy Semi-residential structure 11 6.8% 12.8% centres (11.8%) Consultancy centre 19 11.8% 22.1% Total 161 100,0% 187.2% 27 TheMostFrequent Valid cases: 86 Pathologies in the Year 2005 Naturally enough, there are sig- illnesses that affect population On average over 28% of pa- nificant differences in the typol- bands that live in conditions of tients of the Catholic health- ogy of problems that the centres grave poverty, with which are care structures which filled in have to address given the vari- connected poor conditions of the questionnaire have prob- ous contexts in which they hygiene and inadequacy at the lems connected with infectious work. However, it is interesting level of diet. These are the ill- or parasite-related illnesses; to observe that the percentages nesses of the poor, evident signs 25.5% have mental problems of some pathologies such as, for of the condition of the grave and behaviour disturbance; example, infectious and para- poverty of the populations with 13.4% suffer from respiratory site-related illnesses and those which Catholic health-care illnesses; and 10.3% have prob- connected with the digestive structures are more likely to lems connected with the results system present similarities in come into contact. of congenital malformations the same latitudes of the world. and chromosome anomalies. Indeed, one is dealing here with TABLE 3 Tab. 3. Sources of funding in 2005 (multiple answers) Typology of sources of funding Abs.val. %ofanswers %ofcases by economic macroarea Area of development* Sources of funding Public funds 17 14.4% 38.6% Funds from public agencies 9 7.7% 20.5% Donations from individuals 16 13.7% 36.4% International bodies 7 6.0% 15.9% Catholic NGOs 12 10.3% 27.3% Non-Catholic NGOs 5 4.3% 11.4% Patients and their families 27 23.1% 61.4% Other sources of funding 24 20.5% 54.5% Total 117 100.0% 265.9% Developing areas ** Sources of funding Public funds 10 11.1% 24.4% Funds from public agencies 3 3.3% 7.3% Donations from individuals 13 14.4% 31.7% International bodies 6 6.7% 14.6% Catholic NGOs 9 10.0% 22.0% Non-Catholic NGOs 2 2.2% 4.9% Patients and their families 27 30.0% 65.9% Other sources of funding 20 22.2% 48.8% Total 90 100.0% 219,5% * Valid cases 44 ** Valid cases 41

DOLENTIUM HOMINUM N. 71-2009 Tab. 4. Criteria utilised in the allocation of resources in the sphere of planning of the structures that filled in the questionnaire by macro-economic area (multiple answers) for 2005 Criteria for the allocation of resources Abs. values %ofanswers % of cases by macroeconomic area Developed areas* Criteria for the allocation of resources Cost/benefit 20 29.4% 54.1% Cost/life expectancy 2 2.9% 5.4% Cost/improvement of quality of life 24 35.3% 64.9% Solidarity/subsidiarity 21 30.9% 56.8% Other criteria 1 1.5% 2.7% Total 68 100.0% 183.8% Developing areas** Criteria for the allocation of resources Cost/benefit 22 35.5% 57.9% Cost/life expectancy 7 11.3% 18.4% Cost/improvement of quality of life 28 45.2% 73.7% Solidarity/subsidiarity 4 6.5% 10.5% Other criteria 1 1.6% 2.6% Total 62 100.0% 163,2% 28 * Valid cases 37 ** Valid cases 38 Tab. 5. The most urgent problems in the management and organisation of the structures that filled A study of the sources of in the questionnaire which are said to need immediate action funding on which is based the economic sustainability of the Answers Catholic health-care structures Most urgent problems Abs. %of % which answered the question- values answers of cases naire is interesting if one con- Lack of networks 27 17.5% 38.6% siders the differences between for connection the centres that work in devel- Lack of Catholic health-care oped countries and those in de- 19 12.3% 27.1% veloping countries. The struc- personnel Lack of funds to support tures in the developing coun- 51 33.1% 72.9% tries have greater difficulty at the health-care structures Difficulty in formulating the level of access to sources of 27 17.5% 38.6% public funding than is the case training projects Inability to perform specific with those in developed coun- 7 4.5% 10.0% tries (14% of the answers of the roles in pastoral care in health developing countries compared Local health-care emergency 23 14.9% 32.9% to 22% in the case of devel- Total 154 100.0% 220.0% oped countries). It is more like- Valid cases 70 ly, even though slightly so, that they receive donations from pass through these centres as not years to life, with an evident private individuals (14.4% of regards the work of care and reference to the importance of the answers from the develop- assistance that is provided improving the quality of life of ing countries as opposed to within them. the population of the whole of 13.7% in the case of developed the world. From these data, countries). Lastly, it is not of TABLE 4 quality of life would appear to secondary importance to ob- constitute the centre of the plan- serve that specifically in the But what are the criteria that ning of structures that work in poorest countries Catholic govern the administrators of the most deprived areas and in health-care structures receive Catholic health-care structures the richest ones. However, there greater support from patients in the allocation of available re- do not fail to be differences and their families (30% of an- sources? In both developed and which emerge when one analy- swers in developing countries developing countries the preva- ses the further criteria which are as opposed to 23.1% in devel- lent criterion is that which re- subsequently taken into consid- oped countries). This fact is lates costs to improvement in eration. Indeed, whereas in de- very important because it quality of life (35.3% of an- veloping countries the criterion stresses the nearness of the re- swers in developed countries subsequently adopted is that lationship that is installed be- and 45.2% in developing coun- which relates costs to benefits in tween Catholic health-care tries). This is a criterion that treatment (35.5% of answers), structures and the populations seemstogointhedirectionin- in developed countries the crite- that turn to them. Their eco- dicated years ago by the WHO rion of solidarity/subsidiarity is nomic support constitutes an when during a famous cam- established (30.9% of answers). indirect indicator of the level of paign of sensitisation it upheld satisfaction of the users who the need to add life to years and TABLE 5

DOLENTIUM HOMINUM N. 71-2009 At this point we could but ask Tab. 6. Human resources available in the Catholic ourselves what the most prob- health-care structures that filled in the questionnaire lems to be addressed were in the Year: 2005 (multiple answers) sphere of the management and Answers Professional figures organisation of Catholic health- % available Abs. % of care structures. The question values answers of cases which had the greatest concen- Doctors 74 9.9% 85.1% tration of answers was ‘lack of financial resources’ (33.1% of Psychologists 50 6.7% 57.5% answers given by 73% of the Sociologists 25 3.3% 28.7% answering structures). This Rehabilitation therapists 50 6.7% 57.5% brings out critical economic Professional educators 33 4.4% 37.9% condition which cannot but Social assistants 42 5.6% 48.3% have consequences for person- Nurses 78 10.4% 89.7% nel, thereby generating a sense Auxiliary technical workers 55 7.3% 63.2% of uncertainty which provokes Auxiliaries 71 9.5% 81.6% dissatisfaction and de-motiva- Administrative workers 70 9.3% 80.5% tion. Only subsequently, and a few percentage points distant, Volunteers 54 7.2% 62.1% do the problems of adequate Chaplains 55 7.3% 63.2% networks for connection with Men or women religious 66 8.8% 75.9% other local realities and difficul- Caregivers, councellors 28 3.7% 32.2% ties in formulating training pro- Total 751 100.0% 863.2% jects appear. 29 Tab. 7. Personnel who work outside working hours. Year: 2005 (multiple answers) Health-care personnel Answers Personnel who work % outside working hours Abs. % of TABLE 6 values answers of cases Medical staff 45 19.2% 67.2% This table brings out the fact Nursing staff 51 21.8% 76.1% that in Catholic health-care Auxiliary staff 44 18.8% 65.7% structures there are multiple Administrative 50 21.4% 74.6% professional specialist figures not only in the medical disci- Staff of the pastoral service 44 18.8% 65.7% plines but also in other discipli- Total 234 100.0% 349.3% nary areas, thereby achieving Valid cases 67 more overall care and treatment Tab. 8. Episodes of absenteeism. Year: 2005 for suffering people. Medical and nursing figures predomi- Occurence of episodes Abs. Val. values nate without, however, in as- of absenteism % F sessing the personnel available, YES 46 52.3 the heads of the structures who NO 42 47.7 filled in the questionnaire Total 88 100.0 stressing the insufficient num- Absent cases No answer 2 bers of nurses and other profes- Total 90 sional support figures such as psychologists, rehabilitation Tab. 9. Frequency of cases of absenteeism in the year 2005 therapists, social assistants, so- Frequency of episodes Abs. Val. % ciologists, counsellors and care- of absenteism values % accumulated givers. Rarely 17 36.2 36.2 TABLE 7 Sometimes 22 46.8 83.0 Often 6 12.8 95.7 In this survey of the Pontifi- Always 1 4.3 100.0 cal Council we tried to explore Total 46 100.0 certain aspects of the work load Absent cases Not applicable 44 of people working in these Total 90 structures. To this end, the struc- tures that answered the ques- ten provided service outside not only leads to a greater rigid- tionnaire were asked which pro- their normal working hours ity in conditions of work for fessional figures most often (21.8% of the answers). They these figures but also leads to continued their service outside were followed by administra- excessive work which can only the working hours envisaged by tive staff (21.4% of the an- have consequences for their lev- their contracts. 67 structures out swers) and medical staff (19.2% els of satisfaction and motiva- of 90 answered this question of the answers). These data as tion as regards their work. and pointed to nurses as the pro- well seem to confirm the fact fessional figures who most of- that the scarcity of nursing staff TABLE 8 AND 9

DOLENTIUM HOMINUM N. 71-2009 Excessive work, like a low Tab. 10. Moments of financial difficulty because of which personnel level of flexibility in working did not receive their salaries on a regular basis. Year: 2005 hours, may be only one of the Irregular payment of salaries Abs.values Val. % reasons why over a half of the YES 13 14.1 structures that filled in the ques- tionnaire in 2005 registered NO 73 85.9 cases of absenteeism (52.3%). Total 86 100.0 However, the phenomenon Absent cases No answer 4 seems to be still characterised Total 90 by its occasional character and does not constitute, at least for Tab. 11. Incentives for the payment of personnel. the moment, a ‘pathology’ of Year: 2005 (multiple answers) the system. 83% of centres de- Answers clared that they had experi- Typology of incentives Abs. % of % enced only a few cases of ab- values answers of cases senteeism. Only in 17% of cas- es were their frequently recur- Incentives for doctors 45 22.5% 78.9% ring episodes (cf. tab. 9). Incentives for nurses 44 22.0% 77.2% Incentives for auxiliaries 42 21.0% 73.7% TABLE 10 Incentives for administrators 40 20.0% 70.2% Incentives for the pastoral service 29 14.5% 50.9% In order to understand Totale 200 100.0% 350.9% whether the economic-financial Valid cases 57 30 difficulties of Catholic health- care structures could influence Tab. 12. Typology of formulas for contracts for personnel. behaviour involving absen- Year: 2005 (multiple answers) teeism, those filling in the ques- Answers tionnaire were asked if during Typology of forms % the year 2005 moments of fi- of contract Abs. % of nancial difficulty had occurred values answers of cases leading to personnel not receiv- Full-time permanent contract 70 42.4% 94.6% ing their salaries on a regular Part-time permanent contract 28 17.0% 37.8% basis. Only 12 structures out of Full-time temporary contract 41 24.8% 55.4% 90 declared that they had had Part-time temporary contract 24 14.5% 32.4% this kind of problem and what- Consultancy/project 2 1.2% 2.7% ever the case it had taken place Total 165 100.0% 223.0% only rarely. This fact would ap- pear to confirm, and the use of Valid cases 74 the conditional tense is obliga- tory, that the possible reasons TABLE 12 place the value of investing in for absenteeism are to be found human resources at the centre elsewhere. But what are the formulas for of things, and as an ineluctable contracts that govern the work element which should however TABLE 11 relationship between these pro- be flanked by policies involv- fessional figures and the ing flexibility in work which al- An interesting fact which Catholic health-care structures low objective difficulties of an should be commented upon as to which they belong? 74 struc- economic character to be ad- regards positive initiatives to tures out of 90 answered this dressed. For this reason, perma- support the human resources question and declared that the nent contracts are followed by employed in the health-care full-time permanent contract temporary contracts (40%), ei- world is the adoption of incen- was the most widespread form ther full-time (24.8% of an- tives. At least 57 structures out of contract (42.4% of answers swers) or part-time, and project of 90 declared that they had given by 96.4% of those who contracts. adopted measures of this kind, filled in the questionnaire). If above all for medical and nurs- one then considers part-time TABLE 13 ing staff (respectively 22.5% permanent contracts it is possi- and 22% of answers given by ble to observe that two-thirds of In order to explore the real 80% of the structures). These personnel in Catholic health- existence of conditions of flexi- groups were followed by aux- care structures are permanent bility in the management of iliary and administrative work- staff. This is a very important overall working hours, those ers. However, the system of in- fact if one considers the in- filling in the questionnaire were centives would appear to be creasing spread in the contem- asked to indicate the profes- a transversal measure adopted porary labour market of tempo- sional figures for whom their in a generalised way for rary contracts and project con- contracts envisage an organisa- health-care workers (each tracts, which are also of a tem- tion of their working hours in structure, indeed, answered on porary character. This fact can line with their family needs. average 3.5 options from those be read in two different ways: Only 36 Catholic health-care indicated). as an indicator of a decision to structures out of 90 (a little

DOLENTIUM HOMINUM N. 71-2009 Tab. 13. Professional figures for whom is envisaged more than a third) answered an organisation of their working hours in line with the needs this question and they called at- of their family lives within the context of the overall hours tention to a greater flexibility in of their contracts. Year: 2005 (multiple answers) the contracts of medical staff (23.6% of the answers given by Personnel for whom is Answers those who filled in the ques- envisaged an organisation tionnaire), followed by those of their working hours in working in the pastoral service line with the needs of their Abs. % of % values answers of cases (20.9% of answers). A lower family level of flexibility is to be found Medical staff 26 23.6% 72.2% in relation to the professional Nursing staff 20 18.2% 55.6% figures of the nursing and ad- Auxiliary staff 21 19.1% 58.3% ministrative sectors. This fact is Administrative staff 20 18.2% 55.6% in line with the fact that there is Pastoral staff 23 20.9% 63.9% a shortage of nursing staff. This Total 110 100.0% 305.6% shortage has consequences for conditions of flexibility as re- Valid cases 36 gards their work.

Tab. 14. Structures to which in 2005 personnel who had made TABLE 14 a formal request were transferred (multiple answers) Structures to which Answers About 30 out of 90 Catholic health-care structures declared personnel made a formal Abs. % of % 31 request to transfer values answers of cases that they had received during the course of the year 2005 re- To a public structure 13 21.7% 56.5% quests to be transferred by their To a private structure 18 30.0% 78.3% staff in order to go to private To a structure 8 13.3% 34.8% structures (30% of answers giv- in the same city en by about 80% of cases). It is To a structure in another city 13 21.7% 56.5% worthwhile, therefore, trying to To a structure 8 13.3% 34.8% understand the reasons for these in another country requests. From table 15 one can Total 60 100.0% 260.9% see that the principal motiva- Valid cases 23 tion is specifically of an eco- nomic character. 30% of an- swers provided by the struc- Tab. 15. Principal motivations expressed tures who filled in the question- in the requests for transfer to other health-care structures. naire, indeed, referred to the Year: 2005 (multiple answers) ‘need to improve the person’s Answer economic position’ as being the Motivations for requests % principal reason adopted to ex- for transfer Abs. % of values answers of cases plain the request for transfer. To move closer to home 6 12.8% 19.4% Side by side with this reason there is also that of wanting to To improve economic status 14 29.8% 45.2% belong to a larger structure and To join one’s family 11 23.4% 35.5% probably one with more stabili- To go to a larger structure 10 21.3% 32.3% ty and security. There are also Because of burn out stress 3 6.4% 9.7% reasons linked to the need to be Mobbing 3 6.4% 9.7% near a person’s family. There Total 47 100.0% 151.6% are few examples of this but Valid cases 31 they nonetheless indicate a need for work mobility in this sphere. Tab. 16. Principal reasons for the resignation of health-care personnel in the health-care structures TABLES 15 AND 16 that filled in the questionnaire Answer Although transfers were de- Reasons for resigning Abs. % of % clared by only about thirty of values answers of cases Catholic health-care structures, To go to a larger structure 21 30.4% 52.5% resignations by members of the Because of burn-out stress 9 13.0% 22.5% personnel were indicated by Because of a lack of forty. In this case as well one 13 18.8% 32.5% economic incentives could only ask about the princi- pal reasons for this decision. For health reasons 15 21.7% 37.5% Staff chose to resign in order to Because of family problems 11 15.9% 27.5% move to larger structures (and Total 69 100.0% 172.5% thus one that were more solid in Valid cases 40 financial terms) (30.45 of an-

DOLENTIUM HOMINUM N. 71-2009 swers) and because of a lack of Tab. 17. Structures in which during 2005 were organised sufficient economic incentives professional up-dating and training courses for the (18.8% of the answers). It has medical/health-care staff already been observed that Organisation of professional Abs. Val. Catholic health-care structures updating and training courses values % envisage incentives at the level of pay for certain professional YES 78 87,6 figures but perhaps this is not NO 11 12,4 yet sufficient to meet the expec- Total 89 100,0 tations of their staff. And then Absent cases no answer 1 there are reasons based on Total 90 health and family ties. Tab. 18. Frequency with which these courses were organised in the year 2005 Training Frequency with which Abs. Val. % TABLES 17, 18 AND 19 the courses were organised values % accumulated Once a year 14 18,4 18,4 Without any doubt, training Twice a year 17 22,4 40,8 constitutes a dimension to Once every three months 17 22,4 63,2 which the administrations of At least once a months 28 36,8 100,0 Catholic health-care structures Total 76 100,0 attribute importance. In 78 out Absent cases 32 of 90 structures regular courses not applicable 12 for professional updating and no answer 2 training are provided. This ori- Total 14 entation confirms the intention of these structures to invest in Total 90 their own personnel, supporting them and improving their pro- Tab. 19. Typology of organisation of the courses. fessional skill and expertise, Year: 2005 (multiple answers) and this has positive conse- Answers quences in terms of the perfor- Typology of courses Abs. % of % mance of services. It has al- values answers of cases ready been emphasised that Seminars 51 32,9% 67,1% economic support provided by patients and the families of pa- Conferences 49 31,6% 64,5% tients constitutes an indicator of Residential courses 55 35,5% 72,4% the success of the medical ser- Total 155 100,0% 203,9% vice in a broad sense provided Valid cases 76 by these structures. Almost 60% of courses Tab. 20. Subject areas addressed in courses involving took place with a frequency of the professional training and updating of personnel. at least every three months, the Year: 2005 (multiple answers) other 40% with a frequency of Answers Subjects areas one a year (cf. tab 18), in the % of of the courses Abs. % of form of residential courses values answers cases (35.5% of the answers) and Ethics and bioethics 39 17,0% 52,7% seminars (32.9% of answers) (cf. tab 19). Pastoral care 36 15,7% 48,6% Health-care information and 44 19,2% 59,5% TABLE 20 communication technology Health-care education 42 18,3% 56,8% The subject area most ad- Management and administration 40 17,5% 54,1% dressed in these courses is Pharmacological updating 28 12,2% 37,8% health-care information and Total 229 100,0% 309,5% communication technology Valid cases 74 (19.2% of answers given by 60% of cases). This is an aspect health-care structures invest in success that the use of the com- of especial importance which this area is a symptom of the puterised questionnaire had in deserves a brief comment. The rooting of an information cul- the carrying out of the survey, emphasis placed on this subject ture from which a good organi- above all in the poorest coun- indicates the presence of a cul- sation and management of re- tries. ture that places information at sources, especially if these last These courses were followed the centre of health-care plan- are limited, cannot depart. Sen- by courses in health-care edu- ning. We live in a society of in- sitivity to the use of information cation (18.3% of answers), on formation and technological in- and communications technolo- hospital management and ad- novation. The fact that Catholic gy was also confirmed by the ministration (17.5% of an-

DOLENTIUM HOMINUM N. 71-2009 swers), on the subjects of med- uation of economic uncertainty care in health which in most of ical ethics and bioethics (17% health-care professionals them- the Catholic health-care struc- of answers), and on pastoral ac- selves are afflicted by dissatis- tures of our sample are not very tivity (15.7% of answers). faction and de-motivation. present. 3. In tables 7 to 16 one can 5. The shortage of data on clearly see that it is difficult to pastoral care in health simulates Final Observations engender confidence in the us not to neglect this reality but, health-care professionals em- instead, to point out the needs 1. In order to establish a ployed in Catholic structures and programmes that are most framework of reference involv- because of the fact there is often suited to a more incisive mis- ing values, we have to have a a lack of hope about the future. sion. The evangelisation and summarising approach to the In table 14, in particular, one the specific identity of a major subjects dealt with by the can see that 30 structures out of Catholic health-care structure survey connected with the most 90 had received requests for cannot depart from a major re- urgent contemporary problems new postings by their personnel flection on man, on the mean- in order to understand the con- to go to other structures and in ing of suffering, and from the ditions of mission of Catholic table 15 one can see that the spiritual accompanying of pa- health care, the situation of the principal reason for this is of an tients. These are all aspects that personnel in order to identify economic character. This situa- pastoral care in health must as- the function of their sense of tion makes difficult both the de- sure. However, from the few belonging, and, lastly, activity fence of the Catholic identity of data that are available to us we involving training in order to il- a structure and the services that can see the difficulties that exist luminate the preferences in de- are offered, and also impedes as regards the organisation of cisions regarding choices. In a the maturing of laity who are pastoral care as a service, given 33 reading of these observations able to take on tasks of active that in many structures of our one should also bear in mind witness in pastoral care and in sample it encounters obstacles that the survey was carried out bioethics. in performing the roles that are on the basis of a sample and did 4. Specifically in the ques- allotted to it. The figures who not involve all Catholic health- tions on training projects, one work in pastoral care in health, care structures. can see a certain imbalance be- that is to say chaplains, reli- 2. As can be deduced from tween training of a technical gious and secular people, albeit table 5, the problem that should character and training of an eth- in their low numbers, assure a be addressed as an epochal ical-pastoral character. The sub- sufficient response to the needs emergency is the financial ject most addressed in courses of their structures, not least be- shortfalls in supporting these is health-care information and cause most of the time they health-care structures. We communications technology work outside working hours, should see this fact as the joint and although this consoles the and without receiving any eco- result of the progressive thin- promoters of a correct moderni- nomic payment as occurs with ning of traditional flows of sation at the same time it im- overtime in the other health- charity towards developing poses reflection about overall care professions, and this bears countries and the contemporary training strategies that cannot witness to love and a spirit of weakening of the local financial neglect the training that is nec- Christian charity towards those resources allocated to health essary to ensure that Catholic who suffer which still today, care in socio-economic con- health-care structures are eccle- despite the very many difficul- texts of deterioration and un- sial works of evangelisation. ties, characterises this service. derdevelopment. Even though This apostolic requirement the absence of networks of con- must place on the same level, at PONTIFICAL COUNCIL FOR nection is not seen as an emer- the least, technical training and HEALTH CARE WORKERS gency, it would be advisable to humanistic training: these two The Holy See place at the centre of the intertwining and ethically har- Church as regards health care monised realities must be the Note the subject of subsidiarity in or- subject of initial training for der to allow a re-foundation of every new worker and of per- 1 The number of bishops responsible the Catholic presence in the manent training for all workers. for pastoral care in health is greater than the number of countries because in some world of health and health care. In particular, it is necessary to of these countries there are two bishops Without forgetting that in a sit- encourage courses in pastoral who have this responsibility.

DOLENTIUM HOMINUM N. 71-2009 Hospitals as Settings for the Exploration and Practice of Hope*

This subject, ‘hospitals as 1. Which Hospitals? tance to Health Care Workers settings for the exploration and which then became the Pontifi- practice of hope’, is at one and There are various typologies cal Council for Pastoral Assis- the same time delicate, com- of hospitals according to the tance to Health Care Workers:5 plex and stimulating. At the classifications that are em- ‘In fact, over the course of the level of principle, nothing can ployed and the latitudes in centuries the Church has felt be objected to in this statement which they are located. Each strongly that service to the sick if we consider the kind of ser- one of them in their own way and suffering is an integral part vice that is involved, the con- can be a setting for the explo- of her mission, and not only has ditions involved, and above all ration and practice of hope. The she encouraged among Chris- the activities that are usually problem is to verify the perti- tians the blossoming of various engaged in. Indeed, this sub- nence of the horizon of values works of mercy, but she has al- ject corresponds in a special of each hospital structure as so established many religious way to the fundamental aspira- well as the real existence of hu- institutions within her with the tion of contemporary man, as man and material means that specific aim to fostering, orga- Msgr. Ignazio Sanna observes: correspond to the needs of peo- nizing, improving and increas- ‘Man is a historical being, an- ple who turn to it. As Pier Luigi ing help to the sick Missionar- 34 chored in the chain of the uni- Marchesi observed a few years ies, on their part, in carrying out versal future, a being in com- ago: ‘One can use the Gospel, the work of evangelization have pletion, a being open to the fu- prayer and religious rules to constantly combined the ture who looks for a fixed hori- distance oneself from men, to preaching of the Good News zon of meanings, a stable near- keep them under; science and with the help and care of the ness to happiness, a secure technology when used to sub- sick’ (DH, n. 1). The service guarantee as regards life, love ject men threaten mankind. But given to patients in every and interpersonal commu- one can use religious life, ac- Catholic health-care structure nion… Secularised society, tion, science and technology to should, therefore, be organised which man sees from the win- foster the development of man, in a way that is in conformity dow of his existence, offers to protect him at moments of with this mission. him changing horizons of weakness, to assure that he has In order to perform this role, meaning, connected with freedom, responsibility, and the in addition to the standards re- work, with health, with well- desire to live as a man’.3 quired by specific legislation, a being, with commitment to no- Even though difficulties, Catholic hospital should have ble humanitarian ideals. It gen- above all of an economic char- the following characteristics: erates in him historical hopes acter, are not absent, it is well the centrality of the sick person, of self-fulfilment and expands known that in the industrialised overall care for the patient with in him a wish for new con- world it is the task of the state attention being paid to all the sumption, which is increasing- to assure its citizens good dimensions of his or her person, ly demanding and radical. It health and a suitable health ser- the defence and promotion of also offers him attained vice. In other parts of the world unborn life, commitment to the achievements of liberation and this happens relatively less or rehabilitation of the disabled human promotion which ren- does not take place at all. This and qualified care for dying der aspiration to another life compromises the hope of innu- sick people, the training of per- and another dimension super- merable human beings in the sonnel at a human, Christian fluous. Lastly, it makes him rest of the world. and professional level, a forget death and the questions From an ideological and cul- prophetic presence in the most that are inevitably linked to tural point of view, a distinc- difficult and newest areas of death’.1 However, when illness tion is usually made between medicine, quality and efficien- comes into play, together with Catholic hospitals and public cy in the ministry of the spiritu- its series of pains and suffer- hospitals. A Catholic hospital, al and religious accompanying ings, of fractures and questions like other health-care institu- of the sick person and his or her about meaning that receive no tions of the Church, is ‘a spe- family relatives, the safeguard- reply, he then yearns for that cific way by which the eccle- ing of humanity in care and ser- necessary power, to quote Var- sial community implements vices, and the promotion in the illon, which requires human the mandate to ‘heal the sick- areas in which it operates of a hope in order to be achieved.2 ’’. 4 This was officially empha- health-care culture based on au- Almost immediately, however, sised by the Servant of God, thentic human and Christian one sees the need for certain His Holiness John Paul II, of values. All of this should be clarifications: what hospitals venerable memory, in his Mo- achieved without neglecting a are we talking about and what tu Proprio Dolentium transparent and suitable admin- kind of hope? Hominum (11/02/1985), by istrative and economic manage- which he created the Pontifical ment of the hospital, even Commission for Pastoral Assis- though, as Cardinal F. Angelini

* Paper given by H.E. J.L. Redrado, O.H. during the series of meetings on the encyclical Spe Salvi, The Political Charity International Association, 8 october 2008 well observes, a Catholic hospi- Suffering, too, observes the the possible arrival of a better, tal has ‘the duty to act so that Holy Father, is a setting for more luminous and human the human and spiritual budget’ learning about hope. It is this world, which certainly do not of its ‘management has priority inasmuch as it creates an in- have the same weight and sig- over the economic and adminis- eluctable experience of human nificance. Now, hospital activi- trative budget’.6 life which it is not possible to ty can correspond to two per- With respect to a public hos- eliminate despite the efforts and sonal and social horizons pital, it should be pointed out investments made in this direc- whether one is dealing with ser- tat this is the property of the tion. Suffering enters personal vice to an individual patient or state and it has a more juridical existence without knocking and activities involving medical- character in order to distinguish blows up many human projects. scientific research that seeks to it from a religious hospital; as a In this way, suffering makes us solve a situation that involves state service, it is non-confes- experience the limits of our be- millions of human beings. sional and ethically pluralistic. ing and the limits of our action. Over the years, however, the at- Thus, Christian faith teaches us tention that has been paid to le- that the elimination of suffer- gal and structural aspects has ing, like the elimination of the reduced to a minimum from a sin and finitude which underlie juridical point of view the dif- it, can only be worked by God. ferences between a Catholic We know now, thanks to Jesus, hospital and a public hospital.7 the Son of God made flesh, Both of them have to face up to who suffered, died and rose the same problems of an eco- again, that suffering can acquire nomic, cultural and technical- a meaning and inspire praises to 35 scientific character. God, joy, and hope in the heart (nn. 36-37). In addition, for in- dividuals as for societies, inter- 2. Settings for action with suffering and a suf- Learning about and fering person determines the Practising Hope level of humanity when suffer- ing is accepted and shared. For The Holy Father Benedict this to happen with individuals XVI devotes the last part of the and societies, individuals second encyclical letter Spe should find in their own suffer- Salvi to settings for learning ing and in the suffering of oth- about and practising hope and ers a meaning, a pathway of pu- he dwells upon three: prayer rification, of maturation and of (nn. 32-4), acting and suffering hope (n. 38). This principally (nn.35-40),and judgement (nn. means two things: the capacity 41-48). In these dense and won- to be-with those who suffer in derful pages, the Supreme Pon- loneliness, that is to say an apti- By their nature, hospital ac- tiff describes hope in terms of tude for comfort, and the accep- tivities, which involve medical- concentric and complementary tance/bearing of suffering out scientific research and the treat- circles (n. 35), that is the per- of love for good, truth and jus- ment of, and care for, sick peo- sonal horizon, the social hori- tice.8 Indeed, we should never ple, fully belong to the horizons zon and above all else the theo- forget that God participates in of acting and suffering. Indeed, logical horizon, which includes our suffering. a person who turns to a hospital the whole of the creation, in service is a being in need whose line with what St. Paul says in life is threatened at its founda- his letter to the Romans: ‘For 3. Can a Hospital be Seen tions by illness and the malaise the creation waits with eager as a Setting for Learning that this illness causes.9 He or longing for the revealing of the about and Practising she wants to get better, that is to sons of God… the creation it- Hope? say he or she wants to see the self will be set free from its balance of his or her vital func- bondage to decay and obtain First of all we should under- tions restored. He or she thus the glorious liberty of the chil- stand what kind of hope should nourishes the hope that he or dren of God’ (Rm 8:18-21). be explored in a hospital. At the she will be able to overcome his In this paper, of interest in a beginning of section 35 of Spe or her current crisis and return specific way is the tandem act- Salvi, the Holy Father makes a to his or her normal life, daily ing/suffering as settings for distinction between small hopes activities, projects, etc. learning about and practising and large hopes, according to But what kind of hope is this hope. Acting is this inasmuch as the importance of the field they and on what is it based? In his every human project is based are applied to and the perspec- encyclopaedic dictionary on the upon it, supported by it, and re- tives of the individuals who are thought of St. , ceives its meaning from it. their bearers – a task that con- Battista Mondin provides the Hope, therefore, is a door that is cerns first of all an improve- following definition of hope: ‘a open to the future and its hori- ment in the condition of the in- feeling of confident expectation zon is the Love of God. dividual and a contribution to as regards the future’.10 In this

DOLENTIUM HOMINUM N. 71-2009 article the author makes an im- activities when compared to the as the reduction in the number portant distinction between the strong hopes that they generate of such structures that work in concept of hope and the charac- in beings who are frail and in local areas, all constitute a tan- teristics that define hope: ‘there need of medical care and treat- gible and irrefutable testimony is both a simply human hope ment. Journalistic news has by to these difficulties connected and a Christian hope: the first now habituated us to the wor- with budgeting.14 bases its confident expectation ries generated by what is In addition, the difficulties of on human calculations and termed ‘bad health care’, an un- an ideological and cultural power; the second bases its equivocal mirror of the difficul- character should not in the least confident expectation on the ties of the existing health-care be underestimated because, as Word of God, on His promises, system, whatever it may actual- the Pastoral Note of the Episco- on His grace’.11 ly be, in fulfilling its mission of pal Commission of the Italian As regards the characteristics guaranteeing good care and Bishops’ Conference for the of the subject of hope, there are treatment to those people who Service of Charity and Health four: it must be a good; a future turn to its services.13 All of this observes, ‘the contemporary or- good; an arduous good; and takes us by surprise and leaves ganisation of the world of lastly a possible good. This last us amazed given that the same health and health care should be distinguishes it in a fundamen- news constantly shows us the understood in the light as well tal way from the feeling that is advances of medicine which are of certain trends of contempo- close to it, namely desire, in constant and almost unlimit- rary culture and scientific and which ‘concerns any good’ and ed expansion thanks to the very technical progress that have af- ‘is directed towards any good, great knowledge that exists in fected the way in which health, independently of the fact of be- the various spheres of medical illness, life and death are 36 ing possible or impossible’.12 science and technology applied seen’.15 One may think, for ex- With respect to the various to the health-care medical sec- ample, of the by now recurrent hospital activities of diagnosis, tor. pushes towards abortion and prognosis, treatment and care, euthanasia16 which periodically these two forms of hope – hu- animate the news, now and then man hope and Christian hope – generating major debate that at are ideally present, at times times leads on to somewhat contemporaneously, at times permissive legislation that does not, depending on whether who not respect the complexity and turns to a hospital service or the delicacy of human life.17 provides it is a believer or not. Thus the horizon of hope, Indeed, hope is imperatively re- which is culturally wandering, quested by the good pursued at times is cloudy and uncer- both by the patient and by the tain. The bishops of Italy agree medical doctor and involves a with this and expressed them- return of the balance and har- selves in the following way in mony of the vital functions, 2001: ‘We wish to address a which have been compromised word of hope to everyone. by illness. Sick people, like oth- Hope, today, is no easy thing. er individuals concerned with Its progressive reduction does the achievement of this good, not help us: the eschatological that is to say in various ways horizon has been obfuscated if medical doctors, nurses, chap- not removed in our culture, like lains and voluntary workers, the idea that history has a direc- work, and in some ways hope, tion that should be followed to- for the achievement of the re- The problems of the world of wards a fullness that goes be- sults aspired to without further health care are not confined, yond it’.18 complications. Too often, un- obviously enough, to questions A question that is not only fortunately, this hope comes up of ordinary corruption, blame- cultural but also anthropologi- against a complex, opposed and worthy distraction or simply by cal thus poses itself. Care for disappointing reality. evident incompetence at the suffering man, in fact, is ab- level of diagnosis or treatment. solutely dependent on the idea Grave and chronic difficulties that one has of man in general. 4. The Pathway of Hope in in obtaining sufficient econom- If his horizon is only earthly, Health-Care and Hospital ic and human resources also then care for a sick person can Structures Bristles with constitute a serious obstacle in be limited to caring for his or Permanent and Always the way of the development and her suffering part alone, thereby Obstinate Difficulties the efficiency of national and reducing him or her to one of international health-care sys- his or her parts. Whereas if man That no health-care system is tems and strongly condition is seen in his entirety, that is to ideal is a part of the nature of them. Resort to the free market say in relation to both his cor- human affairs: no human work, and to private investments in poreal and psychological and in fact, is ever fully up to its health care, the transformation spiritual dimensions, certainly conceptual model. This also of hospital structures into the care that is provided to him and above all applies to hospital health-care companies, as well will not stop only at his sick

DOLENTIUM HOMINUM N. 71-2009 part but will try, at least in ten- energies that act at the bedside must answer… for the use that dency, to deal also with the of a patient: all of these must be he has made of the great gift health of other parts of him be- placed at the service of the pa- that he received. There derives cause the whole person falls tient in homage to the mandate from this the nobility of medi- sick and not just an organ of of the Lord to preach the King- cine which by definition is at his. One may state, therefore, dom of God and heal the sick the service of human life. As that from the concept of man (Lk 9:2). Indeed, as Brother P. such it involves an essential and follows the concept of health, L. Marchesi observes: ‘For a inescapable reference to man in of health care and of a hospital patient a hospital is not a bar, a his spiritual and material structure. cinema or a stadium; it is a wholeness, in his individual and place where one may not be social dimensions: medicine is treated well, where one can be at the service of man, of the 5. Catholic Health-Care neglected, where one can die’.20 whole man, of every man’.23 Structures and Christian Hence the strong need for the These are important words Hope humanisation of hospitals in or- indeed: man, in all the expres- der to make them a setting for sions of his life, belongs to A Catholic hospital, and this hope because a person who is God. It is specifically this be- should never be lost from sight, admitted is a person in a state of longing to God that constitutes is not distinguished from other crisis, in a state of need that the foundation of Christian hospitals because of a particular goes beyond the normal. He or hope and disqualifies in a defin- architectonic structure, because she is a frail person inasmuch itive way all forms of exagger- of the name of the body that as the illness has made him or ated treatment and all forms of owns it, or even less because of her lose control of his or her euthanasia. Thus there is al- the organisational forms of its own body which at times no ways hope, even for those who 37 various departments. It is fun- longer responds to stimuli and no longer expect anything from damentally characterised, seems extraneous to him or her. therapeutic medicine and for rather, by the spirit and the eth- But he or she is also a person whom the only pharmaceutical ical-moral orientation that un- assailed by a thousand ques- that remains is humanity, as in- derlie the services that is pro- tions about his or her falling ill, deed Brother P.L. Marchesi ob- vided to the sick people who about the meaning of health and serves when reflecting on the turn to it. This was made clear illness, of pain and of suffering, hospital-company and moderni- by Cardinal Fiorenzo Angelini about the meaning of life and ty: ‘One can die of modernity in his paper to the international history, from the point of view declares a contemporary slo- conference on the identity of of the personal aspects of fulfil- gan. Instead, one lives through Catholic health-care institutions ment, daily activities, initiatives humanity, one hopes and one organised by the Pontifical and hopes as well. 21 gets better. And when one can- Council for Health Care Work- The question about meaning, not recover one dies in peace ers and held in November 2002: however, transcends the search because humanity is not some- ‘As I have always argued, a for healing in a narrow sense thing that is good that should be hospital inasmuch as it is a because, as Prof. M. Petrini performer paternalistically but Catholic hospital does not have points out, ‘Health in Christian rather it is a resource, an ability, a duty to be different from oth- thought is… inseparable from which has a therapeutic value, it er hospitals or similar health- salvation and the newness and is a ‘pharmaceutical’, at times care structures; it is simply originality of Christianity lies in the best that the hospital has called to be or at least to try to having introduced this concept available to it’.24 be better than other because to of health that is compatible This applies to those patients follow Christ in providing care with a state of illness inasmuch who have to coexist with an in- to those who suffer is to place at as faith makes a person able to curable illness25 and to those pa- the service of the sick the ut- appreciate his or her own suf- tients for whom therapies have most of one’s professional skill fering’. 22 become ineffective and who and expertise with generous The teachings and the pas- need to be prepared to detach dedication, although, as John toral practice of the Church themselves from this world in Paul II has written, however down the centuries, as the Motu order to draw near to the father- important and indispensable it Proprio Dolentium Hominum of ly embrace of that merciful and may be ‘no institution can on its John Paul II quoted above ob- loving God who so loved the own take the place of the hu- serves, bear witness to the con- world that he gave it His Son man heart, human compassion, stant care and concern of its for its redemption (cf. Jn 3:17). human love, human initiative, pastors, at various levels, in this In order to humanise hospitals when it is a matter of coming to area. This is how the Servant of and proclaim hope during this the help of the suffering of oth- God John Paul II expressed penultimate stage of life on ers’ (Salvifici doloris, n. 29)’.19 himself and on one occasion he earth, the Church must be cer- Health-care structures, there- pointed to its theological foun- tainly present with her caring fore, are instruments in the dation: ‘It is the Creator of the with accompanying, with hands of health-care workers, universe who shaped man and prayer and with the sacrament and the same may be said of devised the origin of all things of the anointing of the sick. But medical and nursing expertise, (2 Mac 7:23). Man, therefore, doctors and those responsible economic or technological re- in all the expressions of his life for the care of the patient as sources, and the various social belongs to God, to whom he well should not withdraw

DOLENTIUM HOMINUM N. 71-2009 when, powerless, they see the voke the true God, the only liv- ta degli operatori sanitari (Vatican City, 1995). possibilities of a cure for their ing God, the God of human COMMISSIONE TEOLOGICA INTER- patient dissolve, because ‘Even creatures? Is it not He, perhaps, NAZIONALE, ‘Fede e inculturazione’, in when ‘nothing more can be who listens to them? Who an- Enchiridion Vaticanum, vol. 11 (EDB, Bologna, 1990), pp.846-895. done’, there is still a great deal swers their prayers? Is not the CONFERENZA EPISCOPALE ITALIANA, to be done. First and foremost word ‘God’ precisely for this Testimoni di Gesù risorto, speranza del the pain must be alleviated as reason the word of invocation, mondo. Atti del 4° Convegno Ecclesiale nazionale Verona, 16-20 ottobre 2006 much as possible. But there is the word that became a Name, (EDB, Bologna, 2008). also a work of care, support, consecrated for all time in all COMMISSIONE EPISCOPALE PER IL comfort… Out of professional human languages? We should SERVIZIO DELLA CARITÀ E LA SALUTE (CEI), ‘Predicate il Vangelo e curate i duty, the medical doctor implic- esteem those who prohibit it be- malati.» La comunità cristiana e la pas- itly commits himself to making cause they are opposed to the torale della salute (EDB, Bologna, 2006). the final time of his patient as wrong and the shameful abuse COMITATO PREPARATORIO DEL IV CON- VEGNO ECCLESIALE, Testimoni di Gesù comfortable as possible. Being of those who so often appeal to risorto speranza del mondo. Traccia di ri- of help to the dying in order to ‘God’ to justify themselves; but flessione in preparazione al Convegno ec- clesiale di Verona 16-20 ottobre 2006 make possible a human passing we should not abandon it… we (EDB, Bologna, 2005). over is a task which, beyond the cannot remove all the stains medical doctor, also concerns from the word ‘God’ and we Works

those who work in the field of cannot leave it whole, but we ANGELINI Fiorenzo, Quel soffio sulla care. In a particular way it con- can raise it up from the ground creta (Vatican City, 1990). cerns the Christian community. and, stained and lacerated as it ANGELINI Fiorenzo, L’uomo delle beat- itudini (Vatican City, 1986). It is the very logic of the Gospel is, raise it up above an hour of ASURMENDI Jesús, (Éd. De l’Ate- that leads the disciples of Jesus great pain’.27 lier/Éd. Ouvrières, , 1999). 38 to place at the centre of things BIANCHI Enzo, AIDS vivere e morire in comunione (QIqajon, Magnano, 1997). those who are pushed to the H.E.Msgr. JOSÉ L. REDRADO BOVON François, L’Évangile selon margins by the logic of power. OH, Saint Luc 9,51-14,35 (Labor et Fides, Those who are losing their lives Secretary of the Pontifical Council Geneva, 1996). for Health Care Workers, FAGGIONI Maurizio Pietro, La vita are the poorest of the poor. The the Holy See. nelle nostre mani. Manuale di bioetica Church is a debtor to them for teologica (Ed. Camilliane, Turin, 2004). 26 CHENU Bruno, Dio e l’uomo sofferente their service of hope’. (Qiqajon, Magnano, 2005). I will end this paper with a FILIPPI Nella, Le voci del popolo di Dio quotation from the philosopher (Edacalf, Rome, 2004). FUKUYAMA Francio, L’uomo oltre Martin Buber who tells us how l’uomo. Le conseguenze della rivoluzione the name of God is the last hope biotecnologia (Mondadori, Milan, 2002). to be invoked during terrible Select Bibliography GRELOT Pierre, Espérance, liberté, en- gagement chrétien (Médiaspaul/Éd. moments of suffocating anxi- Dictionaries Paulines, Paris-Montréal, 1982). ety: ‘Yes, God is the most over- JONAS Hans, Il principio responsabil- loaded word in the whole of hu- CARRIER Hervé, Dizionario della cul- ità. Un’etica per la civiltà tecnologica tura. Per una analisi culturale e l’incul- (Einaudi, Turin, 2002). man language. No other word turazione (LEV, Vatican City, 1997). MARCHESI Pier Luigi, SPINSANTI San- has been so soiled and lacerat- CINÀ Giuseppe, LOCCI Efisio, ROC- dro, SPINELLI Ariberto, Per un ospedale ed. Precisely for this reason I CHETTA Carlo, SANDRIN Luciano (ed), più umano (Ed. Paoline, Cinisello Bal- Dizionario di teologia pastorale sanitaria samo (MI), 1985). must not forgo it. Generations (Ed. Camilliane, Turin, 1997). MARCHESI Pier Luigi, SPINSANTI San- of men have off-loaded the DUFOUR Xavier-Léon (ed.), Dizionario dro, SPINELLI Ariberto, Tecnica, medicina di teologia biblica (Marietti, Genoa ed etica. Prassi del principio responsabil- weight of their afflicted lives 5 1976 ). ità (Einaudi, Turin, 1997). onto this word and have ROSSANO Pietro, RAVASI Gianfranco, PEDERZINI Novello, Per soffrire meno, stamped it into the ground; now GIRLANDA Antonio (ed.), Nuovo per soffrire meglio (Editrice Pigrizia, it lies in the dust and bears all Dizionario di teologia biblica (San Paolo, Bologna, 19678). Cinisello Balsamo (MI) 1988). RAVASI Gianfranco, Fino a quando their burdens. Generations of MODIN B., Dizionario Enciclopedico Signore? Un itinerario nel mistero del do- men have lacerated this name del pensiero di San Tommaso d’Aquino lore e della sofferenza (San Paolo, (ESD, Bologna, 1991). Cinisello Balsamo (MI), 2002). with their division into religious SANNA Ignazio, Immagine di Dio e lib- parties; they have killed and Documents of the Magisterium ertà umana. Per un’antropologia a died for this idea, and the name misura d’uomo (Città Nuova, Rome, SECOND VATICAN COUNCIL, ‘Costi- 1990). of God bears all their finger- tuzione Pastorale sulla Chiesa nel mondo SANNA Ignazio, Chiamati per nome. prints and their blood. Where Contemporaneo’, in Enchiridion Vati- Antropologia teologica (San Paolo, could I find a word that resem- canum 1962-1965 (EDB, Bologna, 1993), Cinisello Balsamo (MI), 1994). pp. 1264-1466. SANNA Ignazio, L’identità aperta. Il bled it to refer to the GIOVANNI PAOLO II, Lettera Enciclica cristiano e la questione antropologica Almighty?... Certainly men Redemptor Hominis (4 March1979), in (Queriniana, Brescia, 2006). draw caricatures and write un- ASS, 71 (1979), pp. 257-324. SPINSANTI Sandro, Umanizzare la JOHN PAUL II, Encyclical letter Evan- malattia e la morte. Documenti pastorali derneath ‘God’: they kill each gelium Vitae (25 March 1995). dei vescovi francesi e tedeschi (Ed. Pao- other and do this ‘in the name JOHN PAUL II, Apostolic letter Salvifici line, Rome, 1982). Doloris (11 February 1984). TANGORA Giovanni, POMPILI Domeni- of God’. But when all illusions JOHN PAUL II, Apostolic letter Nuovo co (eds.), Il male e i suoi volti (Ed. San and deceptions disappear, when Millennio ineunte (6 January 2001). Lorenzo, Reggio Emilia, n.y.) they are face to face in the JOHN PAUL II, Motu Proprio Dolentium VARILLON François, La Pâques de Jé- Hominum (11 February1985). sus. Une semaine de méditation d’É- deepest darkness and no longer BENEDICT XVI, Encyclical letter Deus vangile (Bayard Éditions, Paris, 1999). say ‘He, He’ but sigh ‘You, caritas est (25 December 2005). VARILLON François, Joie de croire, joie You’ and implore ‘You’, they BENEDICT XVI, Encycical letter Spe de vivre (Le Centurion, Paris, 1981). Salvi (30 November 2007). ZAVOLI Sergio, Se Dio c’è. Dialogo mean the same being, and when PONTIFICIO CONSIGLIO PER LA PAS- con Piero Coda (Rai-Mondadori, Rome- they add ‘God’ do they not in- TORALE PER GLI OPERATORI SANITARI, Car- Milan, 2000).

DOLENTIUM HOMINUM N. 71-2009 Notes 10 ‘Hope is a spiritual force that affects an absolute dominion over life and death’: man as man. It connotes man and distin- n. 9, p. 12. 1 SANNA I., Chiamati per nome. guishes man from other beings like other 17 The Servant of God JOHN PAUL II in Antropologia teologica (San Paolo, goods such as reason, freedom, language, his encyclical letter Evangelium Vitae Cinisello Balsamo (MI), 1994), pp. 382- culture, religion etc. Hope is specific to writes as follows: ‘The fact that legislation 383. the man-being because he i san incom- in many countries, perhaps even departing 2 The following text of Varillon is ex- plete being, in constant movement to- from basic principles of their Constitu- cellent: ‘Sur terre, depuis qu’il y a des wards the future’: MONDIN B., tions, has determined not to punish these hommes, il y a de la religion, une « foison Dizionario enciclopedico del pensiero di practices against life, and even to make de religions » comme dit Pascal. De la re- san Tommaso d’Aquino (ESD, Bologna, them altogether legal, is both a disturbing ligion ou di sacré. Instinctivement, en ef- 1991), p. 576. symptom and a significant cause of grave fet, l’homme cherche une “puissance” ca- 11 IBID. moral decline. Choices once unanimously pable de réaliser son espérance. Au delà 12 IBID., p. 577. The author makes considered criminal and rejected by the de ses besoins élémentaires, il éprouve le clear that ‘if one is dealing with hope as a common moral sense are gradually be- besoin de vivre plus intensément, plus li- theological virtue, its objective must be coming socially acceptable. Even certain brement, plus totalement. Il veut échapper the supreme good, that is to say happiness sectors of the medical profession, which à la précarité, à la fragilité de son exis- or God and its achievement made possible by its calling is directed to the defence and tence, et du même coup à l’angoisse (la by God and not some creature’. care of human life, are increasingly will- précarité engendre l’angoisse et l’an- ing to carry out these acts against the per- goisse engendre le désespoir).Ce que son. In this way the very nature of the l’homme désire, consciemment ou non, medical profession is distorted and contra- c’est une intensité de vie sans limites, une dicted, and the dignity of those who prac- plénitude d’existence sans failles. Ce que tise it is degraded’ JOHN PAUL II, encycli- Nietzsche et Rimbaud appelleront “l’éter- cal letter Evangelium Vitae, n. 4 (25 nité”, c’est-à-dire, la Béatitude’, VARIL- March 1995). LON F., Joie de croire, joie de vivre (Le 18 CONFERENZA EPISCOPALE ITALIANA Centurion, Paris, 1981), p. 216. (C.E.I.), Comunicare il Vangelo in un 3 MARCHESI P.L., ‘Umanizziamo mondo che cambia (Rome, 2001), n. 2. l’ospedale’, in MARCHESI P.L., SPINSANTI 19 FIORENZO ANGELINI, ‘Primo approc- S., SPINELLI A., Per un ospedale più cio agli ospedali cattolici oggi’, in Dolen- umano (Ed. Paoline, Cinisello Balsamo tium Hominum, 52 (2003/1), p. 11. (MI), 1985), pp. 17-18. 20 MARCHESI P., ‘Umanizziamo 39 4 PETRINI M., ‘Ospedale cattolico’, in l’ospedale’, in MARCHESI P. L., SPINSANTI CINÀ G., LOCCI E., ROCCHETTA C., SAN- S., SPINELLI A., Per un ospedale più DRIN L., (eds.) Dizionario di teologia pas- umano (Ed. Paoline, Cinisello Balsamo torale sanitaria (Edizioni Camilliane, (MI), 1985), p.20. Strada Santa Margherita (TO), 1997), p. 21 ‘During the first moment I did not re- 800. alise what was happening and to such an 5 Cf GIOVANNI PAOLO II, Costituzione extent that I asked myself: am I so seri- Apostolica Pastor Bonus sulla Curia Ro- ously ill that they are prohibiting me from mana, nn. 152-153, (Tipografia Poliglotta receiving visits, telephone calls etc.! They Vaticana, 1988), p. 69. This teaching is told me that I sweated a great deal; this is echoed by Cardinal Fiorenzo Angelini, 13 It is not unusual for the mass media true because once I was discharged I President Emeritus of the Pontifical Coun- to report terrible stories of gauze, scissors, found a large number of pyjamas: so cil for Health Care Workers: ‘behind the nails and other pieces of metal left inside many changes, so many tests and so many objective meaning [of Catholic hospitals] parts of people bodies undergoing opera- medical examinations, now this, now that, there are centuries, even millennia, of a tions; grave examples of neglect of a per- and then having to ‘obey’ because the sit- history of pastoral carein health, a salient son by operating on a healthy organ rather uation was grave. I moved my body with- expression of evangelisation’: ANGELI- than a sick one; underestimation of the out having any strength, without wanting NI F., ‘Primo approccio agli ospedali cat- clinical situation of a patient who is left to anything, it was no longer my body, it tolici oggi’, in Dolentium Hominum, 52 himself and then dies; of deaths caused by needed everything, it belonged to other (2033/1), p.11. routine operations for appendicitis or people, to medical doctors, to nurses…’: 6 ANGELINI F., ‘Primo approccio agli angina; without speaking about episodes REDRADO, J. L., ‘Testimoni dell’amore nel ospedali cattolici oggi’, Dolentium of corruption and situations of conflict dolore’, in Dolentium Hominum, 63 Hominum, 52 (2033/1), p. 11. which involve medical doctors and rela- (2006/3), p. 51. 7 ‘This specific identity has lost a great tives of a patient in op position (to give 22 PETRINI M., ‘Tradizione cristiana. deal of its meaning given that most hospi- only a few recent examples – cases such Prospettiva cattolica’, in PANGRAZI A. tal institutions are state-owned and many as those of Terry Schiavo or Eluana (ed.), Salute, Malattia e morte nelle gran- religious hospitals, thank to the juridical Englaro), etc. For a study of some such di religioni (Ed. Camilliane, Turin, 2002), peculiarity of the classified hospital, are in cases see PUCA A., Etica della vita e del- p. 38. Annota il noto biblista R. Fabris: large part similar to state structures’: S. la salute, Camillianum, Roma 20042, pp. ‘The gospel tradition of which Mark de- LEONE, “Ospedale civile, in CINÀ G., LOC- 129-177. pends… selected certain miracles of heal- CI E., ROCCHETTA C., SANDRIN L., (eds.) 14 Protests against the decisions of ing or liberation from physical malady Dizionario di teologia pastorale sanitaria, some regional authorities, including that and re-read them from a religous point of pp. 804-805. of the Lazio region, forced to close health- view. Thus, beyond physical healing, the 8 The Holy Father writes: ‘Further- care structures in order to balance their gospel reading perceived salvation tout more, the capacity to accept suffering for books after going beyond their projected court, introducing into it a typicaally reli- the sake of goodness, truth and justice is budgets, are by now a part of the national gious element – faith’ (cf 7:1-10; 8:50)’: an essential criterion of humanity, because scene. FABRIS R., ‘La salvezza secondo Luca’, in if my own well-being and safety are ulti- 15 COMMISSIONE EPISCOPALE PER IL BARBAGLIO G., FABRIS R., MAGGIONI B., I mately more important than truth and jus- SERVIZIO DELLA CARITÀ E LA SALUTE, Vangeli (Cittadella Editrice, Assisi 200410 tice, then the power of the stronger pre- Predicate il Vangelo. La comunità cris- ), p. 1221. vails, then violence and untruth reign tiana e la pastorale della salute (EDB, 23 GIOVANNI PAOLO II, ‘La medicina è a supreme. Truth and justice must stand Bologna), n. 8, p. 11. servizi dell’uomo, di tutto l’uomo, di ogni above my comfort and physical well-be- 16 Referring to the Prometheus-like ap- uomo’, in Dolentium Hominum, 7 ing, or else my life itself becomes a lie’ (n. proach of modern man, the authors of the (1988/1) 6, cf ID., Dolentium Hominum 38). above-mentioned Note observe: ‘Two (Motu Proprio), n. 2. 9 S. Leone writes: ‘What in essential very evident symptoms of this conception 24 MARCHESI P., ‘Umanizziamo terms does being admitted to hospital are, albeit with differences as regards mo- l’ospedale’, in loc. cit. pp. 27-28. mean? First of all to experience a state of tivations and outcomes, on the one hand 25 MINO J.-C., FRATTINI M.-O, need which is not connected with the ordi- exaggerated treatment and on the other FOURNIER E., ‘Pour une médecine de l’in- nary needs of daily life… It is a sign of a euthanasia. Seen closely, between exag- curable’, Études, 4086 (2008), 754-757. pathology and thus of a frailty that could gerated treatment and euthanasia there is a 26 SPINSANTI S., Umanizzare la malattia not otherwise be dealt with and thus it certain logical continuity because in them e la morte. Documenti pastorali dei connotes an experience of finitude, which it is always man who does not accept ad- vescovi francesi e tedeschi (Ed. Paoline, is perceived more the more it was distant dressing himself to death in a human way: Rome, 1982), p. 26. from the existential horizon of the patien- with exaggerated treatment man uses all 27 BUBER M., L’eclissi di Dìo (Mon- t’: LEONE S., ‘Ospedale civile’, in loc. cit,, his means to postpone death whereas with dadori, Milan, 1990), pp. 22.23, quoted in p. 808; MINO J.-C., FRATTINI M.-O, euthanasia man arrogates to himself the CHENU B., Dio e l’uomo sofferente (Edi- FOURNIER E., ‘Pour une médecine de l’in- right to bring forward and bring about zioni Qiqajon-Comunità di Bose, Mag- curable’, in Études, 4086 (2008) 753-764. death. In both cases, he wants to exercise nano, 2005), pp. 19-20.

DOLENTIUM HOMINUM N. 71-2009 The Mental Capacity Act 2005: Bioethical Assessments

In April 2005 the British par- dealt with. It is interesting, about the rejection of life-sup- liament passed the Mental Ca- therefore, to see what has been porting treatment. The key pacity Act 2005 (MCA). From legalised in the sphere of point lays down that every hu- a bioethical point of view it is bioethics and in particular as re- man is irreplaceable and thus interesting to examine certain gards life-support through the each life should be cherished, key points of it and above all to artificial administration of food one’s own life, when life is hard discuss the question of the arti- and water. and at its end as well. The life ficial administration of food of a sick person or a dying per- and water. According to some son or a disabled person should of the reactions to it, this law Key Points of the MCA be respected on a par with that allows, indeed imposes on, of a healthy person. Now, one medical doctors the obligation The Mental Capacity Act reason for concern in people to withhold hydration and nu- seeks to clarify what a person about the rejection of life-sup- trition or to withdraw their ad- can do beforehand as regards a porting treatment is the fear that ministration of such things in future situation when he or she a sick person will be neglected the case of sick people who no is not able to understand or take and not receive the treatment 40 longer have the capacity to un- decisions. It is presumed that that he or she needs. To sum- derstand or to decide and who every adult has the right and marise: there is fear about so- had previously decided that therefore the capacity to make a termed under-treatment. There these should be rejected. I will decision until proved other- is a second and more important begin with a little history but I wise. He or she can also indi- treatment because even if such will then dwell upon certain cate one or more attorneys who neglect is requested by the pa- key points and discuss, at the will then take a decision as to tient, this can be because in that end, the question of artificial what is the best thing to be person there is a lack of value hydration. done for the patient. In this way bestowed on his or her own the law seeks to guarantee the life. The MCA also raises the right of an individual to decide question of why a patient may A Little History on what health-care profession- be worried about the adminis- als and social workers can and tration of life-supporting treat- When a few years ago the cannot do in relation to that in- ment. Being mortal as we are, first draft of this parliamentary dividual. It should be pointed we know that we are destined document was published there out that as regards the impor- to die. To live well, we should were very many well-grounded tant matter of a prior decision embrace this valuable gift and concerns both on the part of ju- involving the rejection of treat- accept the inevitability of rists and amongst medical doc- ment needed to support life this death. It is important to recog- tors. The jurists feared that one must be done in written form nise that life will finish and to could procure a person’s death with witnesses, be valid, and be prepare ourselves for death in by refusing to provide a life- applicable. It is specified that as the best way possible. When supporting treatment. Doctors regards what is in the best inter- death draws near we must be feared that they would be ests of the patient, this can nev- able to accept this reality and forced to cause the death of in- er have the motivation of wish- not look for futile forms of dividuals because of negli- ing to bring about his or her treatment. Many people are gence. Groups representing death. worried that they will not be al- vulnerable people feared that It is interesting to observe lowed to die but will be sub- this new law could legalise eu- that as regards the rejection of jected to unwanted and unnec- thanasia. Out of respect for the medical treatment, some people essary treatment. To sum up: common good many people are more worried about the people are worried about resort and also Catholic bishops in danger of under-treatment and being made to exaggerated England and Wales took an ac- neglect or even a lack of hydra- treatment. What is worse: ab- tive part in the debate. At least tion (starvation) for elderly pa- sent treatment or excessive one thing was clear: the law tients. Others are more con- treatment? It is rightly pointed would not have changed the cerned about the danger of out that two elements must be prohibition on euthanasia and over-treatment and the power borne in mind: that of cherish- on assisted suicide. In addition, of modern medicine to make ing life and that of accepting nobody would have been able the process of dying uselessly death. The first means that to take a decision as regards burdensome. The MCA indi- death should not be the purpose themselves or another person cates that it is important to bear of acting or not acting. The sec- that sought to meet a wish for in mind both these concerns. In ond means that one should not death. However, as regards the this context the MCA addresses flee from the inevitable and ‘pro-life’ guarantee certain the decision on the end of life. look for a possible treatment problems still remained to be First of all it deals with concern that will prolong life when this

DOLENTIUM HOMINUM N. 71-2009 is futile. The MCA explicitly cide, the question arises of his hydration’ is a medical treat- declares that nothing has been ability or otherwise to engage ment and thus can be withheld changed as regards the prohibi- in a decision.2 But, and here the or withdrawn, that a health-care tion on euthanasia or assisted analysis changes, assuming that worker must take into account suicide, even when this is re- the prior decision to reject treat- the wishes and feelings of the quested by the person involved ment is valid and applicable to patient. Whatever the case, al- on compassionate grounds. the situation, the MCA then ad- lowed but not granted, even if Both remain grave criminal of- judges that it is illegal to pro- one is dealing with an illegal fences according to English law vide treatment. In these circum- medical act, the behaviour of and are important for vulnera- stances the medical doctor can- the medical doctor is certainly ble and depressed people. This not impose the treatment, even immoral because the legislation law changed nothing on this if this treatment would save the is unjust. John Paul II declares: point and thus it remains clear life of the person involved. This ‘The passing of unjust laws of- for health-care professionals is because, if the decision in ten raises difficult problems of and social workers and for favour of rejection is legal, be- conscience for morally upright those in positions of power that cause it is valid and applicable, people with regard to the issue it is never legal to give or fail to the artificial administration of of cooperation, since they have give treatment in order to make food and water is illegal, even if the right not to be forced to take people die. However, the MCA this leads to the death of the pa- part in morally evil actions’.3 allows a prior decision to be tient. However, whenever hy- made as regards treatment bear- dration is necessary to remove ing on life and here we are discomfort, then the Code of dealing what are commonly Practice allows fluids, which known as ‘living wills’. Given should be seen, however, as a 41 that here we encounter bioethi- part of the general obligation to cal questions, I will now specif- keep a person comfortable but ically address myself to this not in order to support the life subject. of a person. This is certainly hard for a conscientious doctor who works for the best interests Bioethical Questions of his or her patients. Whatever and Living Wills the case, given that the decision that leads to death is not taken The Code of Practice recog- by the medical doctor, one nises forms of treatment called could say, and it is said, that the basic or essential care which health-care worker is not guilty are required to keep a patient of negligence and the problems comfortable and which should that result from it. There are rarely or never be rejected. If a limits as regards the help given patient can swallow and digest to people and above all else he or she should always be of- when someone rejects all help, To illuminate these difficult fered nutriment and water by and in this situation nothing can problems, Catholic morality mouth. Health-care profession- be done. I do not agree, specif- refers to general principles on als should continue to provide ically because this is a question cooperation in evil actions. Be- such treatment in the interest of of cooperation in wrongdoing. cause of a grave duty of con a patient who can neither un- science, Christians like all men derstand nor take decisions. of good will are called not to The law requires these patients Cooperation in Wrongdoing provide their formal coopera- not to be neglected and they by Omission tion to those practices which, should not suffer needlessly be- even though allowed by civil cause of hunger and dehydra- My disagreement is based legislation, are opposed to the tion. In the case of Leslie first of all on the law itself be- Law of God.4 Thus in order not Burke, Lord Philips said: cause in prohibiting a decision to act in an illegal way, it is ‘when a competent patient indi- that involves death it adjudges never licit to act in an immoral cates a desire to be kept alive it to be illegal. In addition, in way. Now, the artificial admin- through artificial feeding and requiring that a medical doctor istration of food and water, al- hydration, any medical doctor be concerned with everything though it does not transgress who deliberately leads to the that is best for the patient, he or civil law, above all if this in- end of the life of the patient by she cannot passively witness volves the death of the patient, not continuing does not only the death of his or her patient. means cooperation by omission not do his duty but is guilty of Thus how can the legislature in the death of the patient. This murder( [2006] QB 273 page assert that a doctor who admin- is what John Paul II teaches in 302) . When one moves to the isters food and water commits a Evangelium vitae: ‘For a cor- prior decision of a patient the criminal offence because he or rect moral judgment on eu- MCA declares that the decision she engages in an illegal ac- thanasia, in the first place a can never be motivated by a tion? But someone could con- clear definition is required. Eu- wish to die.1 For that matter, if tinue, given that for the MCA thanasia in the strict sense is somebody clearly requests sui- the act of ‘artificial feeding and understood to be an action or

DOLENTIUM HOMINUM N. 71-2009 omission which of itself and by certainly, moral when one these acts against life should be intention causes death, with the speaks about basic or essential guaranteed to physicians, purpose of eliminating all suf- care! health-care personnel, and di- fering. “Euthanasia’s terms of rectors of hospitals, clinics and reference, therefore, are to be convalescent facilities. Those found in the intention of the The Divine Right who have recourse to conscien- will and in the methods used”’.5 to Conscientious Objection tious objection must be protect- In answering certain questions ed not only from legal penalties of the Bishops’ Conference of In the MCA, at least explicit- but also from any negative ef- the USA about artificial feeding ly, there is nothing on conscien- fects on the legal, disciplinary, and hydration, the CDF de- tious objection. The Code of financial and professional clared, first of all, that the artifi- Practice adds something, de- plane’.10 Awareness of the invi- cial administration of food and claring that health-care profes- olable good of life and divine water is morally obligatory, sionals and social workers are law which jealously defends even in the case of patients in a not obliged to do something that right precedes all positive permanent vegetative state that is against their beliefs. human law. When this human (PVS). In this way suffering However, they must not simply law contradicts divine law, the and death because of a lack of abandon patients or cause them conscience affirms its primary food and water (starvation) are suffering.8 right and the primacy of divine prevented. The CDF also de- law: ‘We must obey God rather clared, and this is very impor- than men’ (Acts 5:29).11 An au- tant, even though competent thoritative confirmation of this medical doctors adjudge with comes from Benedict XVI who 42 moral certainty that the patient declared that conscientious ob- will never regain conscious- jection is also a right of phar- ness, that this administration macists. He said this during his must continue because the pa- address to the International tient is ‘always a person with Federation of Catholic Pharma- fundamental dignity and this cists: ‘conscientious objection, must receive ordinary and pro- which is a right your profession portionate treatment, which in- must recognize, permitting you cludes, in principle, the admin- not to collaborate either direct- istration of water and food, in ly or indirectly by supplying an artificial way as well’.6 products for the purpose of de- The answers of the CDF au- cisions that are clearly immoral thoritatively confirm the such as, for example, abortion Catholic approach to the artifi- However, it is stated with all or euthanasia… they have an cial administration of food and clarity that ‘to refuse to take educational role with patients water: this is not medical treat- part in committing an injustice to teach them the proper dosage ment but basic care which, at is not only a moral duty but al- of their medication and espe- the level of principle, must be so a basic human right. If such cially to acquaint them with the provided. In order to avoid all were not the case, a human per- ethical implications of the use misunderstanding, I would like son would be forced to carry of certain drug’.12 It is certainly to quote a declaration of the out an action that is intrinsical- the case that following one’s Catechism of the Catholic ly incompatible with his or her own conscience in obedience to Church: ‘Discontinuing med- dignity ‘To refuse to take part divine law is not always an ical procedures that are burden- in committing an injustice is easy path to take. It can involve some, dangerous, extraordi- not only a moral duty; it is also sacrifices and difficulties, nary, or disproportionate to the a basic human right. Were this whose weight it would not be expected outcome can be legit- not so, the human person would licit to deny. At times heroism imate; it is the refusal of ‘over- be forced to perform an action is needed in order to remain zealous’ treatment. Here one intrinsically incompatible with faithful to such demands. How- does not will to cause death; human dignity, and in this way ever, it is necessary to proclaim one’s inability to impede it is human freedom itself, the au- clearly that the life of the au- merely accepted. The decisions thentic meaning and purpose of thentic development of the hu- should be made by the patient if which are found in its orienta- man person passes by way of he is competent and able or, if tion to the true and the good, this constant faithfulness to not, by those legally entitled to would be radically compro- conscience maintained in recti- act for the patient, whose rea- mised. What is at stake there- tude and truth.13 sonable will and legitimate in- fore is an essential right which, terests must always be respect- precisely as such, should be ac- ed’.7 The difference as regards knowledged and protected by Conclusion administration is completely civil law’.9 Pope Wojtyla draws clear and brings out the confu- the logical consequences and The contrast between the sion that is present in the MCA. declares: ‘In this sense, the op- MCA and the Catholic ap- What is legal and also moral portunity to refuse to take part proach as regards the artificial when one speaks about medical in the phases of consultation, administration of food and wa- procedures is neither legal nor, preparation and execution of ter is luce clarius. For one it is

DOLENTIUM HOMINUM N. 71-2009 medical treatment that can be but should commit health-care Notes rejected beforehand and can be workers to contest such a leg- 1 Cf MCA 1,5 and 4, 5. interrupted; for the other, it is islative obligation. ‘We must 2 Cf Code of Practice, 9.9. basic care that remains obliga- obey God rather than men’ 3 JOHN PAUL II, Evangelium vitae, n. tory until nature itself rejects it. (Acts 5:29). 74. 4 Cf ibidem. Hence it is evident that what is 5 EV, n. 65. legal is not for that reason also Rev. BONIFACIO HONINGS, 6 See 1 August 2007. moral. Indeed, quite the con- OCD, 7 CCC, n. 2278. Professor Emeritus 8 Cf Code of Practice, 9.61- 63. trary! In fact, specifically in the 9 of Moral Theology at the EV, n. 74. bioethical field the difference is 10 Ibidem. Pontifical Lateran University, 11 Cf. Carta degli Operatori sanitari. essential because it makes the The Pontifical Urbanian university, Pontificio consiglio della pastorale per legislative obligation not to ad- Consultor of the Congregation for the gli operatori sanitari (Vatican City, minister, which is imposed on a Doctrine of the Faith, 1995), 143. medical doctor, simply im- Consultor of the Pontifical Council 12 Cf BENEDICT XVI, address of Mon- for Health Care Workers, day 29 October 2007. moral. Thus the true con- Ordinary Member ad vitam of the 13 Cf CDF, Dichiaraziione sull’aborto science, certain and upright, is Pontifical Academy for Life, procurato, 18 giugno 1974, in AAS 66(1974) 744, n.24. not obliged to oppose the law The Holy See.

Prior Decisions Concerning Life: a Guide for Catholics 43

The Minister for Justice of a prior decision, whether per- useless forms of treatment, that Great Britain published in sonal or delegated, with respect is to say treatment that only 20051 ‘The Mental Capacity to medical treatment there do prolongs life. However, two Act’ accompanied by a Code of exist, on their own and in them- things must be borne in mind: Practice to explain the details of selves, difficulties. We are deal- love for life and acceptance of its implementation and the legal ing here with the right for it to death. One can, therefore, admit responsibilities that are in- be used with prudence, and pa- under certain circumstances volved. The Bishops’ Confer- tients can ask for treatment that that the illness has its natural ence of England and Wales in is entirely appropriate to their development, even though this 2008 published ‘The Mental wellbeing. It should be ob- means that one wants to die. As Capacity Act and Living Wills served, however, that not every- a confirmation of this the Cate- – A Practical Guide for thing allowed by the Act is right chism of the is Catholics’.2 In the preface the from a moral point of view. And quoted4 (see p. 24 at the end and Archbishop of Cardiff, Peter it is made clear that the decision p. 25 at the beginning). At this Smith, clearly observes that this to refuse food and water is point stress is laid upon the dif- edition was necessary after the morally unacceptable (see p. ference between the Catholic perplexity that had been felt in 21, last lines). If this treatment approach and the approach of various quarters ( see pp. 5-8). were refused with the intention the Mental Capacity Act. For This Guide presents the possi- of making the patient die, one this law ,ANH is medical treat- bilities that the Mental Capacity would be dealing with a serious ment; for Catholic morality it is Act offers to people concerned crime. A medical doctor who a natural means by which to as regards future health and refused artificial hydration and preserve life, it is a treatment treatment (see pp. 13-20). It food, thereby causing the death involving care. The criterion is, seeks above all to point out the of a patient, would not only not and always remains, that of the possibility of deciding, in the fulfil his deontological duty but greatest wellbeing of the pa- case of mental incapacity, to would also be guilty of murder. tient. Thus a refusal or the inter- delegate this decision to a third The example is given of Leslie ruption of ANH when the death party as regards the rejection or Burke, specifically with refer- of the patient is not imminent interruption of artificial alimen- ence to ANH (see p. 22, at the would be clearly against this tation – hydration and/or nutri- end). It is further stated that the criterion inasmuch as it would tion (ANH) (see pp. 9-12). I implementation of a prior deci- cause death. The case is differ- will now examine with the sion can be changed. ent when the body itself en- greatest attention the guidelines gages in the rejection, in other on prior choices from the point words when it no longer ab- of view of conscience. The Moral Obligation sorbs or no longer excretes. In to Accept Treatment that case one is no longer deal- ing with accelerating death but Choices Concerning Future There is both a personal and of removing the disturbance of Health and Treatment a family obligation to engage in the tube. In addition, every de- care for health.3 However, there cision to interrupt treatment As regards the possibility of is no obligation to engage in must be done with upright in-

DOLENTIUM HOMINUM N. 71-2009 tention; this means, in a nega- way possible. Another step for dal, a question may arise as to tivesense,thatitmustbenever good practice is correct ethics the mental capacity of the per- carried out with the intention of that avoid the danger of over- son in question. Whatever the accelerating the death of the pa- treatment or under-treatment. case, in rare cases of a suicidal tient (see pp. 25-26). Whatever the case, it is impor- refusal we must consider two As a confirmation of this, tant to encourage good practice levels: the refusal as such and what John Paul II said about pa- as much as possible. But what cooperation with this refusal. tients in a vegetative state is should be done in the case of a As regards the suicidal refusal quoted: there is an obligation to prior decision that is no longer in itself, even if legalised, this is provide the normal treatment of at the present time in the best always self-destruction and the use of nutrition or hydra- interests of the wellbeing of the non-acceptance of life as a gift tion. The Congregation for the patient? This decision, however from God. It is thus always Doctrine of the Faith (CDF) imprudent, remains legally something that should not be confirmed this obligation in its valid. Let us suppose that a per- done.6 With respect to coopera- reply of 1 August 2007 to the son took that decision many tion, the Church teaches that question posed to it on the sub- years ago when there was no ‘voluntary cooperation in sui- ject by the Bishops’ Conference suffering or illness. In this case cide is contrary to natural law’7 of the United States of America there can be a reasonable doubt (see pp. 32-33). (see p. 27). as to whether that decision is still hic et nunc applicable in the specific situation. For that The Question of Respect matter, where the prior decision in the Case of Refusal involves a rejection of treat- of ANH 44 ment, even though this is now valid and applicable, the treat- The decision should be re- ment is illegal. The law pro- spected even if the refusal caus- hibits the medical doctor from es death. The Code of Practice imposing treatment even if this says, nonetheless, that one can- would save life. For a conscien- not refuse beforehand actions tious doctor who attends to that are needed to keep a person achieving the best possible in a comfortable state. Liquids wellbeing of the patient, this is should be given if they neces- harsh. Obviously, he or she is sary in order to alleviate a per- not blameworthy as regards the son’s stress. On the other hand, consequences that derive from the Code of Practice sees nutri- his or her non-provision of tion and hydration explicitly as treatment because the law re- medical treatment that can be moves his or her professional refused. The bishops rightly Questions for Health-Care responsibility in this area (see make clear, and this is, and I re- Professionals and Social Care pp. 30-32). peat the point, the essential dif- Professionals ference, that artificial nutrition and hydration should not be The first professional impli- What Should be Done placed in the same category as cation is respect for the person if the Prior Decision medical treatment. ANH be- being cared for and not causing is Suicidal? longs to basic care and this, at him or her any harm. Profes- the level of principle, should al- sionals must identify the great- The Mental Capacity Act es- ways be provided.8 Even of the est wellbeing of the patient, tablishes two things. The first is intention behind the refusal is show respect for human life, that every act that is carried out not suicidal, the non-applica- take care of the patient, and and every decision that is taken tion of ANH has this effect. In protect and promote his or her should aim to achieve the great- this situation, health-care work- health. est wellbeing of the patient. The ers must do everything possible Thus the decision to refuse a second is that a judgement in for the greatest wellbeing of the treatment with the intention of the matter cannot be motivated patient and consider whether having the patient die, even if byadesiretobringaboutdeath. the prior refusal is specific, death is willed as a means, is As a consequence, it is explicit- valid and applicable or other- never morally licit. Health-care ly established that there is no le- wise. In the case of doubt, they professionals must never ad- gal change as regards a ‘no’ to must provide ANH to the pa- judge the life of a patient as not assisted suicide or euthanasia. tient as long as they are respon- being worthy of life (see pp. 29- Given, however, that the suici- sible for his or her greatest 30).5 So how should a health- dal motivation is not always ev- wellbeing. In the case of dis- care worker behave towards a ident to other people, a health- pute they must appeal to the patient when he or she is en- care worker must give the pa- Court of protection. Where the trusted with a medical treat- tient the benefit of the doubt interruption of ANH is contrary ment of treatment involving and not presume that the refusal to the greatest wellbeing of the care? The first step for good reflects a suicidal intention. It patient, they must withhold practice is to establish through should also be observed that if their treatment of his or her (pp. dialogue the facts in the fullest the motivation is clearly suici- 34-35).

DOLENTIUM HOMINUM N. 71-2009 Questions Regarding Code of Practice lays down two 40-41) are indicated. A glossary the Decisions points: the first is that health- of the terms that are employed of ‘Third Parties’ care and social professionals makes this Guide even more are not obliged to do something valuable (pp. 51-55). The Guide goes on to make against their own beliefs; the specific observations on mat- second is that health-care and Rev. BONIFACIO HONINGS, ters that concern those who social professionals must not OCD, have to decide in the place of a simply abandon their patient. A Professor Emeritus of Moral Theology at the person who is incapable of un- medical doctor who adjudges a Pontifical Lateran University, derstanding and deciding. It is plan of action, for example, as The Pontifical Urbanian university, preferable that one is dealing regards the refusal of ANH, to Consultor of the Congregation for the here with a person who is re- be unethical, must speak and Doctrine of the Faith, ferred to and whose name and listen to his colleagues and to Consultor of the Pontifical Council for Health Care Workers, surname are written down. For the relatives of the patient. Con- Ordinary Member ad vitam of the this reason, according to the tinuing to be certain that this Pontifical Academy for Life, law, it is not valid to indicate plan of action does not serve TheHolySee the position of a person, for ex- the best wellbeing of the pa- ample the Superior of a reli- tient, the medical doctor must gious Congregation. As regards not formally cooperate, that is motivation, it is laid down that to say he or she must cease care Notes the decision can never be moti- for the patient. In the case of 1 See http://www.justice.gov.Uk/gui vated by the wish to have some- material cooperation, the med- dance/mca-code-of-practice.htm one die. However, the decisions ical doctor must, in the light of 2 The Catholics Bishops’ Conference have to be taken seriously. Let his or her ethical obligation, of England & Wales, Department for 45 Christian Responsibility & Citizenship, us suppose, however, that a prudently weigh the alterna- The Mental Capacity Act and ‘Living medical doctor does not agree tives (pp. 37-38). Aware of the Wills’: a Practical Guide for Catholics with the decision as regards the complexity of material cooper- (Published 2008 by the Incorporated Catholic Truth Society, 40-46 Harleyford intentions. In that case the first ation in a specific situation, the Road, Vauxhall, London SE115AY). step is a discussion in order to bishops do not give general 3 The CCC teaches: ‘Life and physical reach an agreement. If he or she rules but instead refer to the health are precious gifts entrusted to us by God. We must take reasonable care of does not manage to achieve doctrine of the Church in this them, taking into account the needs of this, an appeal can be made to sphere. A great deal of practical others and the common good’ (n. 2288). the Office of the Public wisdom is required which takes 4 ‘Discontinuing medical procedures that are burdensome, dangerous, extraor- Guardian to intervene. Where into account the factors that are dinary, or disproportionate to the expected the intentions are legal but involved in order to arrive at a outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one where the medical doctor be- judgement of conscience. Are does not will to cause death; one’s inabil- lieves that the pathway of ac- there alternatives? How urgent ity to impede it is merely accepted. The tions does not correspond to is the action? What good or evil decisions should be made by the patient if he is competent and able or, if not, by what is in the best interests of is possible? What are the possi- those legally entitled to act for the patient, the patient, in that case the bilities of deception and scan- whose reasonable will and legitimate in- health-care worker can appeal dal? What are the precise cir- terests must always be respected’ (n. 2278). to the Court of Protection. In cumstances of the situation? Is 5. ‘Best interests relate to the benefits the meantime the medical doc- this action in conformity with and burdens of treatment should never re- tor can legally apply the treat- the special role, the responsibil- flect a judgement that the patient’s life is not worth living’ (p. 30 at the end of 5.2) ment that he or she adjudges to ities and the vocation of the in- 6 The CCC teaches: ‘Everyone is re- be the best for his or her patient dividual (see appendix pp. 47- sponsible for his life before God who has (pp.36, 5.8; see also pp. 43-46). 49). For further information as given it to him. It is God who remains the sovereign Master of life. We are obliged regards the teaching of the to accept life gratefully and preserve it for Church certain authoritative his honour, and the salvation of our souls. Conscientious Objection sources such as the CCC,the We are stewards, not owners, of the life God has entrusted to us. It is not ours to CDF on ANH (1 August 2007), dispose of’ (n. 2280). The Mental Capacity Act of the Charter of the Pontifical 7 See CCC, . 2282. 2005 does not contain an ex- Council for Health Care Work- 8 The CCC teaches: ‘Even if death is thought imminent, the ordinary care owed plicit section on conscientious ers, and Evangelium vitae to a sick person cannot be legitimately in- objection. Nonetheless, the (1995) of John Paul II (see, pp. terrupted’ (n. 2279).

DOLENTIUM HOMINUM N. 71-2009 Accompanying the Family

The biography of every pa- which threatens the life of a that have been imposed on it tient is also the biography of loved one, produces strong by the illness. his or her family: his or her at- structural and relational Whether the crisis is man- titudes, thoughts, memories, changes in a family. Faced aged positively or negatively experiences and projects are with a crisis that removes tran- depends on the kind of family inevitably bound up with his quillity, threatens internal system that exists, on whether or her near or distant family equilibriums and forces people it is fundamentally healthy or relatives. to adopt new roles and tasks, problematic. The family one comes from the various components of a has a determining impact on family can react with anxiety- the structure of one’s identity inducing, aggressive, bal- Healthy or and in the development of anced, blame-attributing, con- Problematic Families one’s habits and tendencies structive or depressive atti- which have a positive or nega- tudes and so forth. Virginia Satir, a famous tive effect on one’s life. Each family adopts different scholar who studies family A genetic map is not only an strategies in responding to ill- problems, has drawn up cer- inheritance of physical and ness. Amongst the commonest tain criteria which allow us to psychological features. It is al- attitudes or mechanisms are discern whether a family tissue 46 so an inheritance of learning or denial – the rejection, the non- is fundamentally healthy and limits as regards communica- acceptance of the illness, the able to face up to critical mo- tion, the way in which one idea of behaving as though ments or whether it is prob- manages one’s wounds or fam- nothing had really happened; lematic and helps to compli- ily secrets, lives out conflicts hyper-protection – on the one cate the impact of suffering or differences, approaches dif- hand concealing one’s feelings and death. Healthy families are ficulties or failures, and from the patient and on the characterised by: the emotion- demonstrates affection or dis- other the practice of a conspir- al balance of their members; approval. acy of silence, the truth of the respect for and appreciation of The family can educate a situation is not openly commu- the individuality and diversity person to love, to engage in di- nicated; idealisation – one of every one of their members; alogue, to open himself or her- may observe an excessive trust a positive relationship with so- self, to bear things, to give in the ‘omnipotence’ of med- ciety; a high level of cohesive- himself or herself, to forgive, ical doctors or in the miracu- ness and communication but also to have prejudices, to lous power of medical science amongst their members; a gen- criticise, to shout, to blas- or forms of treatment; subli- eral stability of the family pheme and to hate. mation – an attempt is made to structure based upon clear Each family has its history find refuge or consolation in norms and rules; a flexibility and its dynamics. There are spiritual certainties: ‘pray if and not rigidity of the roles those who are born in family you want to get better’; ‘those within it. Problematic families groups where they feel wel- who believe do not cry’; are characterised by: attitudes comed, affirmed and stimulat- dramatisation – there are dis- involving control and authori- ed and those who are born in proportionate and hysterical tarianism on the part of one of situations that are charac- reactions; acceptance – there their members in relation to terised by oral and physical vi- prevails an attitude of healthy the other members; a tendency olence, by fractures in relation- realism and balance and posi- to destructive criticism; an ab- ships, and by a lack of ethics tive cooperation with the sence of important individuals and of discipline. health-care workers; and re- and models (for example of a However, it is important to gression – there is closure and parent because of death or di- bear in mind that we are the social isolation in the face of a vorce); a lack of affection children and not the slaves of drama which the person thinks where the relationships are our past. Those who have been other people cannot under- based upon emotional dis- conditioned by their past in a stand. tance; an internal disorganisa- negative way are able to over- In general, the response of a tion evident in roles and come it by engaging in con- family to the event of illness lifestyle; and the presence of structive choices and a process involves disorganisation and specific problems such as of interior maturation. A diffi- dismay. There then follows a mental illness, alcoholism, cult past does not make us un- moment of research: the mem- sexual abuse, drug addiction. happy for ever. bers of the family ask them- It is clear that whether one is selves about how they should dealing with a substantially face up to the situation by acti- ‘healthy’ or ‘sick’ family has a The Impact of a Grave vating the resources of the profound effect on reactions Illness on a Family group. A third stage involves to, and the living out of, the the gradual adaptation of the event of illness. An unfavourable diagnosis, family group to the changes In other words, as regards

DOLENTIUM HOMINUM N. 71-2009 the attitudes that are adopted ships with other people, and journey that goes from the ini- one does not begin from zero from rules about sex to rules tial stage of diagnosis to the but with the baggage of one’s about facing up to pain, illness acute stage of therapy, from past, with the climate created and death. Some of these rules the stage of remission and by one’s parents and the way are very useful and are inter- hope to the stage of relapse in which they related to each nalised by children for the when everything becomes other and their children. whole of their lives; others can complicated, and on to the fi- generate major difficulties and nal outcome when the thera- block growth. The task of edu- pies are palliative and prepara- Fundamental Tasks cating in separation is often the tions are made for detachment. work of the father. The family often becomes Those who create a family These two tasks, which are responsible for the most de- take on two fundamental tasks: so essential in facing up to life manding part of care, especial- with openness, realism and dy- ly in the domestic context. 1. Educating in love namism, are of extreme impor- Despite all this, especially in and intimacy tance during the final stages of health-care institutions, the our pilgrimage on earth as family is often systematically Parents are called first and well. neglected by health-care work- foremost to bring up their chil- The experience of dying al- ers who, instead, devote all dren to develop ties, to feel lows a patient and his or her their attention to the sick per- loved and to love. This experi- family relatives to experience, son. Some observations are ence helps them to feel accept- first of all, valuable moments thus necessary: the observation ed and appreciated and to start of intimacy, giving expression that the family is often kept at off well in life. On the other to feelings of mutual gratitude the margins or ignored by the 47 hand, where affection and and communicating them health-care staff; one often warmth do not exist a child ex- through gestures and non-spo- notices attrition or competition periences insecurity, loneliness ken language. between the health-care work- and at times a sense of being At the same time, the ap- ers and the family as regards abandoned. In general this first proach of death requires the responsibilities in caring for task is interpreted by the moth- courage to prepare oneself to the patient; the family is seen, er who welcomes, nourishes say goodbye, to prefigure the at times rightly, as a burden or and supports the lives of her detachment by assuring the an obstacle in the process of children. There is the risk that continuity of the tie through care and treatment; the infor- excessive love will be trans- memories, the horizon of the mation that is transmitted as formed into possessiveness or transcendent, and spiritual regards the condition of the jealously and will interfere nearness. relative or the purpose of the with the healthy development therapies that are used is for- and independence of her chil- mulated in a hurried way and dren. in a technical language that is not very understandable; and 2. Educating in separation at times there is a tendency to and respect for differences exclude the family from deci- sions that in some ways con- A child is not a copy of his cern it. or her parents but instead is The burdens of a grave or called to realise his or her own terminal illness invoke dia- individuality and difference. A logue and concrete coopera- healthy process of growth tion between the health-care helps him or her to establish workers and the family. limits, to define the boundaries In particular, the unity of the between himself or herself and family should be safeguarded his or her neighbour so that he as an essential objective or or she does not fuse with, or care and treatment. become absorbed by, other people. The pedagogic of sep- aration is an invitation to bring Challenges for a Better out one’s own uniqueness. One Health-Care Workers Accompanying of the Family way of educating in separation and the Family is through the development of Within institutions many expressed or tacit rules which The crisis of illness opens families trust and entrust them- the parents transmit to their up the doors of a hospital not selves to specialists and tech- children. These rules concern only to the patient but also to nology in order to obtain the various spheres of life: from his or her family. The family is best results at the level of care how to manage emotions to not a spectator but a direct pro- and treatment for their relative. how to express intimacy, from tagonist in a drama that con- At times, they may feel dis- rules about work to rules about cerns it. In the accompanying turbed by a lack of attention behaviour, from rules about of the patient it is in the front and communication, by the safety to rules about relation- line on a long and difficult limits imposed by the rules,

DOLENTIUM HOMINUM N. 71-2009 and by functional relationships support include: activating pal- habits, levels of tiredness, the that are inevitably depersonal- liative care teams made up of use of resources, signs of anxi- ising. medical doctors, nurses, vol- ety or depression…; teaching But it is above all within the unteers and other professionals the family relatives the tech- domestic walls that the family in order to respond in a more niques of caring and of physi- has to manage the long trial of effective way to the various cal and psychological assis- illness. Many of its members needs of the patient and his or tance in order to promote bet- feel oppressed by the excessive her family relatives; creating a ter care for their relative; and responsibility, without medical climate of cooperation be- accompanying the family rela- or nursing support, and wor- tween health-care workers and tives not only during the stages ried about the increasing prob- families and open communica- of anticipatory mourning but lems that taking care of a seri- tion which fosters information also during those that follow ously ill person involves. and provides space for listen- mourning and adaptation to a The tasks of care which are ing and questions so as to help modified life. increasingly burdensome the patient in a more effective Inasmuch as the family re- physically and psychologically way; fostering a unitary ap- ceives psychological support consume the family relatives proach which contemplates and practical information on and run the risk of producing not only the needs of the sick how to help and comfort a rel- depression and hopelessness. person but also those of the ative, the event of dying – al- Society, through its health- family unit; paying attention beit painful – .will not produce care resources, voluntary work not only to physical needs but bitterness and dismay but will and religious institutions, is also to psychological and spir- be experienced in line with hu- called upon to be near to these itual ones in order to assure an man nearness and solidarity. 48 families in order to make their overall service; monitoring the via crucis less painful and changes that are taking place Rev. ARNALDO PANGRAZZI Professor at the ‘Camillianum’, make them feel less out on within the family at the level the International Institute of the their own. of relationships, changes in Theology of Pastoral Care in Health, Some general guidelines for roles, the restructuring of Rome, Italy

DOLENTIUM HOMINUM N. 71-2009 Testimonies

Physician and Apostle: a Survey of the Life and Virtues of the Servant of God Pedro Herrero Rubio

Spain: The Association of Christian Health-care Workers

Suffering, a School of Life: the Servant of God Manuel Lozano Garrido Physician and Apostle: a Survey of the Life and Virtues of the Servant of God Pedro Herrero Rubio

Pedro Herrero Rubio was A Professional Doctor were strange at those latitudes, born in (Spain) on 29 such as infantile Kala Azar (a April 1904 to a well-off family Dr. Rivera, ex-president of desert malady), which two and was the only child of Pedro the College of Doctors of his young daughters of a poor fam- and Emilia. His father received Province described him as ‘an ily, whose father was in prison a monthly salary from the exceptional doctor, the proto- because of the war and whose Provincial Government of Ali- type of an altruistic vocation, an mother was in a state of total cante and was later mayor of exemplary companion and deep poverty, had contracted, and the municipality of Orihuela. friend, but above all an emi- frustrated at his fruitless at- Pedro did not fail to have the nently good man’. ‘Pedro was tempts to find a cure for the ill- resources of a human upbring- happy in being able to help oth- ness, he went to Paris and Brus- ing, both as a baby and a child, ers to look for happiness and he sels to study the case, engaged and this situation continued un- found no better pathway than in research and returned with til his specialist university edu- that of dedicating himself com- the right treatment. He paid for cation at prestigious centres in pletely to doing good… He everything out of his own mon- 50 Spain, France and Belgium. He chose the medical profession ey – his trips, stays and the married on 29 April 1931, at the because he perceived that drugs. He had the girls admitted Sanctuary of Our Lady of Mon- amongst the best ways of doing to the Charity Hospital together serrate di Orihuela. His bride good in the world he lived was with their elder sister aged nine; was Patrocinio Javaloy Lizón that of being a medical doctor. he subjected her to a rigorous who was also member of a In addition, he chose paedi- supervision because to get bet- prosperous family. Both had atrics (of which he was a pio- ter she had to eat only tomatoes had an attentive Christian up- neer and mentor in our and honey. She was protected bringing. Province) because he knew that day and night by a kind of crys- children have the greatest need tal sphere. From what the girl, of protection, above all when who is now an adult, says, Don The Development of his Life. they are sick, especially in the Pedro entered that little Testimony society of his time which was dwelling for nine days and on so populated with invalids… his knees said a number of Dr. Carlos Mazón, a hospital Medicine was not an end for prayer. It must have been the doctor: ‘Father Herrero was the him but a means, a means by novena of Our Lady of Reme- father of paediatrics in Alicante; which to do good’. dy, the patron saint of Alicante. he enjoyed speaking about his In this way of doing things own city, spontaneously re- the Servant of God Pedro Her- membering in his conversations A Prestigious Doctor rero Rubio presented himself to typical personalities he had God at the end of his existence known during his childhood, el- We may observe in passing in this world. Those who knew ements of history, traditions and various national and provincial him could not find a better epi- his numerous friends’. ‘As a honours such as the Gold taph for his grave than the fol- person I can say that he did not Medal, or local honours such as lowing: ‘Pedro Herrero, physi- seem to belong to this world.. the Distinguished Son of Ali- cian and apostle’. He always lived in a far off cante Medal, but we cannot but way, a distract way… a militant remember what he said to Dr. Christian, with a rooted faith, Matilde Jover when, at the Apostle and Physician whose witness was a living and height of the Rambla de Mén- constant example which we dez Núñez, she congratulated When as a child he played at would all like to emulate. As a him on the award of the charity celebrating Holy Mass with his professional doctor one could cross first class with a white friends in the street and gave define him in the following ribbon (August 1978): childlike sermons, the desire to terms: he gave of himself com- “Matilde, my glory is the cross make others better seemed to pletely. For him, working hours of Our Lord Jesus Christ”. This spring from his limpid con- did not exist and he dedicated answer remained for ever in- science which was taking its himself to his patients with the scribed in the heart of that pres- first steps forward. best of his expertise and the tigious paediatrician. For this reason, some of the broadest of smiles… He could Asín Lamaigneire: ‘He was witness as his process stated have died a millionaire but he up-to-date with the latest med- that when Dr. Herrero entered died in the shade of the patri- ical knowledge because he the home of a sick person one mony of his wife, thanks to studied in order to continue and did not know whether the man whom he was able to engage in update his medical criteria’. who came in was a physician or innumerable works of charity’ Faced with illnesses that a priest.

DOLENTIUM HOMINUM N. 71-2009 Nobody left his company ‘One day he had a couple of Christ. He was very devoted to without being spoken to about gypsies marry in church. How- the Passion of Christ, the Sa- God, without being invited to ever, at the end they withdrew cred Heart of Jesus and the wed the Church, or without because they thought that their Most Holy Face of Christ. stress being laid on the fact that clothes were not suitable for the His devotion to the Eucharist the child should be baptised or occasion. Don Pedro then sent and Mary was typical of a well that a person should pray. In- them to his home so that his formed man, a strong devotion deed, he himself asked for a wife could give his wedding which every day was more fer- certificate of , marriage clothes to the groom and dress vent. As a night worshipper, he or death in order to facilitate the the bride, and thus it was that was a model. bureaucratic process that was the wedding could be celebrat- Hª Guadalupe: ‘When he was required in each case. After his ed’(Hermana Guadalupe). told to rest during his nights of death many of these documents His wife, Donna Patrocinio, nocturnal worship, he replied were found in his office as well declared: ‘He was primarily “There is a great deal to repair. as letters received from bish- concerned about the spiritual There is a great deal to ask from ops, parish priests and mayors salvation of everyone, he God for sinners”’. about cases where he had been prayed for his patients; at times an intermediary in order to help people said that he worked mir- his increasingly poor patients. acles’. Always Ready Because of the religious per- to Help Anybody secution of 1936 he said to one person who spoke to him: “For At the height of the war and me everybody is equal, all peo- the religious persecution in ple are children of God and if Spain, three armed militiamen 51 we should exaggerate in our knocked at his door in the mid- care it is precisely in relation to dle of the night and said to him those who say that they are dis- “come with us”. Don Pedro tant from God”. took his clothes (without doubt He was an active member of he relied upon his wife in this Catholic Action. When the sec- area until reaching eternity) and ond anniversary of the pontifi- went out with them. While they cate of Pius XII was celebrated were walking along they told it was he who gave the princi- him that one of their daughters pal speech in front of the four was seriously ill and that they branches of Catholic Action. were taking him to treat her. José Mª Simón, a lawyer: The girl recovered from her ill- ‘He dedicated all his energies to ness. The father of the girl Catholic Action above all as wanted to pay him for this by president of the diocesan coun- offering to kill anyone who mo- cil of the men’s branch… he lested him on his way back to gave of himself totally in all his the president’s office of the works and to such an extent that College of Doctors. Don Pedro, he left behind him as he passed who never allowed himself to by an impress that cannot be Dr. Rivera: ‘He practised the be paid, no less did not accept cancelled’. specialisation of paediatrics out the payment that the militiaman of a vocation, inasmuch as he offered him. believed that a child is a being His wife: ‘His colleagues and A Doctor of Prestige who in need of protection, and even nurses said wonderful things United Science and Faith more so if that child is sick… about him and they did not The whole of his life was an protest or feel fear, but they Because during the period of apostleship because for every- knew that he required good the civil war and in the immedi- one that came into contact with treatment for sick children, es- ate post-war years spiritual him, the friends and family rel- pecially those that were poor’. needs were at time extremely atives of his patients, he was an The titular bishop of that pe- high, Don Pedro took advan- example of Christian virtue, in riod has stated: ‘When he visit- tage of his ministry with chil- that his example was very ed the poorest children he dis- dren to baptise his little patients great’. played great respect, he re- or to invite people to regularise quired the greatest care towards their matrimonial situations. them because he always loved Monsignor Barrachina Este- A Profoundly Religious Man them very deeply… A virtuous van: ‘His zeal for the wellbeing life dedicated to other people, of souls was demonstrated, for This Servant of God lived his above all to the poorest and in- example, in asking for docu- Christian life in a constant spir- valids who for him were the ments from parishes for his itual growth that lasted for the children he treated and amongst children, at times to obtain the whole of his life. The founda- these the orphans of the provin- marriage of their parents and at tion of his faith was a personal cial charitable association’. times to baptise a family rela- relationship that was close and A. Mancebo: ‘During the tive’. continuous with the Risen Jesus (1936-39),

DOLENTIUM HOMINUM N. 71-2009 the Servant of God was impris- professional sense. The Auxilio tion and immediately left the oned together with a group Social was the body that sought sick man and set to worship- from Alicante on the prison- to remedy the living conditions ping the Most Holy Host’. boat ‘Rita Sister’ which was an- that afflicted the less favoured Dr. Javaloy, grandson of the chored in the port of Valanza. classes of Spanish society in the Servant of God: ‘At the end of He was freed from this thanks post-war period. This was an his prolonged and at times tir- to the intervention of the work- opportunity for Don Pedro to ing mornings of work, although ers and militiamen of the port test out his great heart and he we were tired and hungry and it of Alicante who pointed out attended to the children of the was already 3.30 or 4.00 in the that he was a doctor who treat- foundations of the Gota de afternoon, and we had not had a ed their children for nothing. Leche in the famous Paseíto de mouthful of food since 9.00 in On the other hand none of the Ramiro, in the medical dispen- the morning, before going adults in the houses next to his sary of the sea port called home he always took me to en- returned from the front. Don ‘Madre e Hijo’, and above all in gage in a moment of prayer be- Pedro returned safe and sound, the ‘Hospitalillo’ of the provin- fore the Most Holy Host in a he was never molested and he cial charitable association. monastery near home’ (Ca- was protected by the workers Even though he was very de- puchins). and militiamen voted to the Eucharist, in order This Servant of God studied to care for his neighbour he left every case in detail; he engaged everything to serve him or her. in research and prayed for his Witnesses have declared that at patients. least twice, as far as they knew, Donna Pila Artiaga: ‘I am a even though he was already witness to the rigour with 52 wearing evening dress and had which he studied the cases of in his hand the staff for the Cor- his patients because for the pus Domini procession, when whole of my life I saw the light asked by a mother or a father of his home turned on at half who were worried about their past five in the morning and I children and wanted his help, observed that he did this in or- he left his staff behind and went der to study, and he did this to visit those sick children. every day until the hour of Mass’. His wife donna Patrocinio Ora et Labora has declared the same and added that he studied every This Servant of God had ab- case in detail. solute trust in the Lord but did Don Salvador de Lacy, a everything possible to learn lawyer: ‘For him the lunch hour about medical science and to was imprecise and very many use it for each one of his pa- times the goodness of the meal tients. diminished because he came to From the homily at his funer- lunch late. He took a very brief al: ‘Full of God, as one who nap in a chair and then went to had received Mass and commu- his personal clinic which was in nion, he threw himself into our his home and which opened streets, squares and nearby and without exception at five o’- distant villages, and imparted clock in the afternoon… He did his medical science with the vo- not fail to take advantage of cation of a priest and the dedi- every opportunity to advise and cation of an apostle’. instruct in a doctrinal sense both parents and family rela- Don Amalio, his assistant tives’. health-care technician: ‘I re- A Man of Prayer The engine that moved his member that he even treated for and of Worship great heart to dedicate itself to nothing the sons of a man the performance of so much whom he could not bear be- Msgr. Barrachina, bishop good was his profound faith cause he was a very ardent emeritus: ‘Don Pedro was rig- which was expressed in love for Communist’. orous as regards everything the Most Holy Eucharist: every Don Francisco Llaneras: ‘He connected with God, the Most day he began his working day, was taken to the front at Teruel Holy Trinity and the Most Holy which went from 5.30 in the (December 1938-January 1939) Virgin, and the Eucharistic morning until 11.00 or 12.00 at to serve the Red Army as a sol- presence of Christ. The sac- night and at times until 1.00 of dier in the village of Alobras ristan of San Nicola told me the following day, with Holy and in that locality he treated that during a wedding the Mass which he always attended for free the sick people of the groom fainted. Don Pedro hur- with his wife. village who asked for his help’. ried to help him but while at- The first Friday of every During the years 1939-1966 tending to him heard the bell month he made his care avail- our medical doctor matured in a that announced the consecra- able in his parish in order to

DOLENTIUM HOMINUM N. 71-2009 take communion to the sick and his parish, Don Pedro asked Sanidad: ‘When he visited sick he did this with a devotion nar- them to point out to him where children in the poor neighbour- rated by the priest. Don Federi- the most needy poor were so hoods he left a hundred peseta co Sala: ‘I am a witness to this, that he could give them things note under the pillow after ex- and it did not only happen once. and other forms of care. At amining them. He did this to When on the first Friday of the times I said to him: “I don’t help them pay for the prescrip- month he took the Most Holy want to say anything else to you tion. At that time a hundred pe- Host with his car to comfort a because I know how you are. I setas was worth two day’s pay’. number of patients and when do not tell you to give to me”. the car drew near to Piazza St. And he answered: “Showing Nicholas, he or his wife began me the homes of poor people is In Grottoes and Hovels the rosary until the neighbour- a good thing because for me to hood of Requena where a sick give to the poor means to have After the religious persecu- woman lived. If because of a piggy bank that is in heaven tion of the 1940s and 1950s, heavy traffic the journey lasted and means that the Lord looks this Servant of God also helped longer than expected, he added after me. What we give is very sick people in the grottoes of a number times the stations of little; it’s a disgrace. If we do the neighbourhood of San Blas, the Most Holy Host to the not know the cases, we do not of the Castle of St. Ferdinand, rosary. During the journey he sleep. You will be doing me a of the poor houses of Las never pronounced a wasteful favour if you point out the Provincias (near to the Castle of word… If the sick person was homes that should be helped. St. Barbara) and the neighbour- poor, without allowing that per- To give to the poor means to hood of Cortés (which was son to realise it he left a size- give thanks’. completely inhabited by gypsy able sum of money under the After his death many families families who lived as they 53 pillow’. testified that Don Pedro, after could in shacks or grottoes). ‘His nights of adoration were visiting a patient, left gifts un- Dr. Amalio Pérez, assistant an example for his companions: der the pillow without anyone, health-care technician, has told he worked with enthusiasm to not even the priest, realising the us: ‘He felt no repugnance sit- conserve and spread the wor- fact. ting with complete amiability ship of the Eucharist. For ten His wife: ‘He cared for the and affection next to patients years he was emeritus vice- sick until their end. He was with tuberculosis, typhus, president, as is written in the wonderful. During the night, at meningitis and every other kind minute book: ‘a title that is whatever hour, he went quickly of illness which made their granted to the Distinguished to find his patients’. home in those people who had Mr. Don Pedro Herrero Rubio, Mrs Martínez Sala. Donna no hygiene or any kind of com- in recognition of his extraordi- Patro told me: ‘You do not fort; he sat next to them on their nary merits as constant and vet- know what that man was: every beds or a straw bed on the floor, eran adorer of the Host and man morning when we left home to full of poverty, lice and all that of good’. go to Mass, the first thing that ilk; I was unable to do this, I he asked me was: “Patro did felt repugnance at that state of you remember it?” And he was affairs, but he did not. With Generous with the Poor talking about money for alms what affection he treated them! and this was to make sure that I I was unable to reach his level’. Dr. Don José Riquelme. ‘We was carrying it in my purse. All All the sick people of those lived with Pedro in the univer- the poor people were waiting at grottoes knew that charitable sity lecture rooms. At that time the doors of the College of St. ‘children’s doctor’, whose he already bore clear witness to Nicholas to receive help from humble care, without fail, took his profound and constant reli- Don Pedro’. them to clinics if this was the gious direction and propensity Donna Adela Mancebo, sec- right course of action. ‘Many to charity. Once, when he was ond cousin of the Servant of times visits, lifts and gifts were student in Madrid, he saw a God, has stated: ‘His charity to- the same thing’, remembers Fr. man pass by in Lavapiés wards his neighbour was com- Federico Sala. Square; his countenance was pletely exaggerated. For exam- Don Amalio (an assistant that of a suffering old man and ple: Almansa is a town that is health-care technician) has de- he was wearing summer clothes 92 kilometres from Alicante clared: ‘Don Predro went in the month of January. The and every time that they called round the whole of the city, cold made him tremble and he him to treat the sick even both in the most populated had a pale and afflicted face… though it was dawn he went in neighbourhoods and in the he invited him to come to the a taxi to reach it (Almansa) and poor and disadvantaged out- home of his uncle and aunt, he paid the fare out of his own skirts. I knew all the districts near to the square where he pocket. He asked if the family and he, who trusted me, called lived, he gave him one of his could pay the fare and if they me to help in all the services most comfortable overcoats and told him that it could not, not that he provided to his patients, treated him affably’. only did he not make them pay rich and poor alike’. ‘Some Mrs Asunción Rubio states but he even left some money time when I was taking one of that because he belonged to the under the pillow, and this is ad- my children to his home he at- Conferences of St. Vincent de dition to paying the taxi fare’. tended to us when he had fin- Paul and to the Caritas group of Ginés Ortuño, a driver from ished with the rest and I saw

DOLENTIUM HOMINUM N. 71-2009 that he was very tired; I said to what charity is. I learnt at his who was prostrate on his bed. him: “You are very tired, side what charity is. Whereas After the first words the sick please have a rest”, and he professionally he was an insti- man said to the priest: “I have replied “No, I am fine, further- tution, his human values were seen Jesus Christ”. The priest more I have to make some vis- extraordinary. The whole of Al- replied: “Yes, when you have a its and he listed for us a series icante knows this. I always high temperature you can have of sick people whom he had to called him Saint Pedro because visions”. “When I say that I see in specific places which at a person as good as he was have seen Jesus Christ”, an- times were faraway. That look- could not exist… If a child fell swered the sick man, rather se- ing for poor and sick people in ill at three in the night and I did riously, “I am referring to a those hovels in those barren not call him at home… the next good man who without know- fields which surrounded the day he would rebuke me, even ing me visited me, administered city of Alicante; that going on though I had doctors who could to me, treated me and even took stone roads at any moment, en- have done the thing perfectly. me to hospital, that man is Don countering at times rain and He was like that’. Pedro Herrero”. low temperatures during the Rev. Fernando Mata, OP, These brief descriptive ele- night. He did everything for priest and doctor: ‘He was very ments show the pathway of a God. He wanted God to smile interested in founding a retreat Christian who knew that a bap- at him’. in Alicante and he managed to tised person must be a saint and Don Amalio goes on: ‘Don do this; in response to his invi- an apostle. Pedro, seeing that a gypsy tation I gave a series of talks in The death of Pedro Herrero mother did not know how to re- Alicante and directed a series of produced a great feeling in move the sores of the spots of spiritual exercises for health- those who had known him. 54 measles, spent a night in her care workers organised by the Proof of this was the huge grotto, charitably treating a ba- Brotherhood of Cosma crowd at his funeral and the un- by so that it would not have and Damian, of which the Ser- expected decision of the bishop marks on his face. It was not vant of God was president until who was present, who an- strange to see him wash a child his death’. nounced the forthcoming open- in a grotto when its mother was ing of the process for his beati- ill’. fication. Laus Deo! Sr. Guadalupe de las Heras, ‘I Have Seen Jesus Christ’ H.E. Msgr. RAFAEL Daughter of Charity: ‘Although PALMERO RAMOS, I am a Daughter of Charity, it On one occasion a canon of Bishop of Orihuela-Alicante, was Don Pedro who taught me St. Nicholas visited a sick man Spain

DOLENTIUM HOMINUM N. 71-2009 Spain: the Association of Christian Health-Care Workers

The Association of Christ- health-care/social realities, the sponsible for pastoral care in ian Health-Care Workers is an right keys by which they can health within the Spanish association of the faithful with be addressed, and the re- Bishops’ Conference. a public juridical status and sources by which within them was created by the Spanish a Christian life can be lived. Rev. RUDESINDO DELGADO Bishops’ Conference. The participation in the Ecclesiastical Assistant The goals of the members of three work seminars was ac- of the PROSAC this association are: to promote tive and enriching. These were (Association of Christian Health-Care Workers), the Christian laity, to create held contemporaneously and Spain channels and contexts of en- were on conscientious objec- counter; to help health-care tion at the beginning and end workers in the human, spiritu- of life and in ordinary care. Greetings of H.E. al and bioethical field; to coop- We were able to count on Msgr. Jesús García Burillo erate in the promotion of the presence of H.E. Msgr. health; and to contribute to the Rafael Palmero, the head of ‘that the God of our Lord Je- defence of the rights of people pastoral care in health, who sus Christ, the Father of glory, 55 in health or sickness. presided over an excellent Eu- may give you a spirit of wis- Within the context of these charist at the Monastery of the dom and revelation’ (Eph goals, annual meetings are or- Incarnation of the Carmelite 1:17). ganised such as the one that sisters. He took part in the It is a great pleasure for me was held 15-17 May in Avila seminars on conscientious ob- to welcome all the participants and involved the presence of jection and offered some very in this sixteenth National Day about a hundred health-care illuminating words on the of Christian Health-Care workers. They reflected on most urgent challenges facing Workers. Dear Mr. Rudesindo, conscience, responsibility and the association: its renewal and Mr. President and members of solidarity in the health- internal and external energis- the PROSAC association, Don care/social world, ‘convinced’, ing, the need for constant ethi- Abilio, Director of the Depart- as Dr. José Maria Rubio, the cal and moral reflection on its ment for Pastoral Care in President of the Association, professional activity and the Health of the Spanish Bishops’ said, ‘that solidarity, ethics and role of Christian witness in the Conference, I would like you spirituality are the challenges world of health and life, with to feel at home. The city of and principal goals of our pro- special care being given to the Avila opens its doors to each fession, and together we can weakest and most in need. one of you and to all your as- meet them’. At the prayer meeting, the sociation. We are very happy Msgr. Jesús García Burillo, writings of St. Teresa and St. to host an experience of the the Bishop of Avila, presided allowed us Church such as this one, in over the inaugural ceremony to enter the roots of faith, the which you are about to take of the meeting and afterwards celestial joy and pathway of part. bid those present welcome to God. A letter of St. Paul and In the Book of Wisdom we the city where St. Teresa, a other texts taken from his writ- find Salomon’s speech on the model sick person and patient, ings were read. During this nature of wisdom and this ends was born, and expressed the meeting humour and happi- with a prayer. I would like to hope and wish that the partici- ness were not absent and we make it mine at the beginning pants would have the same called it ‘tibilorio’. of these greetings, asking God feelings that had done and We were accompanied over for this gift for all of you: ‘O with which she overcame her this period by Dr. Alexander God of my fathers and Lord of illness: wisdom, patience and Sherchenko, the envoy of the mercy, who hast made all union with God. Rudesindo Metropolitan of Voronezh and things by thy word and by thy Delgado, the Ecclesiastical As- Borisoglensk, the President of wisdom thou hast formed man, sistant of the association, read the Synodal Department of the to have dominion over the the message of greetings and Church of Charity and Social creatures thou hast made, and encouragement sent by H.E. Services of the Russian Ortho- rule the world in holiness and Msgr. José Luis Redrado, Sec- dox Church and President of righteousness, and pronounce retary of the Pontifical Council the Medical Doctors of the Or- judgement in uprightness of for Health-Care Workers. thodox Community of Russia. soul, give me the wisdom that Three exceptional speakers, Below we reproduce the sits by thy throne… for even if Emilia Sánchez Chamorro, greetings of the Bishop of Avi- one is perfect among the sons Francisco Alarcos and Juan la, H.E. Msgr. Jesús García of men, yet without the wis- Martín Velasco, helped us to Burillo, and of H.E. Msgr. dom that comes from thee he learn about contemporary Rafael Palmero, the bishop re- will be regarded as nothing…

DOLENTIUM HOMINUM N. 71-2009 Send her forth from the holy my health, and even if there cuss her illnesses and there is heavens, and from the throne was a great deal it was not suf- an abundant literature on the of thy glory send her, that she ficient. Fainting fits began to subject. But at that time Teresa may be with me and toil , and increase in me and I had such had already overcome those that I may learn what is pleas- bad heart trouble that those years of illness living a full ing to thee’ (Wis 9:1-10). who saw it were very fright- life, a life that was intense and When I was sent as a bishop ened, as were others’(V 4, 5). full of human relationships and to this city to take part in that Given that the physicians of activity, an intense internal and ring that in the apostolic suc- Avila were unable to heal here, external life, embracing the cession leads us back to the her father took her to Bacedas, task of reforming and found- founder of the Church of Avil, to a famous healer, but there ing eighteen convents of the St. Secundus, one of the seven this ‘medical’ treatment was Carmel, overcoming every ‘apostolic men’, I took up the more injurious than her own kind of difficulty, which today words with which John Paul II illness: ‘after two months, de- seem incredible to us for a began his visit to Spain in spite the , life had al- woman of the sixteenth centu- 1982: ‘I have come to Avila to most abandoned me, and the ry. Only a woman of great worship the Wisdom of God’. gravity of my heart trouble physical, mental and above all May this wisdom illuminate from which I wanted to get spiritual capacities would have your deliberations of the six- better was so strong that some- been able to perform tasks teenth World Day of Catholic times it seemed to me that bit- such as these. Teresa certainly Health-Care Workers, in a land, that of Avila, which has given great saints to the 56 Church in whom divine Wis- dom left its tracks, above all in those who are luminous light- houses in the Spanish Church and the Universal Church, St. Teresa of Jesus and St. John of God! I invite you to open your hearts to welcome, as they did, the Wisdom of God. We are in the city that was the birthplace of St. Teresa. There are many people, every day, who come here from the five continents of the world to learn about this city and in par- ticular to visit places where this saint was born, lived, prayed, reflected, founded a new Carmel, and was an extra- ordinary model as a woman, humility and life as prayer. ing teeth wanted me to sepa- appreciated health, esteemed Teresa was also a model as a rate me from it. I had a con- it, looked for it, recommended sick person. I am sure that all stant fever and I was worn it and made it the subject of of you would have wanted to through, because for almost a her prayers to the Lord: ‘I wish have had her as a patient. St. month they had given me a for health of the body’(cit. Teresa in her life suffered be- purgative every day, I was so 299,5); ‘I pray to the Lord that cause of various illnesses. In worn out that my nerves began he may continue my health’ the Convent of Grace here in to contract, with almost un- (cit. 457, 8); ‘I am in better Avila, which she joined when bearable pain which meant health than usual. May God she was still a teenager, she re- that I had no rest night or day, grant it body and soul as I membered that she ‘had a ma- and I was very sad’ (V 5, 7). wish’ (cit. 2, 14). jor illness which made me re- Not seeing any improve- With great wisdom, Teresa turn to my parent’s home’ (V ment in her condition, her fa- learnt to overcome illness and 3,3). Of her childhood she re- ther took her back to Avila. no longer wanted to depend on membered that ‘with my fever Her physicians thought she her pain: ‘I clearly see that in came great weakness. I have would die and said that she many things, although in fact I always had bad health’(V 3, 7). had tuberculosis. She was am ill… when I am not so During her novitiate in the twenty-one and on the night of much cared for and treated, I Convent of the Incarnation, at 15 August 1539 ‘I had a crisis have much more health’ (V 13, the age of twenty, she over- that lasted more or less four 7). She recognised the need to came ‘the terrible illnesses that days’(V 5, 9). care for herself primarily by I had, with the great patience St. Teresa remembered all of advising others: ‘it is more im- that the Lord gave me’ (V 4, 9). this twenty-five years later portant to give oneself to oth- The cause was the fact that ‘the when she wrote the book on ers than be ill’ (cit. 234). ‘I do change in life and food injured her life. Medical doctors dis- not deprive myself of every-

DOLENTIUM HOMINUM N. 71-2009 thing that I see as necessary, terruption of Pregnancy and the model of St. Teresa, a which is not little, and even Sexual and Reproductive woman who occupied the something more than is com- Health’, which means the right same geographical space that mon in these parts’ (cit. 10). of a woman to have an abor- you will over the next few Illness, like everything else tion from the fourteenth week days. in her life, she addressed in a of pregnancy until the twenty- direct way: ‘Until I imposed second when there is a danger on myself that I would no to her life or health, or when Greetings from longer worry about my body there are grave anomalies in Rafael Palmero and my health, I was always the foetus. Abortion is guaran- bound without being of use’ teed as a part of the services 1. As Regards your (V 13, 7). And she incarnated offered by the National Health Challenges this with patience and faith. Service as a public and free These are the virtues that led service and this pre-supposes a In the letter that you sent me her to distance herself from it: juridical change in the law on some time ago, inviting me to ‘when the Lord sees that it is freedom of conscience to take part in these National needed for our good, health; which a large number of med- Days, you let me know which when not, illness. May it all be ical doctors and health-care are the most urgent challenges blessed’ (cit. 2, 4). And above workers appeal in order not to that you have to address: the all with love: ‘at times illness practise abortion. A few days renewal and the internal and itself is true prayer, when it is prior to this, the Minister for external energising of the asso- the soul that loves, in the offer- Health announced that the so- ciation, the need for constant ing of love. Here love acts’ (V called ‘day after pill’ will be ethical and moral reflection on 7, 12). Teresa learnt to live her sold in pharmacies without a our professional activity, and 57 illness with peace and joy, to medical prescription and with the role of Christian witness in the point of being immense no application of an age limit. the world of health and life, joy, which was the fruit alone These are two examples of with special attention being of her union with God: ‘noth- contemporary news that di- paid to the weakest and most ing that takes place on earth rectly bear on conscience, on in need. These are important will afflict it… neither illness, responsibility and on solidarity challenges that require a suit- nor poverty, nor death’(M 5, as regards Catholic health-care able response. At these mo- 3,3). workers. ments hurried, incidental or I hope that all of you will I am also convinced, like all utilitarian responses are of no have the feelings with which of you, that ‘together we can’. use. These kinds of response, Teresa overcome illness: wis- This is the subject of the sec- which may appear to be effec- dom, patience and above all ond paper of these Days. To- tive in essential terms, are ex- union with God. Only God is gether we can, first of all amples of flight because they enough: this is the belief that through our union with Christ, accommodate reality without gave meaning and fully filled as Teresa of Jesus did. Togeth- solving the problems. Teresa’s life. The rest is impor- er we can in communion with We must keep silent and lis- tant because it helps us to live the Church, which confesses ten to the Lord who is amongst our union with God and our one Lord, one faith, one hope us and calls us to be faithful to service to others. unified in one body, one Spirit, what we are. These challenges, As you well know, we are one God and Father. The Mag- read with care and listening to going through a profound isterium of the Church offers the words of God, refer us transformation of culture as re- Catholics and society a very back in the ultimate analysis to gards matters connected with abundant doctrine in favour of the identity of your associa- health, reproductive health, life and the human being, tion. Expressed in other terms, scientific research on embryos, which you know well. they are an invitation to be euthanasia, in definitive terms A great ‘Yes’ to human life aware of what we are. the radical idea of the nature of must occupy the central posi- The introduction to the life and human beings. These tion in our ethical reflection on Statutes of the Association are subjects that concern ‘con- the dignity of the person. Re- states that you are Christian science, responsibility and sol- specting human life, the digni- health-care workers, that you idarity in the health-care/social ty of the person, care for the want to carry out in the world world’, as the slogan that you health of the individual and the of health and illness the mis- have chosen for these Days community are the primary sion that Jesus in his Church has it. duties and joys of a medical entrusted to us.1 This identity Without going too far away doctor. cannot be taken for granted. from our subject, yesterday the I hope that all of you will When a Christian health-care Council of Ministers, denying pass these Days in peace, with worker, called on by other the scientific evidence on the joy and wisdom, divine and things, loses sight of what he origins of life and ignoring the human wisdom, during the or she is, he or she does not great demonstrations that were Easter festivities that we are find in himself or herself the held in favour of life, such as celebrating. I hope that this meaning of what he or she the ‘Madrid Demonstration’, will be a reflection that will does. In these circumstances, approved, as was predicted, transform life into prayer and the hurry of events, routine or the Bill on the ‘Voluntary In- prayer into life, according to abandonment always appear

DOLENTIUM HOMINUM N. 71-2009 on the horizon as a temptation. derness, compassion and gratu- Samaritan. Compassion is re- It is thus advisable to return to itousness’.4 Secondly, because lational and requires the pres- one’s identity and always keep ‘The parable of the Good ence of the other, who is not it in mind in order to address Samaritan remains as a stan- indifferent. Mere proximity the challenges that face us with dard which imposes universal does not generate love, but consistency and faithfulness. It love towards the needy whom love generates proximity, it is is in our identity that we we encounter “by chance”’5. A love that makes us neighbours. should try to look for lasting sick person is a source of iden- As John Paul II declared: ‘This responses. tity for a Christian health-care love makes itself particularly worker. In the encounter with noticed in contact with suffer- 2. The Parable of the Good him or her your identity is ex- ing, injustice and poverty - in Samaritan (Lk 10:25-37) pressed in mercy, in responsi- contact with the whole histori- bility and in solidarity. cal “human condition,” which When reflecting on the title in various ways manifests of these Days, namely ‘Con- 3. Mercy Manifests the man’s limitation and frailty, science, Responsibility and Christian Identity both physical and moral. It is Solidarity in the Health- precisely the mode and sphere Care/Social World’, there According to Luke, one of in which love manifests itself came to me the words of John the characteristics of God (cf. that in biblical language is Paul II that were spoken on the Lk 1:54; 6:36) is the explana- called “mercy.”’6 threshold of the Jubilee of the tion of the behaviour that Jesus As a consequence, nearness, year 2000: ‘I extend a warm adopts towards the poor, the a look and compassion bring invitation to those involved sick and sinners (cf. Lk 17:13; out our Christian identity: be 58 professionally or voluntarily in 18:38). Faced with a sick per- aware of your identity when the world of health to fix their son, one should not pass by or you draw near to a sick person, gaze on the divine Samaritan, change direction. A Christian when you look at him or her so that their service can be- health-care worker, who in a and when you feel compassion come a prefiguration of defini- sick person finds his reason for for him or her. tive salvation and a proclama- existence and meaning of life, tion of new heavens and a new must go up to him and look at 4. Responsibility Refers Back earth “in which righteousness him (cf. Lk 10:33). The Samar- to a Dialogue of Love dwells” (2 Pt 3:13)’.2 itan, who had not expected that with God Following this approach, I day to have met a wounded invite you to think with calm man, had very different plans. Although mercy makes us and peace about the parable of Faced with the unexpected, he neighbours, a Christian health- the Good Samaritan so that does not change his route but, care worker discovers in a sick with awareness of your identi- instead, remains on the path he person that mediation that is ty you can respond to chal- was walking. A Christian required to respond with faith- lenges and grow in solidarity health-care worker knows how fulness to the Christian voca- towards the sick. ‘From centu- to stay, he or she is able to tion: Christ, in making himself ry to century the Christian change his or her pastoral pro- present in a sick person, calls community’, declares the gramme because he or she to us. Vocation is a dialogue of apostolic exhortation, Christi- wants to come to the sick per- love between God who calls fideles laici, ‘in revealing and son that he or she has encoun- and man who answers. The re- communicating its healing tered in a hospital, in a clinic sponsibility of a Christian love and the consolation of Je- or during a visit. health-care worker refers back sus Christ has reenacted the We have to stay in order to to a dialogue of love with God gospel parable of the Good look. To look means to move which takes place in the en- Samaritan in caring for the out of ourselves and take our counter with a sick person. vast multitude of persons who eyes off ourselves in order to The Good Samaritan made are sick and suffering. This see the other. Our look himself a neighbour to the came about through the untir- reawakens the dynamic of the man, he dressed his wounds, ing commitment of all those will. We do not look as passive and he poured oil and wine on- who have taken care of the spectators but as actors in- to them (Lk 10:34). To treat sick and suffering as a result of volved in the mystery of a sick and bandage the wounds the science and the medical arts as brother. If we look with eyes Samaritan did not hesitate to well as the skilled and gener- of faith, the sick person is no dismount his horse. Love if it ous service of healthcare longer an anonymous person is love stoops down; it reaches workers’.3 but becomes, instead, our down. Paul reminds us of this I offer this parable to you for brother. When we look in this in the Christological hymn of two reasons. First of all be- way, we love. the Letter to the Philippians: cause ‘The example of Christ, Our look makes possible ‘who, though he was in the the good Samaritan, must in- mercy and generates compas- form of God, did not count spire the believer’s attitude, sion (cf. Lk 10:33). The equality with God a thing to be prompting him to be “close” to Samaritan felt compassion, grasped, but emptied himself, his brothers and sisters who are had mercy, and was merciful. taking the form of a servant, suffering, through respect, un- Compassion emerges when the being born in the likeness of derstanding, acceptance, ten- other enters the life of the men’ (Phil 2:6-7). This stoop-

DOLENTIUM HOMINUM N. 71-2009 ing down makes possible the quently, in addition to their solidarity with a sick person performance of the task of necessary professional train- should not constitute an option treating and bandaging ing, these charity workers need for a Christian health-care wounds. Love, which springs a “formation of the heart”: worker. from the encounter, requires they need to be led to that en- From this solidarity with a one to place oneself at the counter with God in Christ sick person, in the contempo- same level as the sick person. which awakens their love and rary socio-cultural context two In imitation of Christ you opens their spirits to others. As urgent tasks flow: the defence should stoop down so that a a result, love of neighbour will of life and the promotion of a sick person can recover his or no longer be for them a com- health worthy of man. Solidar- her health. So respond to your mandment imposed, so to ity commits us, like other vocation, be, that is to say, re- speak, from without, but a Samaritans, to heal, to treat sponsible, in devotion, in self- consequence deriving from and to defend the life of a sick giving, and in gratuitousness. their faith, a faith which be- person. People deceive them- These are the responses to an comes active through love (cf. selves when they ‘think that experience of love that has Gal 5:6).7 they can control life and death sprung from an encounter with by taking the decisions about a sick brother. Only love for a 5. Solidarity Springs them into their own hands. sick person, in which we dis- from Love What really happens in this cover Christ, makes us respon- case is that the individual is sible. The compassion of the overcome and crushed by a Responsibility supports and Samaritan is expressed through death deprived of any prospect justifies the need for on-going his actions. True love is cre- of meaning or hope’.8 And training. The up-dating of per- ative, it does not abandon but Benedict XVI stresses that: ‘In 59 sonnel who work in such a del- instead it looks after. Love is fact, it is necessary to assert vigorously the absolute and supreme dignity of every hu- man life’.9 Faced with the threat that is made to the life of man at its beginning and at its final moment, solidarity is manifested in the proclaiming of the Gospel of Life: you should be through your work ‘stewards and servants of hu- man life’.10 Solidarity requires of you a second task: the promotion of a health that is worthy of man. The danger exists of trans- forming health into an idol to which other values are subor- dinated. This reductive vision of health does not take into ac- count the spiritual and social dimension of the person. icate sector of society is ex- revealed in commitment, in Health is not limited to biolog- tremely urgent and this is even faithfulness and the need for ical perfection: ‘life lived in more the case when a sick per- continuity. True love never suffering also offers room for son entrusts us with the good abandons a sick person to his growth and self-fulfilment, of his or her life. In this sense, or her destiny, it ends the work and opens the way to discover- the words of Benedict XVI are that has been begun, and it is at ing new values’.11 Solidarity eloquent: ‘Individuals who one with him. must encourage us to work for care for those in need must ‘Then’, the parable contin- a health that is based upon an first be professionally compe- ues, ‘he set him on his own anthropology that respects the tent: they should be properly beast and brought him to an person in his or her totality. trained in what to do and how inn, and took care of him. And From this point of view, health to do it, and committed to con- the next day he took out two ‘far from being identified with tinuing care. Yet, while profes- denarii and gave them to the the mere absence of illness, sional competence is a prima- innkeeper’ (Lk 10:34-35). Sol- strives to achieve a fuller har- ry, fundamental requirement, it idarity with a sick person seeks mony and healthy balance on is not of itself sufficient. We neither gratification nor ap- the physical, psychological, are dealing with human be- plause, it is neither momentary spiritual and social level’.12 ings, and human beings always nor skin-deep. Solidarity has need something more than its own roots in an objective tie 6. ‘Together we Can’ technically proper care. They with a sick person that springs need humanity. They need from love: love requires soli- The slogan that you chose heartfelt concern... Conse- darity. From this point of view, for these Days, ‘Together we

DOLENTIUM HOMINUM N. 71-2009 Can’, refers us to communion. tic table we allow our feet to Notes A communion which for us is be washed by Jesus and we en- 1 Cf. ‘Estatutos de la Asociación de sacramental when we remem- ter into communion with Profesionales Cristianos, Preámbulo’. ber our Lord Jesus Christ, Christ and our brothers 2 JOHN PAUL II, ‘Message of the Holy when we celebrate the Eu- through the shared bread and Father for the World Day of the Sick for the Year 2000’, 6 August 1999. charist. the blood shed for us. In the 3 JOHN PAUL II, apostolic exhortation We, too, we need to be treat- Eucharist, service is an expres- Christifideles laici, n. 53. ed, we need someone who will sion of Eucharistic commu- 4 JOHN PAUL II, ‘Message of the Holy Father for the World Day of the Sick for bandage wounds. Christ, the nion. It follows from this is the Year 2000’, 6 August 1999. Good Samaritan, washes our that in service to our sick 5 BENEDICT XVI, Deus Caritas est, n. tired feet, treats our wounds, brother we must all be united: 25. 6 JOHN PAUL II, encyclical letter Dives takes responsibility for our this is the force that is in misericordia, n. 3. sufferings, and redeems us achieved in the frailty of your 7 BENEDICT XVI, encyclical letter Deus Caritas est, n. 31. through his death on the cross. service and your dedication. 8 JOHN PAUL II, encyclical letter Evan- The Eucharist is a school of ‘It thus appears clear’, ob- gelium vitae, n. 15. love at which we learn to be serves Benedict XVI ‘that it is 9 BENEDICT XVI, ‘Message of the Holy Father for the World Day of the Samaritans. ‘The service ren- specifically from the Eucharist Sick for the Year 2009’, 2 February dered to the person who is suf- that pastoral care in health 2009. fering in body and soul takes must draw the necessary spiri- 10 JOHN PAUL II, ‘Message of the Holy Father for the World Day of the Sick for its meaning from the Eu- tual strength to come effective- the Year 1999’, 8 December 1998, n. 6 charist, finding in it not only ly to man’s aid and to help him 11 JOHN PAUL II, ‘Message of the Holy its source but also its norm. It to understand the salvific value Father for the World Day of the Sick for 14 the Year 2000’, 6 August 1999. n. 13. was not by chance that Jesus of his own suffering’. 12 Ibid., n. 13. 60 closely united the Eucharist I invite you to take part in 13 Ibid., 8. with service (Jn 13:2-16), ask- the Eucharist by giving a hand 14 BENEDICT XVI, ‘Message of the Holy Father for the World Day of the ing the disciples to perpetuate to Mary, our Mother. In this Sick for the Year 2008’, n. 4. in memory of him not only the way you will experience that “breaking of the bread”, but al- the impossible becomes im- so the “washing of the feet”’.13 possible and how what has When we sit at the Eucharis- been separated can be united.

DOLENTIUM HOMINUM N. 71-2009 Suffering, a School of Life: the Servant of God Manuel Lozano Garrido

After some brief biographi- Yes to rich, abundant, full wise, believers and non-be- cal references, I have organ- life, that life that Jesus of lievers. ised my paper into two parts: Nazareth has promised us: ‘I suffering, a school of life, and have come so that they may c. Does illness have a Lolo-Manuel Lozano Garrido, have life’ (Jn 10:10). meaning? a witness to the value of suf- The magnificent encyclical fering. of Pope John Paul II, Evan- On 11 February 1984 Pope Manuel Lozano Garrido was gelium vitae, is a text for pro- John Paul II published his en- born in Linares (Jaén) in 1920. found analysis. As ministers of cyclical letter Salvifici doloris He joined Catholic Action in life we are called to proclaim on the Christian sense of hu- 1931. His illness appeared in the value of life, to serve life, man suffering. In this work the 1942 and in 1943 it forced him to celebrate life and to evange- Supreme Pontiff states that onto a wheelchair. In 1956 he lise life. suffering is a universal subject established the review Sinai, a which accompanies man (SD, journal for sick people. He lost b. Pilgrimage through n. 2) and which must be ac- 61 his sight completely in 1962. suffering cepted as a mystery (SD n. 8 He published a large number and n. 11) and he adds that in of books and in 1969 he re- Yes to life, and yet life is order to gain insight into the ceived the ‘Bravo’ prize for constantly subjected to threats. real answer to the meaning of journalism. He died in Linares And here are some of them: on 3 November 1971. In 1994 drugs, alcoholism, road acci- the process of his canonisation dents, consumerism, depres- began in Jaén. sion, sex, the emptiness of life; abortion, euthanasia, hunger, war, death against life, and an 1. Suffering, a School of Life infinity of diseases. Here is a rapid list: almost a a. Life is a gift thousand million people suffer because of poverty, malnutri- Life is life, it is a gift, a gift tion and diseases; every year from God that we must love, 46 million people die; almost care for and steward. We must 850 million people live in say ‘yes’ to life and ‘no’ to ma- zones afflicted by malaria; in nipulation. Life is neither of many countries the average the right nor of the left, it be- life span does not reach the age longs to no political party, and of fifty and the infant mortality it is not the product of a labo- rate is between 100 to 200 ratory; life is from God, and every thousand. In the world we are its sole stewards. there exist: 10 million epilep- suffering we have to turn our We are born to live. Man’s tics; 15 million lepers; 52 mil- gaze to the revelation of divine commitment is life and for this lion people who are deaf and love, the ultimate source of the reason we must learn to live: dumb; and 50 million paralyt- meaning of everything that ex- we must love life, fall in love ics. ists. Love is also the richest with life, give thinks for the 12% of the world’s popula- source of the meaning of suf- gift of life, enjoy life and share tion suffer from a mental fering. It is the answer given life; allow ourselves to be sur- anomaly; we may also add by Christ on the cross (SD, n. prised by life, and know how AIDS to this list, as well as 13). It is the path followed by to live new, different and un- drug addiction, alcoholism, old Christ who accepted pain, and usual moments. How beautiful age, unemployment, migra- experienced by giving it a it is to discover life and to live tions etc. These are the statis- meaning of salvation and sal- it with hope, with confidence, tics of shame that are present vation. He give himself totally with the wish to fight; to live in our society. But it is also a unto death on the cross, but his and not to give any space to long journey, a great pilgrim- resurrection defeated death. sadness, to boredom, or to fear. age of the whole of humanity From that moment onwards To love life, to allow the new through the map of suffering human suffering has acquired to come in, to look at the infi- that speaks to us about its uni- a meaning, it has been trans- nite, to open doors and win- versality and unites all the peo- formed, together with the suf- dows to life so that light, joy, ples of the world: the rich and fering of Christ: ‘if a grain of self-giving and love come in. the poor, the ignorant and the corn that falls to the ground

DOLENTIUM HOMINUM N. 71-2009 does not die it remains alone, nicate (an adviser of young ness of God: joy, a smile, a but if it dies, it produces much people, a journalist, a writer); good mood, cheerfulness…; fruit’ (Jn 12:34). and a man of exceptional faith. holiness in simple and daily things; awareness of the near- d. Suffering is a key b. Some aspects connected ness and at the same time of and opportune moment, with his condition of illness the transcendence or otherness a kairós: and suffering of God: ‘you are here, sitting next to my chair, and affec- For a sick person who A trusting acceptance of his tionately I put my arm around dwells upon his or her life and condition without allowing your shoulders… I have to begins to reflect more serious- himself to be lowered by des- dream that I am seeing you; I ly on its meaning at a time of peration: three human ap- will die if I do not see you, al- illness; a time of God which proaches to pain – desperate most hidden and always un- passes and perhaps finds us rejection or discouragement reachable’. less distracted. (God has abandoned me); res- From these few characteris- Pain and illness are a place ignation (God has sent this, tics, one can observe, and I re- of observation, a school, a uni- God wants it); understanding peat the point, how the Servant versity that teaches us so many of, and the attribution of a role of God Manuel Lozano Garri- things and an opportunity to to, suffering in the redemptive do was transformed and ma- embrace life and at times a work of Christ; giving mean- tured by the intense experience place for authentic conversion ing to the new direction of life of pain and suffering, moving and apostleship. from an active and involved Many saints and simple peo- life to the active contemplative 62 ple have achieved a great posi- dimension. His faith always tive journey through suffering: became stronger with aware Ignatius of Loyola, John of acceptance of pain, to which God, Camillo de Lellis, John he was soon able to give a Paul II, Lolo, and an almost in- meaning – participation in the finite etcetera. This is an expe- work of redemption of Jesus rience that is confirmed every Christ. This enabled him to day in hospitals and in family transform his illness into an in- life. strument of evangelisation.

2. Lolo, The Servant of God Conclusion Manuel Lozano Garrido, a Witness to the Value Lolo was an authentic wit- of Suffering ness to the values of the King- dom, lived in suffering, in an Having as our frame of ref- environment which at first erence the above analysis, I sight could appear to us to be will now point out certain hu- negative, whereas in fact it is man aspects of Lolo and other from the point of view of faith not. Yes, pain, suffering and aspects connected with his ill- (union with the crucified illness have a meaning, this is ness, in the sense of how he Christ) and from a human proclaimed by the Lord with lived out his illness. I will do point of view (change in pro- his words and with his life that this in telegraphic form. fessional direction); the was given totally, passing courage to bear pain and suf- through Calvary, unto death on a. Human aspects in Lolo fering for God and for the the cross. The Church pro- Church – readiness until mar- claims this in its preaching and A positive spirit: life has a tyrdom; the rediscovery of the in its celebrations. In his apos- meaning, independently of the communal value of pain and tolic letter Salvifici doloris, n. objective circumstances; a suffering (offering one’s own 30, John Paul II uses these great generosity of spirit: suffering to God for the com- very strong phrases: ‘suffering Catholic action and service to munity, offering sufferings to- is present in the world in order his parish community (minis- gether with other people to to release love, in order to give ter of the Eucharist ante litter- contribute to the redemption of birth to works of love towards am); extraordinary will power; the world); the dimension of, neighbour, in order to trans- a practical spirit: concreteness and need for, the witness of the form the whole of human in professional activity and de- person who suffers; suffering civilisation into a ‘civilisation cisions – first teaching and as a source of praying thanks- of love’’. Furthermore the then journalism; a spirit that giving to God – ‘I fall on my Supreme Pontiff states that the was totally impassioned: noth- knees and give free expression suffering of man ‘is above all a ing stopped him, not even his to gratitude… I do not want call. It is a vocation’ (n. 26). A forced immobility; an open complaint; give me instead a mysterious call to love more and advising mind: a thirst to smile’; communicating a cer- and to share in the infinite love share everything with every- tain normality of life in pain in of God for mankind. body, that is to say to commu- order to bear witness to near- Paul Claudel said: ‘God did

DOLENTIUM HOMINUM N. 71-2009 not come to eliminate suffer- The Church also teaches kingdom come! If the beloved, ing or to explain it. He came to that a sick person is not a pas- love, the greatest gift of my fill it, to give it meaning sive and useless person but a life is near to me, if I can be through his presence’. person with a great mission – convinced to the depths of my Faced with pain, the man that of being a witness. The heart that who loves me is near who does not believe blames Church equally invites people to me, even in situations of God for everything that hap- to treat a sick person with all tribulation, joy will be in the pens and cries out: where are the technical means possible depths of my heart, which is you God? The man of faith, on but also to look after him or greater than all suffering’ (4 the other hand, tries to discov- her with great humanity and October 2005). er the meaning of his life and respect for the person. The And to end my paper, here is to give it a meaning even when eternal example is the Good a Jewish story. ‘It is said that a it is lived out with difficulty Samaritan, the perfect icon of asked his teacher, why and in illness. Faith does not how to draw near to suffering do the good suffer more than remove cancer, blindness or man (Lk 10). the bad? His teacher replied, any other illness, but it does Indeed, Lolo and many oth- listen a man had two cows, one propose choosing between er men and women have was strong and the other was pain that does not have mean- grown and matured humanly weak – on which of the two ing and pain that has meaning. and spiritually at the school of did he place his yoke? Obvi- To serve life is to specifically suffering. They have known ously on the stronger cow, this – to give a meaning to suf- how to enjoy all the riches that replied the disciple. The fering and death. are contained within it, they teacher than concluded, the And we see this broadly and have felt the presence of God merciful does the same, for the significantly reflected in Lolo, in their lives which thanks to world to move forward he 63 as an example, as a model. He Him became rich and full. places the yoke on the good’. understood the teaching of Je- I will conclude this paper And this is what God did sus and the Church, which with a sentence of Pope Bene- with Lolo. have always stimulated people dict XVI and with a Jewish to fight for health, knowing story. H.E. Msgr. JOSÉ L. REDRADO OH, that despite all his advances I will begin with a sentence Secretary of the Pontifical Council man will never be able to elim- of the present Pope which for Health Care Workers, inate illness or death. reads as follows: ‘May your the Holy See.

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