DOLENTIUM HOMINUM N. 62 – Year XXI – No. 2, 2006

JOURNAL OF THE PONTIFICAL COUNCIL FOR HEALTH PASTORAL CARE

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

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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 Decree of the 41 Human Life: a Precious Gift of God The Bishops’Conference of Spain

XIV WORLD DAY OF THE SICK 44 Modern Society in Conflict ADELAIDE - AUSTRALIA, 11 FEBRUARY 2006 Between the Culture of Life and the Culture of Death 6 Letter from the Holy Father Msgr. Vincenzo Di Muro to Cardinal Lozano Barragán Benedict XVI 47 Prison and Conditions for Depression Rev. Waldemar Woźniak 7 Account of the XVI World Day of the Sick 51 Medical Saints of our Time: Rev. Dariusz Giers Giuseppe Moscati, Riccardo Pampuri, Gianna Beretta Molla 10 Address of His Holiness to the Sick Prof. Massimo Aliverti 2 Benedict XVI

11 Angelus TESTIMONIES Benedict XVI 56 The Lord has Done Great Things for us: 12 Homily He Has Filled Us with Joy! H.Em. Card. Javier Lozano Barragán Rev. Leonardo Nunzio Di Taranto

15 The Mentally Ill Patient: 61 Activity in the Field of Health A Faithful Image of God and Health Care H.Em. Card. Javier Lozano Barragán Episcopal Commission for Health of the Madagascar 21 ‘Go home to your people and tell them all that the Lord 64 From Athens to Sparta: in his mercy has done for you’ we are All on a Journey (Mk 5:19): Issues of Human Dignity with Terri Schiavo Rev. Peter Comensoli Prof. Gianluigi Gigli

26 Where to from here? Msgr. David Cappo THE WORLD CONGRESS OF THE INTERNATIONAL FEDERATION OF ASSOCIATIONS 29 Health Pastoral Care in the Church OF CATHOLIC DOCTORS (FIAMC) H.Em. Card. Javier Lozano Barragán BARCELONA, 11-14 MAY 2006 68 The World Congress of the TOPICS International Federation of Associations of Catholic Doctors (FIAMC) 36 A Pluridisciplinary Dialogue on Human Life 70 Catholic Doctors: Love Your Profession! Rev. Bonifacio Honings, O.C.D. H.E. Msgr. José L. Redrado, O.H.

The illustrations in this edition are taken from the book: “Tatry Góry ” Najpiękniejszeby - RyszardThe Tatra Ziemak, Spell Wydawnictwa Artystyczne i Filmowe, Warszawa 1991

DOLENTIUM HOMINUM N. 62-2006 APOSTOLIC PENITENTIARY Decree

Indulgences granted on occasion of the 14th. World Day of the Sick

The Supreme Pontiff Benedict XVI, motivated by the deep desire that human sickness and pain, borne with resignation and offered to the Eternal Father through the Virgin Mary together with the sufferings of her Son the Redeemer, may produce abundant spiri- tual fruits, and sustained especially by the hope that works and projects of Christian piety and social solidarity for the sick may be encouraged, particularly for those affected by some mental handicap who are more easily marginalized by society and by their own family, at the Audience granted to the undersigned Cardinal Major Penitentiary on 2 Jan- uary this year, has disposed that special be granted to the faithful as follows, on the occasion of the ‘14th World Day of the Sick’, 11 February 2006, the liturgical Memorial of Our Lady of Lourdes, which will culminate in the Eucharistic celebration in 4 the Cathedral of St. Francis Xavier in Adelaide, Australia. A. A Plenary is granted to members of the faithful who, on the usual condi- tions (sacramental Confession, Eucharistic Communion, prayers for the Holy Father’s in- tentions) and in a spirit of total detachment from any inclination to sin, take part devoutly this 11 February in the Cathedral of Adelaide or in any other place established by the ec- clesiastical Authority, in any sacred ceremony celebrated to implore from God the aims of the ‘World Day of the Sick’. The faithful in public hospitals or in any private home who charitably care for the sick as ‘Good Samaritans’, especially those who due to some mental handicap require greater patience, diligence and attention, and, because of their service are unable to take part in the ceremony mentioned above, will obtain the same gift of the Plenary Indulgence if on that Day, at least for a few hours, they generously devote their charitable assistance to the sick as if they were tending Christ the Lord himself (cf. Mt 25:40), in a spirit of total de- tachment from any inclination to sin and with the determination to fulfil as soon as possi- ble the conditions required for obtaining the Plenary Indulgence. Lastly, members of the faithful who, due to sickness, advanced age or other such rea- sons, are prevented from taking part in the above-mentioned ceremony, will obtain the Plenary Indulgence provided that, in a spirit of total detachment from any inclination to sin, with the intention of fulfilling the usual conditions as soon as possible and the desire to take part in spirit with the Holy Father on that day, they pray devoutly for all the sick and offer their physical and spiritual suffering to God through the Virgin Mary, “Health of the Sick”.

B. A Partial Indulgence is granted to all the members of the faithful who, from 9 to 11 February 2006, at any time, address fervent prayers to God with a contrite heart, to im- plore the above-mentioned aims for the benefit of the sick.

This present Decree is in force for this occasion. Notwithstanding anything to the con- trary.

Given in at the Offices of the Apostolic Penitentiary, 18 January 2006, beginning of the Week of Prayer for Christian Unity.

Cardinal JAMES FRANCIS STAFFORD Major Penitentiary

Rev. GIANFRANCO GIROTTI, O.F.M. Conv. Regent

DOLENTIUM HOMINUM N. 62-2006 XIV World Day of the Sick

11 February 2006 St. Francis Xavier Cathedral Adelaide - Australia TO OUR VENERABLE BROTHER CARDINAL OF THE HOLY ROMAN CHURCH, JAVIER LOZANO BARRAGÁN, PRESIDENT OF THE PONTIFICAL COUNCIL FOR HEALTH PASTORAL CARE

From afar, we would like Our greetings to reach all sick people in the world, about whom We are always deeply concerned with an attentive mind and heart. We exhort all those who offer them due care. As the memorial of Our Lady of Lourdes, on which the World Day of the Sick will be celebrated, draws near, We take this opportunity to assure them of Our special closeness.

6 Knowing that these celebrations will take place in Australia, in the city of Adelaide, we would like to send a Cardinal to represent Us. You, Venerable Brother, are particu- larly qualified to fulfill this mission, since for many years you have with profound in- terest devoted yourself to the plight of sick people throughout the world, moreover you superbly lead the Pontifical Council for Health Pastoral Care as its President.

Since the special theme for this gathering is mental illness, We would like to show Our special charity to those people who so suffer, to their relatives, and to all brothers and sisters, who assist these patients with love and patience. Therefore, You Venerable Brother, will convey to them Our feelings and assurance of prayers for their needs. At the same time, you will kindly exhort all Christians and the leaders of religion and na- tions to recognise the dignity of each and every one of these afflicted, and do every- thing possible to protect that dignity.

Therefore, next February 11 you will preside over the liturgical celebrations in the city of Adelaide on Our behalf, and you will convey Our greetings to all. You will in- vite the believers in Christ who gather there to maintain a constant devotion to the Most Holy Virgin Mary, Salus Infirmorum, so that she implores from her Divine Son abundant graces; patience for those in difficulty and a truly outstanding degree of char- ity for everyone.

Finally, we wholeheartedly impart to you Our Apostolic Blessing, which you will, in turn, bestow upon those people who gather in the beautiful Cathedral of St. Francis Xavier on the World Day of the Sick.

From the Vatican, 6 January 2006, the First year of Our Pontificate.

BENEDICT XVI

DOLENTIUM HOMINUM N. 62-2006 Account of the XIV World Day of the Sick

ADELAIDE, AUSTRALIA, 8-11 FEBRUARY 2006

For its fourteenth version, aspect; the pastoral aspect, and diagnosis, the prevention, and the World Day of the Sick re- the liturgical aspect. Also of the treatment of children’s ill- turned for the second time to fundamental importance were nesses. This hospital treats and Australia after the experience the visits to places of treatment cares for children and young of 2001 in Sydney, when thou- and care where the Special En- people who suffer from mental sands of people took part in the voy of Benedict XVI was able disturbances. This hospital is Holy Mass celebrated in the to touch with his own hands famous above all for its neona- Cathedral of St. Mary. various aspects of pastoral care tal intensive care unit and it The preparations for the in health in the capital of neurogenetics laboratory, event in Adelaide involved the southern Australia. which, indeed, enjoys interna- whole of the Australian Church tional prestige. and in particular the local The visits to places of care The last place of care to be Church of Adelaide, led by visited by the Special Envoy of Philip Wilson, The celebration of the Holy the Holy Father was the Hutt who received the initiative Mass in the great chapel of the Street Centre. This is a day with enthusiasm. The subject Calvary Health Care Hospital centre, founded by the Daugh- 7 that the Bishops of Oceania began the intense day of 8 Feb- ters of Charity of St. Vincent wanted to examine at this ruary, which was marked by de Paul, at which over two event was ‘Mental Health and prayers and meetings that the hundred homeless men and Human Dignity’. Special Envoy of the Pope held women are given help every The Holy Father, in full har- with the health-care profes- day. Most of these people are mony with the Bishops’ Con- sionals and the agents of pas- victims of mental disturbance ference of Australia, wrote in toral care in health of three im- brought about both by a com- his Message for the World Day portant health-care centres in plex family situation and by al- of the Sick of 2006 that Adelaide. cohol and drug addiction. In through the event of Adelaide After the Eucharist was over, addition to medical doctors, the ‘wanted to Cardinal Lozano Barragán, ac- psychologists and social work- call the attention of public companied by the delegation ers, hundreds of voluntary opinion to subjects connected of the Pontifical Council, visit- workers offer their service free with mental disturbance which ed the modern departments of every day at this centre. This by now afflicts a fifth of the Calvary Health Care Hos- structure is the flagship of the mankind and constitutes a real pital: the maternity section, the charitable activity organised by and authentic socio-health-care surgery department, the onco- the Archdiocese of Adelaide. need’. logical unit, and the hospice In expressing his own near- for long-term patients. The The day of study ness to all people afflicted by President of the Pontifical mental disturbances and to Council expressed his thanks On Thursday morning, 9 those who provide inestimable and gratitude to the Sisters of February, over three hundred service to them, especially in the Little Company of Mary, people gathered together at the Oceania, the Holy Father ap- who are in charge of this fa- modern Convention Centre of pointed as his Special Envoy mous hospital structure in the Adelaide to take part in a day His Eminence Cardinal Javier city. This religious Congrega- of study on the subject ‘Mental Lozano Barragán, the Presi- tion, which was founded in Health and Human Dignity’ dent of the Pontifical Council 1877 in England with the aim After the presentation of the for Health Pastoral Care, who of serving very poor sick peo- proceedings by Dr. Francis went to Australia accompanied ple, administers nine hospital Sullivan, the Director of by a group of people represent- centres in Australia. The work Catholic Health Care Australia, ing his Pontifical Council, un- and the devotion of the Sisters which is an association of the der the leadership of its Secre- to the sick and infirm is a con- Catholic health-care institu- tary, H.E. Msgr. José Luis Re- firmation of the fundamental tions of Australia, the Special drado OH. role that the Catholic Church Envoy of the Holy Father offi- has had in bringing the Gospel cially opened the conference of Life and Health to the popu- on the scientific analysis of the The Celebration lation of the distant continent state of mental illnesses and of the World Day of Australia. the mentally ill in the world The second hospital struc- and in particular in Australia. As is by now a tradition, the ture visited by the delegation In his prolusion Cardinal celebration of the World Day from the Vatican was the Lozano Barragán expressed of the Sick of 2006 in Adelaide Women’s and Children’s Hos- the concern of the whole of the also had three principal as- pital, a hospital centre which is Church about the alarming fig- pects: the doctrinal-scientific highly advanced in the prenatal ures on mental disturbance,

DOLENTIUM HOMINUM N. 62-2006 which, indeed, is continuing to dent of the Council for the De- juridical and political up-dat- grow in all parts of the world, fence of Children of the Arch- ing’. Effective pastoral care in and emphasised the urgent diocese of Adelaide, who health must be based upon need for joint action by gov- spoke on the mental health and these priorities, to which ernments and civil society. All emotional wellbeing of preg- should be added ‘the sense of government institutions are nant women as fundamental el- responsibility and the strong called to intensify their efforts ements in the future develop- religious motivation of each on behalf of people who suffer ment of children; and lastly person that is involved in the from mental disturbance be- Msgr. David Cappo, the Vicar provision of such care’. cause ‘every mentally ill per- General of the same archdio- A moment of key awareness son is a creature of God who cese who in his paper ‘To- was represented by the words faithfully reflects the image of wards, Where, From Here?’ of Shirley Peisley, who is in- the crucified Christ’. The Pres- outlined the pastoral strategies volved in the evangelisation of ident of the Pontifical Council that the local Church must im- the Aborigines of Kauma and for Health Pastoral Care ac- plement, beginning specifical- who spoke about the various companied his paper with the ly with the observations to initiatives by which the Christ- results of research carried out emerge during the proceedings ian message is being spread by the Pontifical Council itself of the World Day of the Sick in amongst that people. based on eighty-four centres Adelaide 2006. The paper of Magde McGuire for the mentally ill. From this also commanded much atten- survey it emerged, inter alia, The pastoral day tion. Magde McGuire is the di- that in the spread of mental ill- rector of Catherine House, a nesses cultural and religious On Friday morning, 10 Feb- structure in southern Australia 8 factors, which are themselves ruary, at the Convention Centre which provides accommoda- characterised by a profound of Adelaide, the Special Envoy tion and care to women suffer- crisis of values of reference, of Benedict XVI met two-hun- ing from mental disturbances play an important part. dred and fifty pastoral workers and to women addicted to alco- The second speaker, Prof. of the Archdiocese of Adelaide hol and drugs, of whom 95% Ian Hickie, the Director of the together with their invited suffered from sexual abuse Brain and Mind Institute and guests. when they were children. Sister Professor of Psychiatry at the In his introductory speech, Julie Dean, of the Congrega- University of Sydney, dis- Cardinal Lozano Barragán pre- tion of the Sisters of Mercy, cussed the situation of mental sented the general vision of who provides pastoral service illness in Australia and exhort- pastoral care in health in the at Catherine House, observed ed the political authorities to Church and emphasised that in that in that centre hard work is make a greater economic con- Oceania two thousand and six- engaged in to find some kind of tribution to non-governmental ty-four health care structures social response for these girls agencies. are currently active. In carry- who are afflicted by mental dis- This was followed by the ing out their mission they are turbance. moving testimony of Ann De- today encountering new diffi- Pat Peake and Annie Boots, veson, a member of the Mental culties: ‘Pain, suffering and of the organisation ‘Southern Health Review Tribunal and death are hidden or presented Cross’ described their experi- the mother of a child with in a distorted way…religious ences with elderly people, schizophrenia who committed personnel are decreasing, Or- above all those elderly people suicide at the young age of ders and Congregations have afflicted by dementia. Other twenty-five. This painful expe- had to leave some hospitals be- papers were given by a person rience led Mrs Deveson to cre- cause they no longer had the in charge of spiritual assistance ate an association for the rela- people to run them. In addi- at the women’s prison of Ade- tives of people afflicted by tion, very many problems of an laide and by a mother and fa- schizophrenia with the aim of economic, scientific, technical ther who talked about the daily improving their quality of life. and political character have experience of living with a The afternoon session of the arisen because of the contem- schizophrenic child. conference was opened by porary needs and requirements In the afternoon those taking Garry McDonald, a famous of medicine and because of the part in the seminar met in work Australian actor and a member approach adopted by various groups co-ordinated by Sister of the Byondblu Association governments’. In the face of Clare Condon and Francis Sul- which addresses questions these problems, the President livan in order to draw up an connected with depression. It of the Pontifical Council for ‘action plan’ to harmonise all is significant that in Australia Health Pastoral Care empha- pastoral care for the mentally the most incapacitating illness sised four aspects: ‘to offer an ill at a local, diocesan and na- is not cancer but depression: a orientation on the value of tional level. million adults and a hundred health, pain, illness and death’; At the same time, the guide- thousand young people suffer ‘to unite all the agents of pas- lines for pastoral care in heath from this malady. toral care in health’; to enter were proposed again during This talk was followed by into contact with the local the meeting of the Special En- papers by Rev. Peter Comen- Churches, and with interna- voy of the Holy Father with the soli, an export in moral theolo- tional, national and local or- Bishops of Oceania. All the gy of the diocese of Wollon- ganisations’; and ‘to achieve a bishops resident in Australia gong; Dr. Prue McEvoy, Presi- constant scientific, technical, and also two from Papua and

DOLENTIUM HOMINUM N. 62-2006 New Guinea came to this Emeritus Judicial Vicar; mem- ragán said the prayer that had meeting. At this meeting the bers of the delegation of the been specially written for the Bishop-Secretary of the Pontif- Holy See; and the Vicar Gen- World Day of the Sick in Aus- ical Council for Health Pas- eral of the Archdiocese Msgr. tralia, and called on Mary, toral Care and its priest Offi- David Cappo. With them there Mother of God and our Moth- cials were also present. During were also the Officials and the er, ‘not to leave us alone on our the fraternal and confidential collaborators of the Pontifical journey’ and ‘to help us to cre- discussion the following burn- Council for Pastoral Care in ate in the world of health, of ing problems connected with Health who had come to Aus- illness and of suffering, friend- pastoral care in health in Ocea- tralia with the Cardinal-Presi- ly and healthy relationships nia emerged: secularisation, dent. that are full of hope and love’. the lack of women religious in After his welcome to the as- The cathedral was full of the Catholic care centres, the fight sembly given in the name of faithful and many took part in against the introduction of the the Aborigine population of the rite through large screens morning after pill; and the Kauma, the Archbishop of that had been placed outside. questions connected with bio- Adelaide read the letter of the Reference should be made to genetics. Pope appointing the President the presence of three great in- of the Pontifical Council for ternational health-care federa- Health Pastoral Care his Spe- tions: the FIAMC (Catholic cial Envoy for the celebrations medical doctors), represented of 11 February. Through his by Dr. Michael Shanahan; the close collaborator and by a CICIAMS (Catholic nurses), special indulgence issued for represented by its President those who took part in the Eu- Mrs An Verlinde; and the FIPC 9 charist, the Holy Father made (Catholic pharmacists), repre- himself spiritually present sented by Dr. Pauline La Siew amongst the faithful who had Mei. gathered in the cathedral. In his homily Cardinal Javier Lozano Barragán, after giving Conclusion the very affectionate greetings of the Holy Father to those The celebration of the XIV taking part in the World Day of World Day of the Sick in Aus- the Sick, emphasised that tralia was a strong moment to through this event the Church call the attention of civil soci- sought ‘to underline the invio- ety to people who are afflicted lable dignity of mental dis- by mental disability, and the abled people and to strive the Church made herself their The liturgical day defend that dignity at any cost, spokesman in relation to the from a cultural point of view as governors and the civil institu- The solemn celebration of much as from an institutional, tions of the state. In this area the Eucharist of 11 February, family and individual point of there were promising meetings the liturgical memorial of the view’. The performance of this with the highest civil authori- Blessed Virgin Mary of Lour- task, explained the Special En- ties of southern Australia: the des, took place at the Catholic voy of Benedict XVI, imposes Prime Minister, the Minister cathedral of Adelaide, which is on all Catholic health workers for Health, and the Mayor of dedicated to St. Francis Xavier. a precise commitment ‘to have Adelaide. Each meeting was a The following people con- their own mental equilibrium, valuable opportunity to focus celebrated with the Special En- indeed the greatest possible, in on various subjected con- voy of Benedict XIV: Cardinal and thus to be strongly an- nected with the field of mental George Pell, Archbishop of chored in a solid objective sys- health. The President of the Sydney; Philip Wilson, Arch- tem of values’. Pontifical Council for Health bishop of Adelaide, and about Afterwards the assembly of Pastoral Care expressed cor- twenty representatives of the about a thousand faithful raised dial greetings to all the authori- Australian Episcopate; Arch- up prayers and songs, animated ties on behalf of the Holy Fa- bishop Ambrose B. De Paoli; by the choir of the cathedral, ther and thanked them for hav- Bishop José L. Redrado Mar- asking the Holy Spirit to de- ing contributed to the excellent chite, Secretary of the Pontifi- scend upon the Church and to unfolding of the World Day of cal council for Health Pastoral fill those who suffer with con- the Sick. Alluding to the first Care; brothers of the dioceses solation. The visible sign of encyclical of Benedict XVI, of Oceania; and Bishop J. Paul this spiritual consolation was the Special Envoy referred to Marx and Bishop Francesco the Sacrament of the Anointing the value of marriage and the Sarego of Papua New Guinea. of the Sick which the Special family founded on love, the in- A large number of priests of Envoy of the Pope and the escapable foundations of a the clergy of Adelaide were Archbishop of Adelaide ad- healthy society. concelebrants, for example; ministered to thirty people af- Msgr. James O’Loughlin, flicted by mental disturbances. Rev. DARIUSZ GIERS parish priest of Salisbury, and Before imparting the solemn Official of the Pontifical Council Msgr. Vincent Tiggeman, blessing, Cardinal Lozano Bar- for Health Pastoral Care

DOLENTIUM HOMINUM N. 62-2006 Address of His Holiness Benedict XVI to the Sick at the End of the Mass in the Vatican Basilica, in Memory of the Blessed Virgin Mary of Lourdes on the Occasion of the XIV World Day of the Sick

SATURDAY, 11 FEBRUARY 2006

Dear Brothers and Sisters, heavy laden, and I will give you rest” (Mt I join you with great joy and I thank you 11:28), Jesus said. In Lourdes he continues to for your warm welcome. I greet you in par- repeat this invitation, with the motherly me- ticular, dear sick people who are gathered diation of Mary, to all those who turn to him here in St Peter’s Basilica, and I want to ex- with trust. tend my greeting to all the sick who are fol- Dear brothers and sisters, this year, togeth- lowing us on radio or television, and those er with my collaborators at the Pontifical for whom this is not possible but who are Council for Health Pastoral Care, we wished united with us by the deeper ties of the spirit, to focus attention on people affected by men- 10 in faith and in prayer. tal illness. “Mental health and human digni- I greet Cardinal Camillo Ruini who has ty” was the theme of the Congress that has presided at the Eucharist, and Cardinal taken place in Adelaide, at which the scientif- Francesco Marchisano, of this ic, ethical and pastoral aspects were also ex- Vatican Basilica. I greet the other Bishops amined. and priests present. I thank the National Ital- We all know that Jesus stood before man in ian Union for Transporting the Sick to Lour- his wholeness in order to heal him complete- des and International Shrines (UNITALSI) ly, in body, mind and spirit. Indeed, the hu- and the Opera Romana Pellegrinaggi, which man person is a unity and his various dimen- arranged for and organized this meeting with sions can and must be distinguished but not the help of numerous volunteers. separated. Thus, the Church too always pro- I am also thinking of Australia on the other poses to consider people as such, and this side of the globe, where Cardinal Javier conception qualifies Catholic health-care in- Lozano Barragán, President of the Pontifical stitutions as well as the approach of the Council for Health Pastoral Care, presided a health-care workers employed in them. few hours ago in Adelaide at the main cele- At this time I am thinking in particular of bration of the World Day of the Sick. families with a mentally-ill member who are Fourteen years ago, 11 February, the litur- experiencing the weariness and the various gical Memorial of Our Lady of Lourdes, be- problems that this entails. We feel close to all came World Day of the Sick. We all know these situations, especially where legislation that the Virgin expressed God’s tenderness is lacking, public structures are inadequate for the suffering in the Grotto of Massabielle. and natural disasters or, unfortunately, wars This tenderness, this loving concern, is felt in and armed conflicts are producing in people an especially lively way in the world precise- serious psychological traumas. These are ly on the day of the Feast of Our Lady of forms of poverty which attract the charity of Lourdes, re-presenting in the liturgy, and es- Christ, the Good Samaritan, and of the pecially in the Eucharist, the mystery of Christ, Redeemer of Man, of whom the Im- maculate Virgin is the first fruit. In presenting herself to Bernadette as the Immaculate Conception, Mary Most Holy came to remind the modern world, which was in danger of forgetting it, of the primacy of divine grace which is stronger than sin and death. And so it was that the site of her ap- parition, the Grotto of Massabielle at Lour- des, became a focal point that attracts the en- tire People of God, especially those who feel oppressed and suffering in body and spirit. “Come to me all of you who labour and are

DOLENTIUM HOMINUM N. 62-2006 Church, indissolubly united with him in her light our candles, symbols of faith and of the service to suffering humanity. ardent invocation of God. The singing of the I would like today to present symbolically Ave Maria of Lourdes will invite us to go in to all the doctors, nurses and other health- spirit to the Grotto of Massabielle, to the feet care workers and all the volunteers involved of the Immaculate Virgin. in this sector the Encyclical Deus Caritas With profound faith let us present to her Est, in the hope that God’s love will always our human condition, our illnesses, a sign of be vibrant in their hearts so that it will enliv- neediness that is common to us all as we en their daily work, projects, initiatives and journey on in this earthly pilgrimage to be especially their relations with the sick. saved by her Son Jesus Christ. May Mary By acting in the name of charity and in the keep our hope alive so that, faithful to of charity, dear friends, you also make a Christ’s teaching, we renew the commitment precious contribution to evangelization, for to relieving our brethren in their sickness. the proclamation of the Gospel needs consis- May the Lord ensure that no one is alone or tent signs that reinforce it. And these signs abandoned in a time of need, but, on the con- speak the language of universal love, a lan- trary, can live illness too in accordance with guage that is understandable to all. human dignity. With these sentiments, I In a little while, to recreate the spiritual at- wholeheartedly impart my Apostolic Bless- mosphere of Lourdes, all the lights in the ing to you all: sick people, health-care work- Basilica will be switched off and we will ers and volunteers. 11

Angelus

SAINT PETER’S SQUARE, SUNDAY, 12 FEBRUARY 2006

Dear Brothers and Sisters, will, you can make me clean”, the leper says. Yesterday, 11 February, the liturgical “I do will it; be clean”, Jesus answers him, Memorial of Our Lady of Lourdes, we cele- touching him with his hand and healing him brated the World Day of the Sick. This year of leprosy (cf. Mk 1:40-42). its most important events took place in Ade- We see here in a concise form the entire laide, Australia, and included an international history of salvation: that gesture of Jesus Congress on the ever pressing topic of mental who stretches out his hand and touches the health. body covered with sores of the person who Illness is a typical feature of the human calls upon him, perfectly manifesting God’s condition, to the point that it can become desire to heal his fallen creature, restoring to a realistic metaphor of it, as St Augustine him “life in abundance” (cf. Jn 10:10), eternal expresses clearly in his prayer: “Have mercy life, full and happy. Christ is “the hand” of on me, Lord! See: I do not hide my wounds God stretched out to humanity, to rescue it from you. You are the doctor, I am the sick from the quicksands of illness and death so person; you are merciful, I am wretched” that it can stand on the firm rock of divine (Conf. X, 39). love (cf. Ps 39:2-3). Christ is the true “Doctor” of humanity Today, I would like to entrust all the sick to whom the heavenly Father sent into the world Mary, “Salus infirmorum”, especially sick to heal man, marked in body and mind by sin persons in every part of the world who, in ad- and its consequences. On these very Sundays, dition to the lack of health, are also suffering Mark’s Gospel presents Jesus to us at the be- loneliness, poverty and marginalization. I al- ginning of his public ministry, totally involved so address a special thought to those in hospi- with preaching and healing the sick in the vil- tals and every other health centre who care lages of Galilee. The countless miraculous for the sick and spare no effort for their re- signs that he worked for the sick confirmed covery. the “Good News” of the Kingdom of God. May the Blessed Virgin help each one find Today’s Gospel tells of the healing of a lep- comfort in body and spirit through satisfacto- er and expresses most effectively the intensity ry health-care assistance and fraternal charity, of the relationship between God and man, expressed by means of practical and support- summed up in a wonderful dialogue: “If you ive attention!

DOLENTIUM HOMINUM N. 62-2006 Homily of Cardinal Javier Lozano Barragán, Special Envoy of the Holy Father for the XVI World Day of the Sick, During the Celebration of the Eucharist in the Cathedral of St. Francis Xavier in Adelaide, Australia

11 FEBRUARY 2006

Your Eminences, your Ex- ativism, the crisis of reference tecting the inviolable dignity cellencies, in particular His values, hedonism and materi- of the mentally ill means go- Grace Archbishop Philip Wil- alism, technological culture ing to the root of the problem. son, Archbishop of Adelaide, closed in itself, the exaspera- It means attending to the sys- I convey to you the most fer- tion of desires produced by tem of values. Since mental vent greetings of the Holy Fa- this culture, the pursuit of the illness is a disequilibrium, any 12 ther, Benedict XVI. impossible, religious and cul- distortion in the system of val- The Holy Father asked me tural conflict and the magic ues that sustain a person gen- to bring his warmest greetings ritualism of several religious erates personal disequilibri- to all of you dear priests, reli- sects. um. In a simple paradigm of gious sisters and brothers par- As major risk situations one reference assumed by contem- ticipating in this memorable notes the precarious means of porary global ethics, which is liturgical celebration, to all subsistence, work, formation produced by mere consensus health care professionals here and education, the lack of help of the majority, we cannot ar- present, to all the people of networks, alienation of human rive at the desired equilibri- God gathered in this beautiful rights, exclusion and margin- um. The reason is that this Cathedral, and to all the people alization, terrorism and wars, paradigm must always change of this great continent of Ocea- lack of the education of senti- according to the mutability of nia: which embraces Australia, mental life, the process of the majority consensus. It is New Zealand, Papua New alienation of reality, the nega- well known that this consen- Guinea and the Pacific Islands. tive conditions of the environ- sus easily changes and is often This celebration of the ment, lack of social protec- manipulated by the mass me- World Day of the Sick places tion, corruption, inequality be- dia. Instead, we need a firm mentally ill people at the cen- tween male and female roles, and balanced system founded tre of our attention. As we absence of parents, separation on objective ethics. These heard from his letter, the Holy and divorce, loss of the value ethics must be rooted in the Father reserves a special at- of the marriage institution, satisfaction of the person’s tention to mentally sick peo- lack of communication and true necessities and not deter- ple. And as a sign of his deep time to stay together in the mined by the whim of desires. concern for the wellbeing of family, immaturity of the fa- Such objective ethics are in these sick people, the Holy ther and mother figures, the the heart of each person, and Father has on this occasion undue delegation of parents’ lead one to insert oneself in a granted a Plenary Indulgence responsibility to third persons vital and creative order that to all those who participate in or institutes, the weakness of improves day by day. this celebration here in Ade- the life project, inadequate Since due to the disorderly laide, and in similar celebra- preparation for married life, presentation of the fundamen- tions around the world. In this conflicts between parents and tal drives this order is some- special way, the Pope accom- their children and aggressive times not very clear in the panies mentally ill people and violent behaviour. heart, there is a need for a fur- with his friendship, closeness According to the indica- ther enlightenment that helps and effective spiritual help. tions of the Holy Father, both to lead the personality to- Mental illness is, alas, grow- in the letter referred to above wards a true satisfaction of ing very fast in the world. It is and in the Message for this necessities. We Christians reported that there are about World Day of the Sick, we know that this enlightenment 500 million people with mental must in our approaches under- is divine Revelation, which disturbances. line the inviolable dignity of we receive gratuitously from There are many and varied mentally ill people and do God. The Holy Father exhorts causes at the origin of the ill- everything possible to protect the leaders of different reli- ness: among the most impor- it at the cultural, institutional, gions in the world to protect tant we find the negation of family and individual levels. mentally ill people. One pro- God and ethical-religious rel- At the cultural level, pro- found way of doing this is by

DOLENTIUM HOMINUM N. 62-2006 strengthening the above men- causes of psychological im- can we prevent mental dise- tioned system of values, espe- balance is family disequilibri- quilibrium and heal it when it cially in the face of the present um, the protection of the dig- presents itself. It is truly a cru- growing secularisation. As we nity of the mentally sick per- cified love, because it makes said already, in this secularisa- son should have its cradle in us identify with disequilibri- tion the only remaining sup- the family itself. Unfortunate- um in order to balance it. port for a personal life is the ly, in many parts of the world With the Holy Spirit we reach changing ethical paradigm, we observe today the disinte- the equilibrium of the cross of whose instability is deter- gration of the family. We must Christ. It is very painful, but it mined by the frequently ma- insist on a programme for the is the only way to the resur- nipulated consensus of the stability of the family, which rection. It is only with this majority. ought to proceed from a seri- kind of Love that we can Mental health professionals ous, adequate and profound come out of the obscure tun- have an important role to play preparation for marriage. We nel of mental illness. here. Above all, something they must take as fundamen- tal to the exercise of their pro- fession is having the best pos- sible psychic equilibrium, and therefore they must be firmly anchored in an objective sys- tem of values. Mental illness in a particular way involves the whole person, and to a 13 major extent its cure does not depend on drugs alone but on the personal relationship be- tween the patient and the healer. The dependence of the mentally ill person on the health professional is particu- larly strong; therefore any disequilibrium affecting the health professional disquali- fies him as such, because his profession is directed to achieve the equilibrium of the have to strengthen the family. In this regard Pope Bene- patient. There is a need to achieve in dict XVI in his first Encycli- The Holy Father also rec- the family a serene, realistic, cal letter Deus caritas est says ommended that I exhort gov- joyful and loving understand- that: “The Spirit, in fact, is ernment leaders to protect the ing between spouses, their that interior power which har- dignity of the mentally ill children, relatives and the ex- monizes the hearts of the be- people. We hope that we have tended family, and the com- lievers with Christ’s heart and now gone beyond the dehu- munity in which they live. moves them to love their manising practices used in the Consolidating a total and in- brethren as Christ loved them, past in the treatment of men- dissoluble stability of the mar- when he bent down to wash tally sick persons. They were riage will provide the right the feet of the disciples (cf. Jn cruel methods that absolutely equilibrium that will be the 13:1-13) and above all when ignored the dignity of the best prevention of the mental he gave his life for us (cf. Jn mentally ill, who were often illness of a family member. 13:1, 15:13).The Spirit is also treated as if they were not hu- For we Christians it is obvi- the energy which transforms man beings. We also hope ous that the true sense of life the heart of the ecclesial com- that the practice in some is only Christ, dead and risen, munity, so that it becomes a countries of classifying those and at the centre of the life of witness before the world to with a different political opin- Our Lord Jesus Christ is the the love of the Father, who ion as insane is something of Holy Spirit, the Spirit of wishes to make humanity a the past. In order to institu- Love, who led Christ through single family in his Son” tionally protect the dignity of redemptive death, and with (Deus caritas est n. 19) mentally sick people, accord- Christ leads all of us to our In fact, individuals who care ing to the development and heavenly Father. On this for those in need must first be proven achievements of psy- World Day of the Sick we professionally competent: chiatric medicine, it is neces- have the opportunity to pro- they should be properly sary that appropriate legisla- claim that at the centre of the trained in what to do and how tions be promoted and applied prevention and care of the to do it, and committed to con- all over the world, especially mentally ill person there is tinuing care. Yet, while profes- regarding the hospitalisation Love. Only with the loving sional competence is a prima- of mentally sick people. understanding of the Holy ry, fundamental requirement, Since one of the prime Spirit who “heals who is sick” it is not of itself sufficient. We

DOLENTIUM HOMINUM N. 62-2006 are dealing with human be- neighbour will no longer be trust, strength and happiness. ings, and human beings al- for them a commandment im- May she confirm us in an out- ways need something more posed, so to speak, from with- standing fraternal solidarity than technically proper care. out, but a consequence deriv- with our afflicted brothers and They need humanity. They ing from their faith, a faith sisters who unite with the suf- need heartfelt concern. Those which becomes active through fering Christ in the depth of who work for the Church’s love (cf. Gal 5:6). Deus cari- their souls! charitable organizations must tas est n. 31. Finally, it is my pleasure to be distinguished by the fact Today we celebrate the assure all of you the blessing that they do not merely meet feast of Our Lady of Lourdes, of the Holy Father Benedict the needs of the moment, but health of the sick. When a XVI, who though in the Vati- they dedicate themselves to mentally sick person feels the can is spiritually present, unit- others with heartfelt concern, affectionate maternal hand of ed in prayer with us in this enabling them to experience Our Lady help and protect beautiful Cathedral of St. the richness of their humanity. him, the world ceases to be Francis Xavier, of the Arch- Consequently, in addition to hostile for him, he feels him- diocese of Adelaide in Aus- their necessary professional self sure and full of happiness. tralia, and in this wonderful training, these charity workers Today we implore Our Moth- Continent of Oceania. need a “formation of the er Mary, health of the sick, to heart”: they need to be led to place all mentally ill people in H.Em. Card. JAVIER LOZANO that encounter with God in the world under her maternal BARRAGÁN Christ which awakens their protection, so that she may President of the Pontifical Council love and opens their spirits to console them, enliven them, of Health Pastoral Care, 14 others. As a result, love of give them confidence and the Holy See

DOLENTIUM HOMINUM N. 62-2006 The Mentally Ill Patient: a Faithful Image of God 9 FEBRUARY 2006

Is the Mentally Ill Patient quality of life of patients and The personnel in the above a Deformed Image of God? their families.1 centres is comprised of med- Mental disorders affect more ical doctors, psychologists, frequently those populations psychiatrists, rehabilitation I SOME DATA ON that are less fortunate economi- therapists, professional educa- MENTAL ILLNESSES cally culturally and intellectu- tors, social assistants, nurses, ally. Millions of individuals auxiliary technical staff, ad- 1. Current Situation have to bear on their body and ministrative staff, volunteer mind the psychological conse- workers, chaplains, religious According to the World quences of malnutrition, armed men and women, counselling Health Organization there are conflicts or natural disasters experts and service staff. 75% 450 million people in the with their heavy burden of of the centres reported that world affected by neurological morbidity and mortality. they have a just sufficient num- or behavioural mental disor- ber of medical doctors; in gen- ders, of which 873,000 com- eral there is lack of adequate mit suicide each year. Mental 2. The Action of the professional resources. These 15 illness is a true health and so- Catholic Church centres offer various services cial emergency. 25% of coun- such as consultation, rehabili- tries do not have laws concern- For this World Day of the tation, school medicine, family ing mental health, 41% have Sick, celebrated here in Ocea- support, social services, work no defined policy on the issue nia, the Pontifical Council for orientation, accompanying, and in over 25% of health cen- Health Pastoral Care made a home care and pharmacy. tres patients do not have ac- survey on the pastoral care of The most significant mental cess to basic psychiatric med- mental health in 84 centres disorders taken care of in these ication; among 70% of the dedicated to mental patients in centres are: personality disor- world population there is less the Catholic community in ders, drug abuse-related disor- than one psychiatrist for every various countries across the ders, psychosis, mood disor- 100,000 people. five continents. ders, anxiety disorders, cogni- As to dealing with mental A questionnaire, carefully tive and dissociative disorders, disorders, it may be asserted drafted by experts in the field eating disorders, sleep disor- that in the past 50 years great was sent to 129 Bishops re- ders, adaptation disorders, se- strides forward have been sponsible for pastoral care in vere degenerative organic dis- made, evidence of which are health in various countries of orders, and congenital mental the technological advances in the world. We received replies insufficiency. The most fre- the field of new psychotic and from 23 countries, of which 9 quently treated pathologies are mental health medicines, from Africa, 17 from the Amer- personality disturbances, psy- which have considerably im- icas, 6 from Asia, 51 from Eu- chosis and mood disturbances. proved the quality of life of the rope and one from Oceania. Personality disturbances main- mentally ill. Nevertheless, the The data collected from Africa ly due to psychosis and drug conditions of assistance to came from Cameroon, Ghana, abuse are more frequent in the mentally ill patients are quite Senegal and South Africa; in age band of 17-25 years. Re- deficient as a result of limited the Americas from Bolivia, garding the prevention of men- funding, the lack of under- Canada, Chile, Colombia, Cu- tal disorders, it is interesting to standing among authorities, ba, Ecuador, Mexico and note that disorders hardly ap- the serious problem of the so- Trinidad and Tobago; in Asia pear in the age band of 0-16 cial stigma that the patients from China, Indonesia and years; hence, it is in this stage and their families have to face, Turkey; in Europe from Aus- that prevention can be much all of which have serious tria, Belgium, Ireland, Italy, more effective. repercussions on social sup- Poland, Portugal and Spain; The approach in these cen- port networks in many coun- and in Oceania from Australia. tres is mainly characterised by tries that consequently deterio- The structures of interest teamwork, even though it is rate. The number of “home- were mental health centres, generally not systematic. Inno- less” mentally ill patients has day hospitals, psychiatric ser- vative therapies used are hyp- considerably increased in vices, residential and semi-res- notherapy, music therapy, wealthy countries. It is alarm- idential centres, centres of co- game therapy, theatre and art ing to see how serious mental operatives for reintegration, laboratories. disorders are simply dealt with consulting rooms and clinics. At the level of prevention, a using bureaucratic and juridi- 43% of the funding is from culture of welcoming people cal or legal solutions without public sources, 33% from pri- with problems of mental in the least taking into consid- vate sources and 23.3% from health is promoted, together eration the daily needs and the donations. with appropriate pastoral pro-

DOLENTIUM HOMINUM N. 62-2006 grams that give due attention delegating responsibilities to of humanity have made happi- to the psychological aspects of third parties or institutions, ness coincide with order, in its patients. When facing a full- weakness of the shared life cosmic adjustment. In Orien- blown disorder therapeutic in- project, inadequate preparation tal thought we find Taoism, terventions – some of which for married life, conflicts be- according to which the active are systemic – are given to re- tween parents and children, masculine principle, Ying, duce disabling consequences and aggressive or violent be- must adjust to the flexibility for the patient: screening, self- haviour.2 of the feminine principle, help groups, training of health Yang, which in the final professionals, family support, analysis represents the order context analysis, reconstruc- of the universe, even though tion of the affective and rela- II. MENTAL DISORDER this order is flexible only up tional fabric, pastoral pro- to a certain point and changes grammes, collective prayers By God’s grace, the work according to the transforma- and assessment. carried out by the Catholic tions of the universe. More or These centres are connected Church in this area is indeed less the same idea was fol- with universities, public hospi- praiseworthy; it is work that lowed by several Stoics of tals, ministries of justice, edu- has been done for centuries as Greek culture who sustained cation, labour, public relations testified by religious orders that one had to be in agree- and health. They also relate and congregations whose ment with the whole of cos- with local bodies, dioceses, charisma consists mainly in mic dynamics, and that per- parishes, police forces, em- taking care of mentally ill pa- fection actually consisted in ployers, home neighbours, tients. 16 neighbourhood communities, Considering how wide- trade unions and charitable in- spread this illness is – 450 mil- stitutions. lion people as mentioned Specific courses for training above – the bishops of Ocea- in pastoral care in mental nia have certainly made a health are organised. In these timely decision to have the courses ethical questions relat- mentally ill person as the key ed to drug abuse, coercive issue for the discussions of this forms of treatment, and the World Day of the Sick. This way to approach a mental pa- shall undoubtedly spur the tient are discussed. Catholic Church to continue It is commonly believed that the work undertaken and it at the origin of mental disor- shall foster dialogue and coop- ders there is a strong cultural eration with the institutions in and religious influence fos- charge of such duties in mod- tered by a crisis of values of ern societies. reference, hedonism and ma- We shall now embark on a terialism, technological cul- reflection on the mentally ill being in harmony with the in- ture, and the exasperation of patient, starting from a Christ- exorable order. At the begin- desires and the search for the ian point of view. We shall be- ning of the Renaissance we impossible, the conflict of cul- gin from basic scientific infor- find the organological thought ture and religion, the magic mation on mental disorder and of Theophrast Bombast Von ritualism of some religious then consider how the mental Hohenheim and Paracelsus, sects, the denial of the tran- patient does not cease to be an who asserted that in a flower scendent and ethical-religious image of God, and as such he one could find the perfect and relativism. deserves every respect.3 total order of the universe, a High-risk situations include macrocosm in a microcosm. insecure means, subsistence The entire universe is like a means, unemployment, poor 1. The Disorder huge living organism to which education and training, lack of we all belong and are its syn- help networks, alienation of There is no doubt that the thesis; the activity of each in- human rights, exclusion and mentally ill patient – though dividual is sustained by a marginalization, wars, terror- still a human being – is some- higher order to which one has ism, lack of education in senti- one who escapes classification to conform oneself, otherwise mental life, the process of de- as a normal person. In other one runs the risk of becoming tachment from reality, influ- words, he does not have the a cosmic anomaly. In a way ence of the environmental con- necessary equilibrium that en- this is close to the thought of text, lack of social protection, ables one to define him as a Nicholas de Cusa with his ide- corruption, imbalance in gen- person with full use of the hu- al of the coincidence of oppo- der roles, lack of parental fig- man faculties. As an individ- sites, as an order in apparent ures, separation and divorce, ual, he suffers from an alter- disorder. Even in the concept loss of the value of the institu- ation of internal order and this of Redemption – especially tion of marriage, lack of com- is translated into an alteration under the influence of St. munication, lack of time to of the external order that in- Anselm of Canterbury – in spend together in the family, volves the whole universe. Western theology, the work of immaturity of parental figures, Actually, the great thinkers Christ is classified as the

DOLENTIUM HOMINUM N. 62-2006 restoration of the violated ju- the cylindrical extension of the hand, the mere biological- ridical order. cell body, known as the axon. chemistry explanation is inad- Such channels represent spe- equate when it comes to the cial permeability points pre- higher functions, especially 2. The Disorder of Neuronal sent in each nervous cell. the ones that refer to abstrac- Synapses These points are special pro- tion and consciousness. As to teins that form pores in the cell consciousness, we clearly ask In recent studies on neuronal membrane of the neuron, ourselves, if it involves turning activity, mental disorder is as- which open and close when back into itself yet it is entirely sociated with alteration in the they are appropriately stimu- made up of a mere biological order of the neurons. Actually, lated, permitting the passage element, is it possible that a according to the description of of external fluids. Through the quantitative element turns into the organic functions in neuro- ion channels they transform itself? It would be and not be sciences, there is evidence of the fluids into electrical im- at the same time. Yet, this im- the complexity of communica- pulses. The electrical impulses plies the absurd violation of tion between the neuronal of the synapses are integrated the principle of contradiction. cells’ send and receive mes- into the neuronal dendrites, Studies carried out in the sages. It is a network of very thus generating a potential ac- scientific field, to which we complex connections, which tion which is transmitted to have referred above, are cer- enable one to perceive and other neurons. It is normally tainly very useful, since, classify, to judge and put in ac- said that the basic model of though a neuronal disorder tion, along the route that ex- the whole set of connections alone does not explain the tends from the external stimu- between neurons represents whole reality of mental illness, lus to the cerebral cortex and the material base of the mem- it is nevertheless an extremely 17 manages, so to say, to organize ory, that is both of the so- important element leading to the organism and attain equi- called “declarative” or con- its explanation and therefore librium and harmony. scious, as well as the “proce- its treatment. We know that the central dural”, memory (the portion nervous system collects and which is used when perform- processes the information sent ing tasks and governing un- 4. The Soul Factor by our sensory organs, which conscious reactions). Hence, it subsequently organises and the sensory information is For a more complete under- manages. All these operations processed progressively in standing of the mentally ill pa- are the material underpinning consecutive layers of neurons. tient, neuronal factors should of the higher functions: think- With the aid of computa- be underpinned by a holistic ing, memory and conscious- tional techniques (neuronal understanding of the psyche. ness. networks), the patterns of Already in ancient times it was There are in particular two synapses of the networks of understood that human life was main instruments to follow the the different layers of neurons necessarily made up of two sensorial – neuronal – cerebral have been plotted. Neverthe- fundamental aspects and that journey, namely the propaga- less, though these techniques its relations for subsistence had tion of the mechanism of ac- have worked well at a lower to be directed to the care of tion and the synapses, in other neuronal level, the real synaps- those elements that we have words the transmission of the es of the cerebral operations in classically defined as soul and electrical impulse of the neu- the whole complex of neuronal body. When speaking about a rons and the passage of a sig- activity have not been fully mentally ill patient in ancient nal from one neuron to anoth- understood, especially those Greece, Socrates preferred to er. Each of the 100 billion of concerning the higher mental consider only the soul, and he our nerve cells is connected functions of consciousness, stated that the illness of the via synapses to about 1,000 to thought, and emotion.4 soul could only be resolved by 10,000 other neurons. Learn- means of maieutics – a tech- ing and acquiring new skills nique leading to the knowledge by the human organism re- 3. Understanding of oneself by purifying the sick quires changes in the synapses, the Neuronal Synapses soul so that it may reveal its in- known as “plastic changes”. In ner truth and is recovered by order to achieve this change, The mere comprehension of the knowledge and practice of all the synapses are involved the action of neurons and the virtues. Plato and Aristotle also and they will, in turn, change relative complexity of their dealt with the issue. Plato, with in every new connection. It is connections is certainly very his dualistic mentality, be- argued that some human skills important for the understand- lieved that the major cause of and abilities depend on the ing of cerebral activity, yet it is mental illness was the body; various patterns of connection not sufficient for its complete mental illness is like the mud present in every individual. and adequate understanding. of the body that soils the soul Connections take place On the one hand, the brain op- of the mental patient, which thanks to the electric impulses, erates simultaneously as one could here be compared to a which neurons receive through whole through large assem- beautiful amphora lying on the the so-called ion channels, as a blies of neurons, and this sea-bed and becomes covered wave of positive electric whole action has not been ful- with mud and debris. Aristotle charge propagating all along ly penetrated yet; on the other supports this view, though with

DOLENTIUM HOMINUM N. 62-2006 a more balanced approach, aspects: the precariousness of ther and venture a statement when he asserts that it is the in- the theories on mental illnesses that might shed light on the is- tellect which imposes harmony and therapeutic strategies, the sue, from the point of view of on the body; a harmonious soul high emotional involvement of moral theology. The statement will give life to suitable forms the mental health care profes- is that: the mentally ill person of the body, avoiding illness sional and technology. Some is not a deformed image of which is typically of the body, scholars believe that the level God but, rather, a faithful im- but at the same time basically of technology in psychiatry is age of God, our Lord. arising from a disharmonious indeed low, in fact the therapy Such a statement intuitively soul. used is not technological but finds confirmation in the We could however affirm interpersonal.7 thought of our Lord when he that classical Greek thought is Nevertheless, in spite of all says: “The Kingdom of God is still present in the current way the difficulties of the studies of within you” (Lk17:21) and of conceiving the biochemical psychological sciences on the “what comes out of the mouth model of psychiatric disorders. reality of mental illnesses, proceeds from the heart, and Today the soul is identified there is at least evidence of the this defiles man” (Mt 15:18). with the biochemical energy of fact that mental illness is due to “For from within, out of the the neurochemical, neuroen- a disorder in reasoning, which heart of man, come evil docrine and neurovegetative is however not lost. It has been thoughts, fornication, theft, systems of the cerebral cortex, affirmed outside Christian murder, adultery, coveting, the hypothalamus, the brain thought that man is made in the wickedness, deceit, licentious- stem, the epiphysis, and the image of God because of his ness, envy, slander, pride, fool- vegetative system. All these rational soul, or in classical ishness. All these evil things 18 structures are linked to each terms, because man is a ratio- come from within, and they other according to a plan aim- nal animal. Now, if man loses defile a man” (Mk 7, 20). ing at self-equilibrium for the his rationality, there would be The Kingdom of God, the prevention of possible irregu- no objection if he were treated existence of the Holy Trinity larities. Mental disorders ex- as a being with human features in each one of us, may be press an imbalance of this who is no longer human.8 found in our heart, the heart multi-system, diffused like a Obviously, this way of seen as the ultimate source of network throughout the whole thinking is just a sophism, be- decisions that give form to our body. The moment one of cause the mentally ill patient whole existence; not only that these systems is unbalanced, has not lost his rationality, but, which was previously defined all the rest will be unbalanced.5 rather, it does not function as it as the fundamental option, but The mentally ill person suf- should. also the whole meaning of this fers from this disorder, which option, with all the actions we varies depending on the type perform to realize it. In other of psychic disorder that affects words, the heart represents all him. In all disorders there is an III. WHAT CAN BE DONE? our dynamism at the service of alteration of these connections, the mission that God has en- or parts of them, which pro- trusted to us. duces an internal disorder that 1. Mental Disorder The Kingdom of God enters will lead to an external disor- in Christian Thought into the loving knowledge and der that is relational in the so- the decision made in the deep- cial sphere. In Christian thought it is est intimacy of our person, Regarding the complexity said that these severe mental which are then realised by the and the seriousness of this dis- illnesses reduce man to sad power of the Holy Spirit, who order, we should not forget the conditions, like a deformed leads us by the hand like Chil- opinion of some psychiatrists image of God, which is com- dren of God, and by the total who assert that the instinct for pared to the suffering servant collaboration that give form to life relates in an indissoluble of Isaiah (Is 53,1-7). Yet, apart our existence, according to the way to the instinct for death. from that deformation, or Law of God. If we want to Both drives intertwine and psy- rather due to it, the mentally ill separate from the Kingdom of chiatry studies them comple- person resembles our Lord on God, we can do so only with menting the “pleasure princi- the cross; and since the cross is an evil heart, to which Christ ple” with the “reality principle” the only way to the resurrec- our Lord refers, and from – the pillars of psychotherapy – tion, the mentally ill person which all the sins come. considering the death instinct has, so to say, a superior level, as an inner necessity of life.6 is worthier and reaches such a The disorder affects both in- level of excellence because of 3. Faithful Image of God stincts and further complicates the magnitude of his love and the state of mental illness. the suffering he endures.9 Therefore, once the mental On the other hand, when re- illness has caused such a disor- ferring to the treatment of a der as to take away from the mentally ill person, psychiatry 2. Is he a Deformed Image mentally ill patient any respon- presents a wide grey area of un- of God? sibility for his actions, qualify- certainties that clinical practice ing them as separation from the and scientific research help to If the above holds true, I divine will – as a sin – the identify under three different would like to move a step fur- mental patient cannot separate

DOLENTIUM HOMINUM N. 62-2006 from God. In other words, the give him a treatment of love. – Fight against relativism, image of God in him cannot be Since the mentally ill patient is consumerism, the pseudo-cul- distorted. In this case his also the image of the resurrect- ture of instinctive desires and knowledge or his volitive op- ed Christ, we have the obliga- pansexualism. tion are no longer sufficient to tion of being the “Good – Promote the dignity of motivate any human action Samaritan,” that is, providing mentally ill patients. that separates him from God. all that is necessary for his – Foster a healthy develop- His bodily and psychic condi- care. We need to think about a ment of the child, including his tions do not allow him to com- series of treatments that should brain functions. mit a grave sin, given that in be devised to pull these pa- – Make awareness programs his state of disequilibrium he tients out of the prostration on mental illnesses for society does not have that full knowl- that is all the more painful the so that people may know about edge and ability of assent re- deeper the psychic suffering is. them and prevent them. quired to sin. In fact these patients often lose – Exhort religious Orders If we approach the argument a sense of human relations and and Congregations, whose from this point of view, where- feel persecuted by a hostile charism it is to take care of by the mentally ill patient does surrounding environment; or these patients, not to waver in not have the knowledge or the the subjectivity of the environ- their commitment and to dedi- faculty of full consent required ment disappears and for them cate particular care to them, to commit a mortal sin, his is people become objects, or are given the particular emergency not a deformed image of God, indifferent or even real threats since that image can only be to their security. deformed by sin. Certainly, it is the suffering image of God, 19 but not a deformed image. He 4. Treating the is a reflection of the mystery of Mentally Ill the victorious Cross of the Lord. Inspired by the image of The treatment for a mentally the Suffering Servant of Yah- ill patient should be a treatment weh (Isaiah 53:1-7) we are of loving care, tenderness, and drawn to a conscious act of kindness, in order to help him faith in the suffering Christ. cope with his imaginary world, It is not by chance that in the perceived as an enemy, a world old popular Mexican language, in which he often drowns. The a mad person was called “ben- treatment which should be per- dito”, that is “blessed” not sonalised and of maximum without the full use of reason- quality also requires maximum ing, he was unable to commit diligence in prescribing treat- sin and was, therefore, destined ments and most appropriate to eternal life. medicines. It will draw from all that this illness presents. It is true that the objective the resources made available – Support these patients disorder of sin and its conse- by science, be it from medical with the administration of quences are manifest in the and technical arts or from the sacraments where this is possi- mentally ill patient; however, research that is always progres- ble. at the same time, there is in sively looking for the most ade- – Enlighten and console the him the historical equilibrium quate medicaments from the mentally ill with the Word of of the only possible order, the psychosomatic point of view. God, if their mental and physi- order and equilibrium of the cal condition allows it. Redemption. Practical Lines of Action – Be aware of the fact that This is not comprehensible the rehabilitation of a mentally to a secularized mentality; it is In this perspective, allow me ill patient is a duty of whole of only understood within the to suggest some guidelines for society together, within the context of Christian optimism, practical interventions, which context of solidarity that shows which stems from a reasoned will help us offer loving care preference for those who are faith that tells us how in such to the mentally ill: most in need. circumstances our obligations – Promote a social and towards a mentally ill person General Interventions: physical environment that on the one hand satisfy our du- – Establish, in the education favours human relations and ty to see the suffering Christ in systems, solid religious foun- for the mentally ill patients a the poor and less protected, dations that help one to work sense of belonging to a con- and on the other promote the out clear and stable horizons, crete community. idea of seeing in the patient the to be followed for a lifetime. love of God who has indicated – Be aware of the system of National Interventions: him as his chosen one, in the values underpinning the whole – Promote, at the national sense that he shall not be sepa- of human life and make refer- and international political lev- rated from Him. ence to it, especially to avoid el, appropriate laws to safe- He is therefore a proof of the mental illness being lived with guard the rights of mentally ill crucified love of God. Hence, anxiety, sadness and despera- patients. the best thing we can do is to tion. – Urge the Health Ministries

DOLENTIUM HOMINUM N. 62-2006 of various nations to have spe- an appropriate maternal and for our faith. Handling them cial attention for the mentally paternal image. effectively means professing ill patients, designing effective – Treat children lovingly, of- our faith in the agonizing and programs for them. fering them at the same time suffering, but at the same time, – Develop and integrate education with determination, victorious Christ. This is the mental health services in all clearness and vigour. sense of today’s celebration of primary health units. – Establish in the family sol- the World Day of the Sick, – Create appropriate institu- id relationships with teachers which is dedicated to mentally tions for better broad-ranging and other persons helping par- ill patients. care for the mentally ill pa- ents with their children, with- tients. out entrusting them with duties H. Em. Cardinal JAVIER – Allocate all the necessary that should never be delegated. LOZANO BARRAGÁN, funds to provide the necessary – Accept mental illness posi- President of the Pontifical Council for Health Pastoral Care, care to mentally ill patients. tively, fighting the stigma to the Holy See. – Provide hospitalization for which such patients are sub- mentally ill patients who re- jected. quire it, as well as their stay in – Understand both the phys- compliance with the recent ad- ical and psychological needs vances in psychiatric medi- underlying mental distur- cine. bances. – Provide housing to the – Enhance the individual po- mentally ill who are homeless, tential of every mental patient. roaming or cannot be kept in – Foster interpersonal com- Notes families. munication between the pa- 20 1 OPS. 1992. issues on mental health – Institutionally support tient and the people around in the community, serie paltex families in which there is a him, especially within their 2 Deriu Fiorenza and Others, Descrip- mentally ill patient with tech- own family. tive Report on the Results of the Re- search of the Pontifical Council for nical and scientific assistance – Free the patient from lone- Health Pastoral Care on ‘Mental as well as with understanding liness, isolation and abandon- Health’. and respect. ment. 3 Cf. JOHN PAUL II, “Address to the 11th International Conference of the Pon- – Promote research related – Teach the mentally ill the tifical Council for Pastoral Assistance to to the different types of mental way to develop their own ca- Health Care Workers,” in Dolentium disorders and appropriate ther- pabilities and sense of self-de- Hominum 34 (1997) 7-9; JOSEPH RATZINGER, “The Likeness of God in the apies for them. termination. Human Being,” ibid. 16-19 – Humanize therapeutic pro- – Teach the family members 4 Cf. ERWIN NEHER, “Basic Mecha- grammes by means of continu- the proper behaviour in relat- nisms of Signalling and Information Processing in the Brian,” in Dolentium ous education for health care ing to a mentally ill member. Hominum n. 34 (1997) 21-24; D. JOHN- workers. – Understand that science STON AND S.M. WU, Foundation of Cel- – Adjust psychiatric treat- alone is not enough to treat a lular Neurophysiology, The MIT Press, ments to the diverse cultural mental disorder: there is a need Cambridge Mass, 1995; E.R. KANDEL, J. H. SCHWARTZ AND T.M. JESSELL, (eds)., patterns of patients. for a holistic approach, includ- Essentials of Neuronal Science and Be- ing all its religious, philosophi- haviour, Prentice Hall International, Inc. Personal Initiatives: cal and scientific aspects. London, 1995; E. NEHER AND B. SAK- MANN, ‘The Patch Clamp Technique’, – Educate within and from – Instil hope in the patients Scientific American, March 1992, pp. the Christian family providing and their families. 44-52. 5 Cf. GIUSEPPE ROCCATAGLIATA, everyone with solid life foun- – Intensify the therapy of “From Deseases of the Soul to Psy- dations in the acceptance of loving care and kindness when choneuroses,” in Dolentium Hominum,” Christ – dead and risen – the treating the mentally ill.10 Ibid., pp. 33-39. reason of our existence. 6 J. DERIDA, Speculare su Freud, Raf- faello Cortina Ed. 2000. – Intensify prevention of 7 CONTINI G., Il miglioramento della mental illness through effec- qualità nella riabilitazione psichiatrica, tive action within families, es- CONCLUSION Centro Scientifico editore, 1999. 8 Cf. IGNACIO CARRASCO, “The Digni- pecially in the first years of ty of Madness,” in Dolentium Hominum, children’s lives. Remembering that sentence Ibid., pp. 124-126. – Strengthen the unity of engraved on the lintel of a 9 Cf. JOHN PAUL II, “Address to the 11th International Conference of the Pon- families, giving the marriage German hospital “Infirmis si- tifical Council for Pastoral Assistance to institution all the power it de- cut Christo” – to the sick as to Health Care Workers,” in Dolentium serves. Christ – I would like to con- Hominum 34 (1997) 7-9; JOSEPH RATZINGER, “The Likeness of God in the – Give more room to coexis- clude my reflection insisting Human Being,” ibid. 16-19 tence in the family, between on this image of Christ suffer- 10 Cf. JUAN LÓPEZ IBOR, “Research in spouses, parents and children ing in the depth of his soul, full the Field of Neuroscience and Mental illness”, in Dolentium Hominum n. 34 and among siblings. of pain and affliction, yet he (1997) 52-58; ANDREA CALVO PRIETO, – Enhance bonds of affec- succeeds in transforming this “Family Reality in Regard to Mental tion and understanding in the evil into a source of life, since Patients in African Countries,” ibid., 101-103; FRANCO IMODA, “Psychothera- nuclear as well as in the en- his pain and suffering consti- py,” ibid., 186-192: PIERLUIGI MARCH- larged family. tute the nucleus of his Resur- ESI, “The Role of the Church in the – Let grandparents assume rection, and therefore our sal- Treatment of the Mentally ill,”, ibid., 205-207; CARLO LORENZO CAZZULLO, their proper roles. vation. Our approach to the “The Acceptance of Mental Illness,” – Offer your own children mentally ill is a difficult test ibid., 81-85.

DOLENTIUM HOMINUM N. 62-2006 ‘Go home to your people and tell them all that the Lord in his mercy has done for you’ (Mk 5:19): Issues of Human Dignity

SPEECH BY REV. PETER COMENSOLI , 9 FEBRUARY 2006

Your Eminence, Your of labour), such uses are by a person. From the non-theis- Grace, My Lords, Minister way of analogy. Dignity’s pri- tic point of view, personhood Zollo, distinguished guests, mary use is in regard to per- is seen as a measurable prop- ladies and gentlemen: sons. The bond between per- erty of our human nature: it is At the outset, I wish to son and dignity is so strong something relative in each in- make clear that actual situa- that we recognise that persons dividual. (Perhaps the most tions of people in matters have a right to dignity – a per- dramatic example of these concerning their dignity do son is worthy of value, re- differing worldviews can be not actually feature in my pre- spect, honour. So to be afford- seen in the current debates sentation. The fact is that I am ed the status of person is to be over the status of human em- not an expert – or even expe- owed certain things, one of bryos and whether or not they rienced – in matters of mental them being dignity. What are to be afforded the same 21 illness. I come to you as happens then, to someone rights as other human beings). someone who has simply whose status as a person is Much of what I have to say known and befriended some denied or questioned in some has its origin and explanation people who live with a mental way? Do they cease to enjoy in the theistic understanding illness. What then, do I hope the right to dignity? These of person. It is important, to contribute today? Firstly, I questions raise a prior, critical then, to briefly outline this wish to put forward a theolog- question, namely: Who is per- position before focussing on ical perspective that, I be- son? what it might bring to our lieve, strongly upholds the ‘Person’ is one of those consideration of the human dignity of people living with genuinely complex words in dignity of those people who mental illness. Secondly, I our vocabulary. Its very exis- live with mental illness. wish to consider the matter in tence as a word cannot be its ethical context and suggest separated from its origins in a foundation that might en- the ancient philosophical and 1. In the image of God sure the dignity of these peo- theological controversies sur- He created them: ple is respected. rounding the status of Jesus a theological I have entitled my presenta- Christ. What emerged from anthropology1 tion: Go home to your people these debates was a word that and tell them all that the Lord both grounded and explained At the heart of the Christian in his mercy has done for you: the nature of our human lives. understanding of human life is Issues of Human Dignity. Not Over the past few hundred that extraordinary statement surprisingly, I shall begin years, however, there has from the Book of Genesis: with the person of Jesus and been a systematic disentan- God created man in the image an incident from his healing gling of ‘person’ from its reli- of himself; in the image of ministry (Mk. 5:1-20). gious and metaphysical un- God he created him: male and Everyone deserves a name, derpinnings. Today, many female he created them. (Gen. don’t they? After all, God philosophers and ethicists 1:27) While there is some- calls us each by name. To be speak of the human person in thing of God in everything known only by a condition – terms of selfconsciousness or that exists, the Creator chose the demoniac – seems unfair. the capacity to rightly subjec- to invest human creation with So, for the sake of his memo- tify our thinking and feeling the image of God’s own self. ry on this day, let’s give him and experiencing. Rather than In the Catholic tradition this the dignity of a name: let’s ‘person’ being seen as the belief is known as the doctrine call him Joshua. principle of our human na- of the imago Dei: being made Dignity lies at the heart of ture, it is seen by many as be- in the image of a personal why we have gathered in ing more akin to a property of God gives us personhood and Adelaide over these few days. our nature. hence the dignity of God’s Our English word ‘dignity’ As you might expect, these own self. Thus, as I pointed finds its roots in the Latin competing philosophies walk out earlier, dignity binds itself word ‘dignus’, meaning ‘wor- very different paths. From the to person. We are never just a thy’. It is a word that affords theistic point of view, person- human something; we are al- value, respect, honour to its hood is the absolute principle ways constituted as a human recipient. While dignity can of human life: you cannot be someone. be used of things (the dignity a human being without being This sets up an important

DOLENTIUM HOMINUM N. 62-2006 corollary: the ‘image of God’ quantifiable and then compa- healing, wanting to stay with that I am is not assigned to, rable between people. The this man who had offered him say, my intellect only or my measure of me as a person is back his life. But then follows self-consciousness. Rather, not relative to someone else: I an unexpected twist: Jesus every aspect of me is created am absolutely a human per- says no, and charges him to: in God’s image – all of me is son or I am not human at all. “Go home to your people and invested with the dignity of By implication, when some- tell them what the Lord has God’s own self, including my one’s status as a person is rel- done for you”. body. This ‘all of me’ is sig- ativised, their dignity is un- Did Jesus heal Joshua be- nificant: it says that each and dermined. cause he felt sorry for this every human being is both en- Moving our focus again to flawed, broken, disordered tirely and always a person Joshua: when Jesus ap- man? What purpose did the created in God’s image. En- proached him – amongst the healing achieve? In asking tirely, because there is no part tombs and in all his violence these questions, let’s not fall of me that is not imbued with and torment – he did so with into the trap of interpreting the dignity of the personal im- that sense of him being ‘one the healing actions of Jesus as age of God, and always, be- of us’, a person. “I am the ‘proofs’ of his divinity or cause there is no time in my same as Joshua, and Joshua is ‘special favours’ bestowed historical reality when I am the same as me.” The vil- upon the few. Rather, the not imbued with this same lagers, it seems, had ceased to healing ministry of Jesus was dignity. view Joshua as a person. Had a sign of the presence of God Returning to our scripture they stopped thinking of him among God’s people: here, in reading, we are told that as ‘one of us’ because he these actions, God’s kingdom 22 when Jesus first encountered could no longer live among is revealed and people are re- Joshua he was living amongst them, a marker of his relation- newed in God’s image.3 the tombs, howling day and al self? And what about What Jesus did was not to night and mutilating himself. Joshua himself? Had he, too, fix what was broken in His mental torment had left perhaps ceased to see himself Joshua, but to restore him to him disoriented and con- as a person, unable, as he was, his dignity as a person in fused. There was only one to tell Jesus his own name, a God’s image. Jesus did not thing of which he was cer- marker of his integral self? heal Joshua out of pity; he did tain: the pain he experienced it as an act of restorative jus- when he gashed himself. It is tice. in his self-mutilation that 2. … and being found This restorative act by Je- Joshua locates himself. This in human form: sus illustrates the integral and pain is real: I am real. moral implications relational form of personhood The doctrine of imago Dei on which we have been re- not only tells us that human If it is true that God created flecting: Joshua could not be beings are persons in the im- each of us as persons in his fully restored to himself (the age of God, but it also tells us image, then it is also true that ‘all of me’) without also be- something of the type of per- God’s own self is in every hu- ing restored to his place in the sons we are. The God of the man being. As Pope John community (the ‘one of us’). Christian faith is a triune Paul put it: “When God turns He had been stripped – figu- God: three persons – Father, his gaze on man, the first ratively and literally – of his Son, Spirit – in one being. thing he sees and loves in him dignity, but he had never There is something essential- is… his own image”.2 This ceased being a person. Be- ly relational about the nature belief poses, for me, a quite cause Jesus recognises this, of God. And it is this relation- profound question in the con- he is able to see himself in ality that is embedded in hu- text of our gathering. What is Joshua. Pope Benedict, when man nature. Like God, each it that God experiences of he was a Cardinal, expressed human person is both unique- himself in the life of someone this beautifully when he said ly his or her own self and with a mental illness? What that Jesus saw in this man the made for others. We are each aspect of God’s own com- full splendour of human cre- a unique subject – with its pleteness is reflected in the ation that had been externally concomitant sense of personal life of a mentally ill person? dimmed through the suffering autonomy; however, this sub- In the story of Joshua, I am of his illness.4 The injustice jectivity is constituted only in struck by the way Jesus and towards the man needed to be and through our relationship he interacted. Initially, Jesus addressed, not the nature of to others. We, like the God in seems to approach Joshua as the man. whose image we are made, if he were being attacked by a With these remarks in are relational beings. parasite: “Come out of the mind, I wish now to suggest a It is because we are rela- man, unclean spirit”. And response to the question I tional beings that we recog- then we have the image of posed earlier: What aspect of nise anyone with a human na- Joshua sitting calmly with Je- God’s own completeness is ture as being ‘one of us’. This sus, “clothed and in his full reflected in the life of a men- ‘one of us-ness’ does not – senses”, restored to his pre- tally ill person? cannot – admit of degrees: it illness self. Clearly Joshua It is said that if you have to is not something that is first was deeply thankful for his give someone a crash course

DOLENTIUM HOMINUM N. 62-2006 in Christianity, two doctrines reciprocated in the human and human persons are made will suffice: the doctrine of self-emptying of Jesus on the to be with God in a commu- the Trinity (which tells us cross. nion of life and love. who God is) and the doctrine It is the Crucified One who of the Incarnation (which tells is the definitive human icon us who God is for us). As I of the divine image. This 3. Not tolerance, but gift: have mentioned, relationships man, in the midst of his suf- a possible framework are intrinsic to being human fering, remains true to himself and in this we reflect the life – that is, fully human – in an Thus far we have explored of the Trinity. This tells us act of sacrificial love. … a theological understanding something of what our human [T]he crowds were appalled that seeks to identify the dig- nature is. The Incarnation – on seeing him – so disfigured nity integral to our nature as that God became one of us – did he look that he seemed no persons. I am mindful, how- adds, I believe, the reason longer human…; a thing de- ever, that this is not the only why we are persons in God’s spised and rejected by men, a path to establishing a set of image. God longed to experi- man of sorrows and familiar rights that recognise the dig- ence the texture of human with suffering, a man to make nity due to all persons, includ- creation so that human cre- people screen their faces; he ing – and especially in today’s ation could share in the tex- was despised and we took no context – those with a mental ture of God. It takes us from a account of him: (Is 52:14; illness. We here share a com- way of being to a manner of 53:3). These words of the mon commitment to ensuring acting: in terms of moral phi- Prophet Isaiah are applied to that the rights of the mentally losophy, from is to ought. the person of Jesus. A broken, ill are accepted and honoured torn, despised body – emptied in society. However, this 23 as an act of utter self-giving – commitment encompasses an reveals the heart of what it additional responsibility. We means to be fully a human must make certain that these person. rights rest on a solid founda- In an analogous way, Isa- tion: pillars need foundations iah’s words can also apply to and the foundations largely persons living with mental ill- determine the moral weight ness. We are challenged to that the pillars can support. recognise in them the broken Late last year Sydney expe- Christ and to accord them the rienced a weekend of rioting. dignity and reverence we For those of you not from would give to Christ himself. these parts of the world, it If anything is to be the ‘mea- was nothing like the Paris ex- sure’ of true personhood, it is perience. Nonetheless, it was the communion created in the an ugly affair, ignited by reciprocal act of love between racial issues and fuelled by al- persons. Any – and every – cohol and testosterone. At the person ‘made in God’s image’ time, and ever since, there The doctrine of the Incarna- can participate in this com- have been persistent calls for tion proclaims that in Jesus munion, no matter how exter- greater tolerance among the Christ God assumed our hu- nally dimmed that image various cultural groups in our man nature without ceasing to might be. In a paper on men- society. be the second person of the tal health given in 1997, Car- At much the same time as Trinity. But it is the reason dinal Ratzinger captured this the Sydney riots, the NSW behind this divine initiative truth well: Our value in the police were bringing to public that is of particular impor- eyes of God does not depend attention their increasing in- tance to our topic today. Jesus upon intelligence, stability of tervention in situations in- himself said: God so loved character, or… health… Our volving people with mental the world he gave his only value in the eyes of God de- illness. From their perspec- Son (Jn 3.16). Jesus’ human pends solely upon the choice tive, police have been inap- nature is constituted as such we have taken to love as propriately manoeuvred onto by a specific act of divine much as possible.5 the front-line of mental health love. God gives his very self a The phrase ‘as much as action, especially in acute cri- human life so that God could possible’ is particularly sig- sis situations. They, too, are be in communion with us, as nificant when we consider the appealing for tolerance, in one of us. In the words of St mentally ill for whom the this context a more tolerant Paul: “Though being in the mystery of suffering is so po- and less institutional ap- form of God, Jesus Christ did tent and the need for love so proach to the mentally ill. not count equality with God a acute. What does God experi- Tolerance has a particularly thing to be grasped, but emp- ence of himself in the suffer- strong place in Australian cul- tied himself to take on a hu- ing of the mentally ill? God ture. It is both a word and an man form” (Ph.2:6-8). In our experiences his choice to be idea that has made its way in- Christian faith, this divine act in communion with his own. to our national psyche. We of self-emptying is most fully Dignity belongs to persons, pride ourselves on being a tol-

DOLENTIUM HOMINUM N. 62-2006 erant society, ready to wel- point: Jesus calls us not only ly if it can be both given and come and embrace people of to welcome the weak and the received. This presupposes all nations and traditions. We rejected… but also the weak the possibility of a relation- label intolerant behaviour as and broken person within our- ship between the giver and re- ‘un-Australian’. Tolerance is selves. We are not different ceiver – in other words, a also a word that has made its from the Joshuas of this sense of self in relation to an- way into Australian Catholi- world: we are simply better at other. Further, the very act of cism, especially in the educa- controlling our fragilities. giving a gift teaches the re- tion scene, as a key interpre- Vanier reminds us that to be- ceiver how to give in turn. tive tool of the Church’s so- friend the ‘stranger’ (I was a The very act of giving a gift cial justice teaching. stranger and you welcomed enables others to become re- Yet, I find talk about toler- me – Mt.25:35) is to befriend ceivers and, in their turn, ance somewhat alarming be- ourselves as images of God. givers and in this way persons cause, by definition, it does Yet, none of this can be becomes more fully them- not demand much of us. Tol- achieved on a diet of toler- selves in that dual sense of erance does not require any ance. With tolerance my own ‘all of me’ and ‘one of us’. real meeting of persons. It darkness goes unchallenged But it is not only the act of simply says: I’ll put up with as I simply allow the stranger giving and receiving that is you doing your thing, so long to slip further into his or her important here: the gift itself as it doesn’t interfere with me world. Tolerance does not ad- has moral significance. doing my thing. Yet, we are dress in any meaningful way Something can only truly be a presenting this as an ideal for the distorted desire to domi- gift if it can be freely given which to strive! In its Aus- nate. In fact, tolerance rele- and freely received. Not all 24 tralian understanding, toler- gates human dignity to a com- ways of human interaction, ance is a deeply utilitarian modity. Appearance and out- nor all things exchanged, re- idea, and for this reason alone come become paramount and spect this fundamental free- we should tread warily. external structures replace the dom. There are some things Tolerance speaks of a cul- commitment of persons to which the giver is not free to ture unwilling to become in- persons. Perhaps this is why give. Likewise, not all ‘gifts’ volved in the lives of others, there is a tendency in Aus- are about protecting the free- born perhaps of a desire to tralia to revert to institutional dom of the receiver. The dominate. We are taught to modes of action in addressing moral structures of justice are climb up the social ladder of the mental health of people. needed to ensure that gift, life, not climb down it: to be a Obviously, tolerance cannot giver and receiver are all in a competitor, not a servant. In provide the foundation on coherent right relationship such an environment, intoler- which to build a society that with one another. ance can easily surface in us upholds the dignity of all peo- Unlike tolerance, gift giv- all because we are not pre- ple. In fact, I believe that we ing is truly other-centred. Gift pared to acknowledge our travel this road to our own giving says: you are impor- own inner fragilities. detriment. tant to me and somehow I am The founder of l’Arche, Where then, do we look to created in and by my giving Jean Vanier, who has lived find a more secure framework to you and you receiving what much of his life in community upon which to build a com- I give as a gift. I truly become with the mentally and physi- mon commitment to the hu- what I do – I give as an act of cally broken, recently wrote: man dignity of the mentally myself – and in this giving ‘The mystery of the weak and ill? This brings me to the final you, too, are created. I note the broken is that they call point in my presentation to- here particularly, the giving forth not only the deep well of day. and receiving of our bodily love and tenderness in us but In recent times, the concept reality.8 Our bodies are not also the hardness and dark- of ‘gift’ has become arguably processions to be disposed of, ness’.6 I find Vanier’s words the interpretive key to the but gifts caught up in the very both confronting and true – Church’s moral teaching, act of giving and receiving – perhaps you do, too. There with God’s own self-giving as and at times all we have let to can emerge within me a deep a paradigm for the moral life. give of or to receive with is inner anguish when I am For example, in his 1993 en- our bodies. Such a reality lies faced with the life and actions cyclical, Veritatis spendor, at the heart of the Eucharist: of a person suffering from Pope John Paul speaks of love “This is my body given for mental illness. Uncalled-for as the principle and source of you… Do this in memory of and unbidden fear can well up the moral life, a love that is me”. in me like a poison: I do not most fully witnessed in the I believe this understanding want to become entangled in “sacrificial gift of Jesus’ life of ‘gift’ offers a robust foun- the struggles of this person on the Cross”: a love that is a dation on which to build a whose ways seem strange to gift “to the end” (VS §20). moral framework capable of me. It unmasks my own vul- The moral theologian, Brian strongly upholding the dignity nerability and insecurity and, Johnstone, has provided a of each person. With tolerance at times, my own inner vio- helpful analysis of ‘gift’ upon there is really no exchange of lence. which I would like to briefly gifts between persons: it pre- Jean Vanier makes this very draw.7 Something is a gift on- cludes the possibility of com-

DOLENTIUM HOMINUM N. 62-2006 munion between persons. recognise as ‘one of us’, man person – the all of me However, by committing to oblige us to look more deeply and the one of us; or perhaps the internal structures of into our own lives. What is it something of the understand- ‘gift’, communion can be that is at the heart of being a ing of gift; or even better, the achieved. I can think of no human person? Whose digni- story of the encounter be- better image to capture this ty is to be upheld? Why does tween Joshua and Jesus. May than St Paul’s extraordinary one person’s suffering make a I be so bold as to invite you to insight that we are all a part of claim upon others? Perhaps, become an emissary, a mes- the one body: ‘God has put all answers to these questions senger of hope, to: ‘Go home the separate parts into the will come only when, like to your people and tell them body as he chose… What is God, the mentally healthy see all that the Lord in his mercy more, it is precisely the parts themselves in the mentally ill, has done’... (Mk 5:19). of the body that seem to be the and come to love the gift they weakest which are the indis- receive. Rev. PETER COMENSOLI pensable ones. It is the parts As I was preparing this talk, Cancellor, of the body we consider least I tried to keep in mind those Diocese of Wollongong, dignified that we surround whom I wished to address. Australia with the greater dignity; and You may be surprised to learn our less presentable parts are that you are not the totality of given greater presentability, my intended audience. The which our presentable parts ideas I have presented are not Notes do not need. God has com- entirely new to health profes- posed the body so that greater sionals who are on the front 1 For a thorough presentation of the position adopted in this section of the 25 dignity is given to the parts line of care for those with paper see: GERALD P GLEESON, Being which were without it, and so mental illness. Nor should Human: A Reflection Paper Commis- sioned by the Australian Catholic Bish- that there may not be dis- they be new to Church leaders ops’ Conference Committee for Doc- agreements inside the body who have a particular respon- trine and Morals (Canberra: ACBC, but each part may be equally sibility to live the Gospel of 2004), and International Theological Commission, Communion and Stew- concerned for all the others’ the poor, the sick and the little ardship: Human Persons Created in the (1Cor 12:18-25). ones of society. And I’m sure Image of God, 2004, found at: Who was Paul thinking of much of what I have said is http://www.vatican.va/roman_curia/co ngregations/cfaith/cti_index.htm. as the weakest, the least dig- very familiar to those of you 2 JOHN PAUL II, ‘The Mentally Ill Are nified, the less presentable? who either live with a mental Also Made in God’s Image’, in Dolen- Perhaps we can see here those illness or share the life of a tium Hominum No.34 (Year XII – No.1) 1997, p.8. who suffer from mental ill- person with a mental illness. 3 N T WRIGHT, Jesus and the Victory nesses: so often they are hid- It is my hope that, through of God (London: SPCK, 1996), p.194. den away, alienated, isolated. you, I might be able to touch a 4 JOSEPH CARD. RATZINGER, ‘The Likeness of God in the Human Being’, To these Paul says: you are wider audience comprised of in Dolentium Hominum No.34 (Year the indispensable ones, you people who in their day-to- XII – No.1) 1997, p.18. are the greatly honoured; you day living, come into contact 5 RATZINGER, ibid., p.19. 6 JEAN VANIER, Befriending the are the necessary gift to each with individuals and families Stranger (London: Darton, Longman of us if we are to complete that live with mental illness and Todd, 2005), p.64. ourselves. And when you suf- and struggle to know what to 7 BRIAN V JOHNSTONE, ‘The Gift: Derrida, Marion and Moral Theology’, fer, we suffer also. do and how to respond. Per- Studia Moralia 42/2 (2004), and ‘In- The presence of mental ill- haps there is something in trinsic Evil Acts’, Studia Moralia 43/2 ness in human lives can seem what I have said that could be (2005). 8 TIMOTHY RADCLIFFE, ‘How to Dis- such a paradox. These people, taken to these people: maybe cover what we Believe’, The Tablet (28 whom we struggle at times to something about being a hu- January 2006), p.12.

DOLENTIUM HOMINUM N. 62-2006 Where to from here? SPEECH BY MONSIGNOR DAVID CAPPO, 9 FEBRUARY 2006

We come together at this im- In 1959, almost 50 years ago, mental health disorders portant international event to the World Heath Organisation throughout the Oceania region affirm the human dignity of all warned that “efforts to have the are still connected to the com- people; an equal human dignity mentally ill treated as other munity and this will result in given to every person, made in sick people who can be cured greater acceptance and allows the image of God. are likely to remain fruitless as for community involvement in Also, we come acknowledg- long as the irrational fear of mental health care. This fosters ing that human nature is both ‘madness’ is not conquered.” strong partnerships between frail and limited, in need of the Clearly, we still have a long professionals and families un- love and grace of God. We see way to go. In Australia, despite like anything that we see in the a broken world and much suf- our economic and technologi- developed world. As recently fering. We strive as disciples cal affluence, despite our auras as 12 January this year, His Ho- of Christ to assist in bringing of sophistication, the discrimi- liness Benedict XVI made par- about his Kingdom, a healing nation associated with mental ticular mention of mental ill- Kingdom; a Kingdom which illness has never gone away. It ness in an audience with civil seeks justice and dignity for all just seems to disappear for a administrators and called upon humanity. time, only to reappear, almost them “not to leave without ade- 26 The frailty of the human con- insidiously, when circum- quate help families which often dition seen in mental illness has stances and opportunity permit. find they have to cope with many forms, some mild and And sadly, the context of today very difficult situations.” some very acute and very de- means that we must work even It is also clear that develop- bilitating. His Holiness Pope harder to change these atti- ing countries are recognising Benedict XVI says in his mes- tudes. The historical record of the importance of incorporating sage to us for the World Day of this early part of the 21st centu- traditional healing in their sys- the Sick that mental illness ry in Australia may well define tems. This creates that essential throughout the world is “a real it as a period where fear chal- cultural bridge which we are and authentic social-health care lenged the cohesion, compas- still struggling in Australia to emergency.” sion and good sense of a coun- understand and incorporate into The key to overcoming this try built on the principles of a mental health services for our emergency is confronting nega- ‘fair go’. indigenous communities. tive attitudes to mental illness On a more positive note, the This is the stuff of contem- and the provision of strategic record is also likely to show porary national plans and vi- and proper services for people that, almost ironically, many of sions in Australia that we now suffering mental illness. our regional neighbours, Papua recognise as ‘best practice’ but We know that the global bur- New Guinea, Fiji, will reap we are still trying to imple- den of mental disorders is stag- enormous benefits from not be- ment. It is vital that you recog- gering. Neuropsychiatric disor- ing in a position to have psy- nise this integration as an im- ders account for 31% of the chiatric units as the mainstay of mense strength that will stand disability in the world – and their mental health systems. you in good stead for the fu- they affect rich and poor na- Around the globe, and because ture. tions and individuals alike. of necessity, developing na- On the other side of the As His Eminence Cardinal tions have recognised that pro- ledger, it is important to recog- Barragan informed us, as we vision for mental health care nise that psychological and so- gather here today there are at must be integrated at the local cial distress appears to be in- least 450 million people deal- health centre, dispensary or vil- creasing worldwide. In devel- ing with a mental or neurologi- lage health post level. And the oped nations this is seen as a cal disorder worldwide. One- key figure in such a venture is direct effect of social change. hundred and twenty-one mil- the primary health worker (a In developing countries, there lion people are suffering from community nurse or allied is increasing evidence that depression, twenty four million health professional), working higher levels of distress can be people dealing with schizo- through existing local commu- linked to the planned develop- phrenia and fifty million peo- nity structures and resources ment projects that import eco- ple with epilepsy. Every year, such as school teachers and nomic and technological 873,000 people commit suicide volunteers. I understand, for change without heeding the so- and ten to twenty million at- example, that Fiji has invested cial impact and the effect on tempt suicide. heavily in education, and the the national psyche. It is impor- For our Oceania region, this high level of participation by tant that we all recognise the represents some 7 million peo- the community is credited as potential threat and the oppor- ple who are dealing with one or the single most important fac- tunities for developing coun- more of these mental or neuro- tor explaining Fiji’s progress in tries to avoid the pitfalls of the logical disorders (WHO: World health education development. developed world. Health Report 2002). The majority of people with I want to turn now to talking

DOLENTIUM HOMINUM N. 62-2006 about the challenges that in- young people and the degree to exclusions. It is an issue we evitably we all face in influenc- which these are again separated must work together to address. ing policy settings and service from developments in univer- Underpinning these three development planning in men- sal care particularly around the key themes is a range of issues tal health. Where to from here? early years of life. The issue of that are disturbingly common And I particularly want to fo- children living with parents across Australian jurisdictions, cus on the constructs of social with a mental illness is only and indeed, internationally. In inclusion being used here in now beginning to make it onto his address, Professor Ian South Australia and other parts the policy agenda in Australia. Hickie has given us an invalu- of the world. Throughout Australia and other able insight into the mental A social inclusion construct countries many young people health system in Australia. begins with the recognition that are the primary carer of a par- There can be little doubt that issues such as poor health, ent with a physical or mental in moving away from one form homelessness, crime rates and illness. This goes largely un- of institutionalisation for peo- poverty are interconnected in recognised by our policy mak- ple with mental illness, we their causes. Therefore re- ers and our services, and means have new institutions. They are sponses and solutions to these that many families live in great our prisons and remand cen- causes must be interlinked and stress and have inadequate tres, our homeless shelters our focused on clear outcomes. quantity of services around boarding houses and hostels. From a social inclusion them. The churn of mentally ill peo- framework, there are three key Thirdly, there is evidence ple through our prison system issues that need to be ad- that people with serious mental is alarming and needs great at- dressed. illnesses are likely to have the tention. worst social outcomes. Even Also, one of the most impor- 27 for people with more common tant battles that we face with mental health problems, there mental illness is ensuring that is real risk of social exclusion, people have a better under- of withdrawal and a lack of standing of the options for connection with the communi- treatment particularly for de- ty. We must not only improve pression. Solutions that are access to accommodation and based on solid scientific evi- support services but also assess dence are now available be- whether clients with a mental cause we know more about illness are getting effective ser- brain functioning and behav- vices through existing accom- iour than every before. modation and social care pro- The work of the Beyondblue grams. I understand that many organisation and the inspira- professionals in the mental tional leadership of Hon. Jeff health system often have low Kennett former Premier of Vic- expectations of what people toria cannot go unacknowl- with mental health problems edged in this context. It was can achieve both in employ- wonderful to hear from Gary ment or when contributing to MacDonald talking about the Firstly, the degree to which society and this is likely to be work of the organisation and mental health is separated reflected in their case planning his own experiences with de- from, often excluded from, the and management. pression. mainstream reform agendas for The words of our late Pope, And we need to respond to physical health. There is an in- John Paul II, on the dignity of the demoralisation that afflicts creasing understanding of the work resonate within as I re- the workforce in our mental close inter-relationship be- flect on this issue. In his en- health service systems. It goes tween mental health and physi- cyclical Laborem Exercens beyond individual services, re- cal health. Studies in Australia (1981) the Holy Father said: gions or States and it creates a have shown that just under half ‘Work is a good thing for level of psychological distress of those with a mental health man – a good thing for his hu- for staff that is continually rein- disorder had a chronic physical manity – because through forced by the inability to pro- disorder. Many people with un- work man not only transforms vide appropriate, effective and diagnosed affective disorders nature, adapting it to his own safe services for the people to will present with somatic needs, but he also achieves ful- whom they are deeply commit- symptoms. The sense that filment as a human being and ted. We have to understand in mental health is managed as an indeed, in a sense, becomes Australia that every day we do acute illness could separate “more a human being”’. not address the system failures those people from the signifi- I believe that the lack of is another day where we chip cant mainstream thinking about meaningful activity in the lives away at the resilience and self- system reforms for chronic ill- of many people with mental ill- respect of the hard working ness that are now centre stage ness and the fact that many committed people that struggle in developed countries. spend much of their time alone to keep an outmoded system Secondly, we need to focus represents one of the most pro- going. on services for children and found and unacceptable social As Anne Deveson reminds

DOLENTIUM HOMINUM N. 62-2006 us in her presentation today and would like to present a chal- said: “I’d like my psychiatric her work on what it is that en- lenge to our Catholic health health needs to be part of all ables some individuals and and social welfare agencies in my health needs, my psychi- communities to rise above ad- Australia. atric services to be delivered in versity and still find hope and We have an opportunity natural health settings, and the meaning, resilience is about through the pastoral care ser- language about psychiatric dis- connectedness. vices that our Church organisa- ability to be the language of all We face probably our most tions provide to the socially health and disability. When I significant challenge in reform- disadvantaged to make a differ- am isolated and ignored be- ing our mental health system, ence. cause of my psychiatric disabil- as we see the professional We have an opportunity to ity, when I am distinguished ‘hope and meaning’ that keeps ensure that people with mental unjustly and my rights disre- our practitioners connected to illness are cared for through garded, that is prejudice; that is their chosen field increasingly our health and social welfare discrimination. Calling it by a eroded. services in ways that support word only used for mental ill- In this regard I must ac- rehabilitation. For example, by ness [“stigma”] allows people knowledge how valuable it is to providing access to work to separate the wrong from oth- be able to learn from the through employment services er social injustices.” ground-breaking experiences provided by Church agencies. This World Day of the Sick of our near neighbour New And we have an opportunity 2006 held here in Adelaide has Zealand. A country recognised to integrate many of our exist- the ability to give a clear pas- around the world for creating a ing health and social welfare toral message to policy makers blueprint for reform and imple- services to provide holistic and in the mental health area as 28 menting that reform on the respectful services to people well as those operating ser- ground. with mental illness. vices. You are to be honoured Clearly, Federal and State Let us embrace these oppor- and supported in your work. Governments have an impor- tunities. You are not alone. Many see tant leadership role in the deliv- I understand the deep com- the problems you see and we ery of mental health services mitment that our management are becoming more focussed and in the reform of our mental and staff bring to the day to day giving more energy to your health services. They must also work of supporting and caring needs; your urgent needs. acknowledge that non-govern- for those in need, particularly And to so many people suf- ment agencies will be key play- in the context of high levels of fering mental illness, we state ers in the adequate provision of demand and finite resources. our clear commitment to ac- community services for suffer- Yet in the face of this de- knowledge and affirm your hu- ers of mental illness, and in turn have a leadership role as well. The Catholic Church as an international leader in many humanitarian causes also has a leadership role in mental health. And as Cardinal Bar- ragán outlined for us, the Church is already fulfilling this role in many parts of the world. And doing so insisting on a holistic understanding of the psyche and a deep respect for the human dignity of people with a mental illness. In his address on human dis- turbances of the human mind, the then Cardinal Joseph Ratzinger reminds us that “one of our tasks as Christians for our brothers or sisters who suf- fer from mental illness is to en- mand we must focus on the man dignity and the assist in sure that their humanity, their dignity of people experiencing providing dignified and inte- dignity and their vocation as mental illness and on the real grated services for your wellbe- creatures in the image and like- and authentic social-health care ing and the wellbeing of the ness of God are fully recog- emergency referred to by the community. nised, respected and promot- Holy Father. Thank you for your kind at- ed.” In closing I would like you to tention. Seeing this as our task, and consider the aspiration of a Msgr. DAVID CAPPO building on the guidelines for young women with a psychi- , practical interventions suggest- atric disability who was an US Archdiocese of Adelaide, ed by Cardinal Barragán, I adviser on mental illness. She Australia.

DOLENTIUM HOMINUM N. 62-2006 Health Pastoral Care in the Church

10 FEBRUARY 2006

One of the most important tions can only be a develop- lums, dispensaries, orphanages, tasks of the Pontifical Council ment of what He tells us. re-adaptation and rehabilitation for Health Pastoral Care is to In general, we can say that centres, mother and child cen- guide people in issues concern- chapter 10 of John’s Gospel, tres, etc. 5,236 are real hospi- ing pastoral care in health. The where Jesus Christ tells us that tals. Many of these centres aim of this study is precisely to he is the Good Shepherd (Jn have been set up at the level of answer the question: “What do 10:1-21), offers us the primary parishes, others at the level of we mean by the Council for approach to understanding the dioceses, while others are na- Health Pastoral Care?” whole of pastoral care. In syn- tional and are directed by bish- After a preliminary consider- thesis, we can say that he fo- ops, religious Orders and Con- ation on the meaning of pas- cuses on three fundamental fea- gregations, or by charities. toral care in health, we will dis- tures: he speaks to his sheep It is worth noticing that in al- cuss three issues, namely: what and they listen to his voice; he most all Bishops’ Conferences is the present situation of health feeds his sheep, to the point of there is a Department for pastoral care worldwide, the giving his life for them; and he Health Pastoral Care, directed positive and negative aspects; gathers them in the sheepfold, by a Bishop appointed “ad 29 the meaning of health pastoral where they should all converge hoc” by the same Bishops’ care, according to the evangeli- and where he defends them Conference. cal and pontifical proposal and against the wolves. In addition to this, there are the elaboration of the proposals To be able to understand the various associations for health by the Council and, lastly, what link between the Church and pastoral care: chaplains, men should practically be done in health, we need to analyse the and women religious, physi- this field, what are the chal- mission of the disciples and cians, nurses, pharmacists, vol- lenges, the proposals, the ways apostles. In Luke chapter 10, unteers, hospitals, who are all to be followed and the answers. the disciples are sent to heal ill- in close contact with health Starting from this perspec- nesses (Lk 10:9) and in Mark care authorities, at diocesan, tive, we are going to offer chapter 16, when Christ finally national and world levels. some guidelines that seem to sends the apostles he tells them be important for the planning to heal the sick (Mk 16:18). or enhancement of the organi- If we now wish to put these zation of health pastoral care two concepts together, pastoral within the Catholic Church. care and health, and see how There may be several levels, we could carry out health pas- but the content does not toral care, we can join John’s change, it will always be health chapter 10 with Mark chapter pastoral care. Certainly, sug- 16 (as well as Luke chapter gestions can be accepted for its 10). Reading them together we organization and enhancement see that health pastoral care at the level of the Bishops’ consists in curing the sick and Conferences, dioceses, parish- making them hear Christ’s es, as well as the religious Or- voice, in feeding them to the ders and Congregations that point of giving our life for work in collaboration with the them, in gathering them all in bishops in the field of health Christ’s sheepfold and in de- pastoral care worldwide. fending them against the If we focus on the continent wolves. of Oceania, according to the most recent figures available to us, this is the institutional PRELIMINARY framework for health pastoral REMARKS I. THE PRESENT care: 2,064 Catholic healthcare SITUATION centres, comprising 152 hospi- tals, 406 dispensaries, 2 leprosy 1. Biblical Foundations The first question that we ask centres, 381 charity homes (for ourselves now concerns the chronic patients, disabled and A general answer as to the current situation of health pas- elderly people, etc.), 64 or- meaning of Health Pastoral toral care in the Church. phanages, 87 nursery homes Care can obviously come from Looking at the statistics, we for children, 260 marriage ad- the Word of God. It is the Lord realize that today there are visory bureaus, 554 special re- who tells us what Health Pas- 109,363 Catholic health centres education centres, and 58 vari- toral Care is, and all our reflec- worldwide. These include asy- ous institutions.1

DOLENTIUM HOMINUM N. 62-2006 1. Positive Issues actually implement health pas- considered when outlining the toral care and the synthesis of direction to be taken by health All what is mentioned above this way, in the model of the pastoral care in the evangelical is positive; however, we would “Good Samaritan”. path. like to underline in particular the presence of bishops in charge of health pastoral care 1. General View of Healings 3. The Evangelical Way in each Episcopal Conference, in the Gospels for Health Pastoral Care the efficacy of international as- sociations of catholic doctors In the Gospel of Mark we If we now wish to outline, on and nurses, the starting of a come across the following mir- the basis of the above elements, union of hospitals operating acles: the healing of Peter’s the path that health pastoral within the Catholic Church, the mother-in-law, the healing of care should take, in order to union of hospital chaplains and the paralytic, who is brought follow in the footsteps of the interest of several Bishops’ down through the roof, the res- Christ, the Good Shepherd, in Conferences in health pastoral urrection of Jairus’s daughter, healing the sick, we could say care, manifested to this Pontifi- the healing of the bleeding that the path for health pastoral cal Council during their “Visita woman, the man with a dry care consists in realizing the vi- ad Limina.” hand, the deaf and dumb, the tal link between the world of blind man from Bethsaida and health care and Jesus Christ, by of leper. showing his salvific presence 2. Negative Issues Mathew reports the healings as a source of love and as a way of the centurion’s servant, of to master life. In this health 30 A first negative issue that two blind men, of the deaf and pastoral care, it is necessary to one observes in health pastoral dumb and of two blind men hear and see Christ and be full care is that of secularism. Be- from Jericho. of hope for the resurrection. cause of the latter, pain, suffer- In Luke, we meet the resur- Each person should be fully ing and death are concealed or rection of the son of the widow friendly, tactful and should presented in a distorted man- of Naim, the healing of the identify with each patient; ner. Quite often, a false idea of hunchbacked woman in the should be compassionate, for- the virtue of charity is intro- synagogue, of the dropsy suf- giving, remove any form of duced, that is, it is presented as ferer and of 10 leprous men. alienation and strive to see that mere philanthropy, so as to John reports the healing of health pastoral care converges gain acceptance in the contem- the centurion’s son, of the para- both in the Resurrection of the porary world. Many times, lytic from Bethsaida, of a blind Lord and in one’s own. In order health pastoral care is obscured man and the resurrection of to follow this path, the three by shades of pain, making it Lazarus. virtues of faith, hope and chari- lose an essential element that On the whole, the Gospels ty should be revived, and deep- should characterize it, that is, report 22 miracles, but it is evi- ened by means of prayers of faith in the Resurrection. If dent that for the synoptics, petition, commendation and both faith and charity fail, the many times different evange- gratefulness to the Lord. virtue of hope too is weakened lists refer to the same miracle.2 and, instead of celebrating Je- sus Christ’s victory over pain 4. A Practical Synthesis and death, health pastoral care 2. Basic elements of the Gospel Proposal is merely focused on charity for Health Pastoral Care and compassion. in the Gospels The practical synthesis can be reached if we see in the Reflecting on these narra- parable of the Good Samaritan tives we can identify the fol- (Lk, 10:25-36) Christ himself II. WHAT IS HEALTH lowing elements that, having (the emblem of our Pontifical PASTORAL CARE? been developed by Jesus Christ Council). when healing the sick, will al- Eight elements can be iden- Gospel Proposal ways be present in health pas- tified in this parable: (i) the toral care accomplished ac- Good Samaritan is fully con- If we wish to deepen the an- cording to the Gospels. We scious of the reality, he sees swer we have been suggesting enumerate the following: the wounded man; (ii) he feels in our opening remarks, we can touching Christ, seeing Christ, compassion, he is touched; succinctly consider four points: hearing Christ, the resurrection, (iii) he treats him, he puts a general review of healings ac- salvation, life, the theological vinegar and wine on his complished by Jesus Christ; the virtues of faith, hope and chari- wounds; (iv) he shares his enumeration of the basic ele- ty, prayer, praise, thankfulness, property, he puts the wounded ments derived from these heal- friendship, compassion, for- man on his horse; (v) he en- ings, in order to carry out giveness, personal identifica- trusts him to competent peo- health pastoral care according tion of the sick and touch. In ple, he puts the wounded man to the Gospels; the evangelical all, there are fifteen major lev- in the care of the hotel owner, way that we can design on the els in Christ’s approach to heal- (vi) he spends his money and basis of such elements, so as to ing the sick, which should be gives him two coins, he is

DOLENTIUM HOMINUM N. 62-2006 completely generous, (vii) if If we want to organize these necessary to carry out a clear anything lacks…; (viii) he pontifical proposals according and profound formation of hu- checks the results when he re- to health pastoral care as de- man consciences and to en- turns. scribed in the opening remarks, lighten them, especially as re- then they should be ordered ac- gards the ethics of biogenetics, Pontifical proposal cording to the there mentioned in order to guarantee that each characteristics: listening, feed- new scientific discovery may How does the teaching of ing and uniting. These charac- serve the integral good of the the Church, especially that of teristics are the foundation of person, always in full respect Popes John Paul II and Bene- the three ministries existing in of his individual dignity. It is dict XVI, view the evangelical the Church: that of the Word, of therefore evident that health proposal on health pastoral Sanctification and of Commu- pastoral care should count on care? nion, according to which, and competent and well-trained ad- The answer can be found es- in the direction of which, we visers. Within health pastoral pecially in 7 Documents: are now going to organize the care it is absolutely necessary Gaudium et Spes, Dolentium magisterial teaching. to update priests and educators Hominum, Pastor Bonus, Salv- on these issues, so that they ifici Doloris, Message for the may assume their responsibili- Year 2000 (Message for the 1. The Word ties, in line with their faith, in a World Day of the Sick in the true and respectful dialogue Jubilee Year), Novo Millennio This is the teaching of the with non-believers. In such a ineunte and the Address of Church on fundamental issues, way, our own expectations, Pope Benedict XVI to the Pon- such as life, death, pain, dis- along with our need for assis- tifical Council for Health Pas- ease, anxiety, etc.. John Paul II tance, can be adequately guar- 31 toral Care on the occasion of its notes that at the centre of the anteed and met. Health pastoral XX International Conference.3 teaching on health pastoral care care should also study the prop- In these documents, the Popes we find Jesus Christ who suf- er methodology to assist peo- establish the tasks of the Pon- fers in those suffering; our suf- ple, their families and society tifical Council in the field of fering is his suffering and, be- as a whole, so as to ensure an pastoral care in health, and the cause of this, is transformed in- incisive presence of the Church finality of the Pontifical Coun- to the joy of his Resurrection. in this pastoral field. It will be cil itself. This is also valid for As a result, health appears as a necessary to combine loyalty to particular Churches. tension towards harmony, the doctrine of the Church with which is understood and lived openness to dialogue with the thanks to the love of the Holy contemporary health world. As Spirit, since the Holy Spirit is a result, we should carry out a the only one that can unite us deep theological study of all with Christ. these issues and increase our Therefore, in health pastoral capacity for mediation.4 care, both training and a pro- As a result, it is extremely found study of the essence of important to take a stance in the the human condition are ex- new frontiers and be up-to-date tremely important. Ethical and in the scientific, technical and religious training is indispens- legal novelties, at a local, na- able, in seminaries, as well as tional and world level. in Catholic universities and in the elementary cathechesis. Moreover, the reality of health 2. Sanctification care systems and their orienta- tions in different countries Health pastoral care mani- should be thoroughly studied fests the solicitude of the The pontifical proposals are and special attention should be Church for the sick and the suf- the following four: to offer given to their proposals in the fering. It also requires special guidance on health, focusing various programs on health attention to health care work- on pain, disease, suffering, care which they intend to car- ers. Pastoral care in health death and life; to unite health ry out. should always start from the care professionals, bishops, In the above-mentioned ad- face of Jesus Christ, at the chaplains, doctors, nurses, dress of Pope Benedict XVI, same time agonized and glori- pharmacists, administrators of the Holy Father emphasises the ous, and should accomplish the health care centres, volunteers renewal and deepening of Redemption that Christ offered etc.; to be in touch with particu- health pastoral care, keeping in us, both in illness and in death lar Churches, with internation- mind current developments in itself. Pastoral planning should al, national, regional and local the knowledge of health care include the way to sanctifica- organisations working in the issues, as diffused by the mass tion in health pastoral care. It field of healthcare; to be up to media, and the high level of ed- should start from the holiness date with problems of health: at ucation of the people to whom of life through prayer, the the scientific, technical, legal they are addressed. Conse- sacraments of the Eucharist and and political levels. quently, the Pope says that it is Reconciliation, Grace, and the

DOLENTIUM HOMINUM N. 62-2006 Word of God. It should make this paradox of Christ being Goal of Sanctification us converge in the Communion both agonized and glorious by of the Trinity. saying that when he is on the To sanctify both the sick and Cross, despite his extreme suf- healthcare workers, so that they fering and pain, he never stops may be united to Christ’s death 3. Communion being God. He is both God and and resurrection. man in the mystery of his death In agreement with the Holy To accomplish communion on the cross. This paradox Father’s teaching in Salvifici in health pastoral care it is nec- meant the resurrection. There- Doloris, it is our goal to evan- essary to coordinate it in an in- fore, the goal of health pastoral gelize the world of sickness telligent way: all the associa- care should always be to evan- and health by integrating what tions of health care workers gelize pain, suffering and is missing in the Passion of should be properly coordinated death, starting from the death Christ, because this is the only and contacts should be kept and the resurrection of Christ. way to respond to the absurdity with the local Churches and of death and the effects of pain with healthcare organizations, Specific Goals and diseases. whether they are Catholic or This goal is mainly the goal not, at local, national and inter- These specific goals should of prayer, whereby we ask national level. be ordered in agreement with Christ to take up our death, the organization envisaged in suffering and pains in his own Operational Synthesis the pontifical proposal, that is, Passion and death, thus offer-

If we wish to summarize the 32 pontifical proposal for pastoral care in health, we could state that its task is to show the con- cern of the Church for the sick and the suffering, through its doctrine, coordination, its con- tacts and research activity.

ELABORATION OF THE PONTIFICAL PROPOSAL BY THE COUNCIL FOR HEALTH PASTORAL CARE

In agreement with the evan- gelical proposal, as interpreted by the Holy Father in the above-mentioned form, the Pontifical Council for Heath Pastoral Care proposes one general objective and three spe- cific goals for health pastoral care.

General Objective on the basis of the three min- ing us the only possible and istries of the Church: the Word, true health. In this goal, we The general objective is: Sanctification and Commu- obviously realize that health is manifesting the face of Christ, nion. not merely made up of wellbe- both agonized and glorious, in ing, but rather of happiness, line with the Apostolic Letter Goal of the Word which is reached whenever we Novo Millennio Ineunte, in or- head towards the harmony of der to enlighten, through the To enlighten, through the life, by taking the only possi- Gospel, the world of health, Gospel, the world of health, ill- ble way, that is accepting the sickness and suffering; sancti- ness and death, transmitting to cross and living in the Cruci- fying the sick as well as health it the strong testimony of the fied Christ. This life is only care workers and coordinating Resurrection. possible if Christ gives it to us, pastoral care in health within In this goal, we wish to high- that is, when he takes upon the Church. light in particular the virtue of himself our death in his death This general goal is in line Hope, in order to answer the and all the evil of the world. It with the Apostolic Letter Novo problem of immanent secular- is the meaning of Christ who Millennio Ineunte, where the ism. We do not want to remain comes to take away the sin of Church as a whole is invited to in a deistic type of transcenden- the world. This union is effect- plan its pastoral action by tak- cy, but rather in a transcenden- ed by the Holy Spirit. There- ing as a starting point the face cy revealed by Christ, by fore, the goal of the health of Christ both agonized and means of his death and resur- pastoral care is to raise prayer, glorious. John Paul II explains rection. so that the Holy Spirit may

DOLENTIUM HOMINUM N. 62-2006 give us health, by joining us in manity, or a mere social com- ization and health, by the econ- Christ, dead and risen. mitment that we have towards omy, by politics and by health. the poor and unprotected. The Second, to collaborate with the The Goal of Communion challenge consists in proclaim- various health workers, such as ing it according to the Goal of doctors, nurses, pharmacists, To coordinate health pastoral the Word, as we noted above. It volunteers, hospital administra- care, in order to accomplish ec- is the proclamation of the tors, bioethics committees, etc. clesial communion. Lord’s resurrection. That is to Third, to favour the develop- Our task in health pastoral say we do have answers to the ment of sanctuaries, where care is solidarity. The sheepfold most profound problems of many people go to pray for mentioned by Christ when he mankind and therefore to their health, Catholic Schools presents himself to us as the death. Today, we usually say of medicine, schools for nurses, Good Shepherd (Jn, 10) is built that a respectful silence is more health organizations, both upon an image, in the Holy valuable to delicately accompa- Catholic and non-Catholic, Trinity, where life is supreme ny these people in front of un- public and private. Fourth, to harmony in infinite mutual do- bearable situations. But saying accompany people in asserting nation. Through this, it is possi- that reveals a lack of faith, their rights to health care; in ble to achieve the union of all when we have answers, or bet- keeping up to date with the in health pastoral care by ac- ter, if we do have the answer of most recent advances in sci- complishing a reciprocal loving Christ, dead and risen. ence and technology and in donation, in order to actually Another challenge consists biogenetics; in facing problems implement a pastoral care in in promoting it. We may get the of the socialization or re-priva- health that brings life in abun- impression that in some places tization of medicine; in dealing dance. this pastoral care, once a real with emerging diseases, such 33 In this way, Christ builds his priority, is now starting to be as AIDS or drug addiction, or body, which is the Church, forgotten. It is too often absent re-emerging ones: tuberculosis whereby each one of us, ac- from pastoral plans. Here we and malaria and other diseases cording to the measure of his are perhaps running into the that are sexually transmitted. own donation, receives the problem of secularism, as we Spirit to accomplish his mis- mentioned earlier. sion in this form: “making the The third challenge consists 4. Answers truth in love, may grow up in in trying to unify health pas- all things into Him who is the toral care in the Church. We are Proceeding in this way, we head – Christ – From whom the trying to accomplish this, or, can already find the answers whole body, joined and nit to- rather, we have always accom- for those who are working in gether by what every joint sup- plished this, but we now need the field of health pastoral care. plies, according to the effective to increase coordination at all We could even be more con- working by which every part levels: international, national, crete, by identifying fields of does its share, causes growth of diocesan and parish. action in each one of the eccle- the body for the edifying of it- sial ministries, in health pas- self in love.” (Eph 4:15-16). toral care. This is the way of realizing in 2. General proposals Regarding the Word, we health pastoral care the union should develop a sound and of all pastoral workers among Generally speaking, these profound theology on pastoral themselves and with Christ, proposals refer to the first chal- care in health and work closely dead and risen. lenge related to coordination. with the catholic Schools of We shall refer later to the two medicine; we should both pub- other challenges. lish and stimulate the publica- We propose to organize tion of studies focused on key III. WHAT SHOULD health pastoral care in each problematic issues raised by BE DONE? country; to keep in touch with modern society. We need a pas- the Pontifical Council; to have toral guide for health care With regard to the realisation diocesan, regional and national workers and we should pro- of this pastoral care in health, I coordination. mote, organize and direct meet- would like to mention the fol- ings, conferences and research lowing four points: challenges, in all fields of interest, espe- general proposals, paths and 3. Paths cially, today, that of bioethics. answers. Regarding sanctification, we We wish to point out four should further revitalize the different paths we should fol- sacrament of the anointing of 1. Challenges low in the field of health pas- the sick, emergency baptism, toral care. First of all, to offer especially in paediatric hospi- One of the challenges con- guidance on the meaning of tals, Viaticum, the celebration sists in guiding it. As we have health, suffering, the problems of the sacrament of reconcilia- already said, it is not mere phil- raised by the new age we are tion and, whenever necessary, anthropy or even a feeling of living in, the complex prob- of marriage. We should make solidarity and compassion for lems raised by bioethics, by the use of the various existing ritu- the disabled or suffering hu- relationships between global- als for pastoral care in health,

DOLENTIUM HOMINUM N. 62-2006 and make them available to diseases of the third age and care is not a mere project of those who need them. It is nec- cancer; we should increase pal- charity in favour of the sick, essary to increase the number liative care and follow the cor- but rather a profound penetra- of liturgical celebrations both rect procedures for organ dona- tion in the essential mission of for the sick and for staff in tion, etc. the Church, a task that Christ healthcare institutions. It is A very special role is played assigned to his disciples and necessary to increase prayer, by The “Good Samaritan” apostles. To accomplish this especially by sick people them- Foundation, created by Pope pastoral care a profound faith is selves. In accordance with the John Paul II at the end of his needed, along with efficient invitation of the Holy Father, life and confirmed by Pope charity and a hope capable of the recitation of the holy rosary Benedict XVI, the purpose of standing any challenge. This is is to be privileged. There is the which is to assist financially the only way to accomplish Union of Sick Missionaries the poorest and less protected God’s plan for health pastoral who offer their sufferings in the sick people worldwide. care, which consists in the imi- form of prayer for the spread of tation of the life of Holy Trini- the Kingdom of God. ty: “Making the Truth in Love” Regarding communion, it is (Eph 4:15). necessary to encourage the CONCLUSIONS above associations of the sick, H. Em. Cardinal JAVIER of the chaplains devoted pas- As a conclusion to all we LOZANO BARRAGÁN toral care in health, of catholic have said above, we can state President of the Pontifical Council for Health Pastoral Care, doctors, of Catholic nurses, of that health pastoral care repre- the Holy See. pharmacists, of hospital admin- sents the ecclesial call to har- 34 istrators, and of volunteers in monize death and life. This ap- health pastoral care. The Asso- parent paradox and contradic- ciation of Catholic Hospitals is tion can only be accomplished also very important. by the Holy Spirit, when he There is a need to promote joins together suffering the celebration of the World mankind with Christ, so that Notes Day of the Sick, which is held Christ himself assumes this 1 Cf. Annuarium Statisticum Ecclesiae, every year in a different conti- suffering and this death, incor- 2003, p.365. nent and is addressed to the porating them in his own pas- 2 Mt 8, 5-13; 9, 27-31; 12 2-23; 20, 29- whole world. We should inten- sion and death. This union ac- 34; Mk 1, 29:32, 40-45; 2, 1-12; 5, 21-43; 7: 31-37; 8, 22-26; Lk 7, 11-17; 13, 10- sify guidance in these areas by complished by the Holy Spirit 13; 14, 1-6; 17, 11-19; 22, 50-51; Jn 4, means of social communica- is not limited here; rather, by 46-54; 5, 1-9; 9, 1-7; 11, 38-44. tion tools; we should defuse uniting us to the suffering 3 Gaudium et Spes 10; Salvifici Do- loris, 26; Pastor Bonus, 152-153; Dolen- statistics for our mutual assis- Christ he at the same time tium Hominum, 2-6; Message of the Holy tance, use the Internet, know unites us to the risen Christ. Father for the World Day of the Sick for the various existing websites, Thus, the Spirit unites us to the the Year 2000, n. 13, in Dolentium Hominum 42 (1999) 9; Novo Millennio make the appropriate connec- victorious Christ, who re-cre- inenute, 28-58; Address of Pope Benedict tions and use more easily the ates the whole universe, and XVI to the Pontifical Council for Health press, the radio and the TV. accomplishes the eternal decree Pastoral Care on the Occasion of the XX International Conference on the Human We should especially take of the Father, that is, total har- Genome, 19 Novemeber 2005. care of sick people who are vic- mony, by pacifying, through 4 Cf. BENEDICT XVI, Address to the tims of the above-mentioned the blood of Christ, all that is in Pontifical Council for Health Pastoral Care on the Occasion of the XX Interna- diseases: AIDS, drug addiction, earth and heaven (Col 1:20). tional Conference on the Human tuberculosis, malaria, chronic Therefore, health pastoral Genome, 19 November 2005.

DOLENTIUM HOMINUM N. 62-2006 Topics

A Pluridisciplinary Dialogue on Human Life

Human Life: a Precious Gift of God

Modern Society in Conflict Between the Culture of Life and the Culture of Death

Prison and Conditions for Depression

Medical Saints of Our Time: Giuseppe Moscati, Riccardo Pampuri, Gianna Beretta Molla A Pluridisciplinary Dialogue on Human Life A PRESUMED CONFLICT BETWEEN MEDICAL-TECHNICAL PROGRESS AND MORAL NORMS

In his address to the members and its dignity.3 To enter into all, that his life is a gift of God, of the Biblical Commission, the subject before us, I would that he is able to know the exis- Pope Ratzinger very rightly ob- like to point out, first of all, the tence of a personal God begin- served: ‘You have once again religious character of this dia- ning with the creation: the ma- come together to explore a very logue. terial world and the human per- important subject: the relation- son that allow him to attain true ship between the Bible and certainties.6 As regards the dia- morality. This is a subject that 1. The Religious Character logue on human life, it is even concerns not only the believer of this Dialogue more important to emphasise but every person as such. And it that ‘with his openness to truth concerns us specifically at a ‘For us too Moses’ invitation and beauty, his sense of moral time of cultural crisis and moral rings out loud and clear: “See, I goodness, his freedom and the crisis. The primordial impulse have set before you this day life voice of his conscience, with his of man, in fact, is his wish for and good, death and evil... I longings for the infinite and for happiness and a fully successful have set before you life and happiness, man…discerns signs 36 life. Today, however, there are death, blessing and curse; there- of his spiritual soul…The soul, many who think that such ful- fore choose life, that you and the ‘seed of eternity we bear in filment must be achieved in an your descendants may live” (Dt ourselves, irreducible to the absolutely autonomous way, 30:15, 19). This invitation is merely material’,7 can have its without any reference to God very appropriate for us who are origins only in God’.8 ‘The and His law. Some people have called day by day to the duty of world, and man, attest that they even theorised an absolute sov- choosing between the “culture contain within themselves nei- ereignty of reason and freedom of life” and the “culture of ther their first principle nor their in the domain of moral norms: death”. But the call of final end, but rather that they such norms are said to consti- Deuteronomy goes even deeper, participate in Being itself, tute the field of ethics that are for it urges us to make a choice which alone is without origin or only ‘human’, they are said to which is properly religious and end. Thus, in different ways, be, that is to say, the expression moral. It is a question of giving man can come to know that of ethics that man gives au- our own existence a basic orien- there exists a reality which is tonomously to himself; the pro- tation and living the law of the the first cause and final end of ponents of this ‘secular morali- Lord faithfully and consistently: all things, a reality ‘that every- ty’ state that man, as a rational “If you obey the command- one calls ‘God’’.9 This religious being, not only can but even ments of the Lord your God character of the dialogue on hu- must freely decide on the value which I command you this day, man life – and this is what I of his behaviour’.1 Pope Bene- by loving the Lord your God, have sought to emphasise – de- dict XVI further makes clear, by walking in his ways, and by notes the incomparable value of and this is what led me to write keeping his commandments and every human person from his this article, that this is an erro- his statutes and his ordinances, conception to his natural death. neous belief that is based on a then you shall live ... therefore John Paul II makes clear on this presumed conflict between hu- choose life, that you and your point: ‘Man is called to a full- man freedom and every form of descendants may live, loving ness of life which far exceeds law; and in the final analysis the Lord your God, obeying his the dimensions of his earthly between the Creator and his voice, and cleaving to him; for existence, because it consists in chosen creature – man. ‘In real- that means life to you and sharing the very life of God. ity, the Creator – because we length of days” (30:16,19-20)’.4 The loftiness of this supernatur- are creatures – has inscribed in- Indeed, ‘The root reason for hu- al vocation reveals the greatness to our being ‘natural law’, a re- man dignity lies in man’s call to and the inestimable value of hu- flection of His creative idea in communion with God. From the man life even in its temporal our hearts, as an interior com- very circumstance of his origin phase. Life in time, in fact, is pass and yardstick for our man is already invited to con- the fundamental condition, the lives’.2 This papal clarification verse with God. For man would initial stage and an integral part provides an overall introduction not exist were he not created by of the entire unified process of to the multi-disciplinary dia- God’s love and constantly pre- human existence. It is a process logue on human life which served by it; and he cannot live which, unexpectedly and unde- rightly so much concerns our fully according to truth unless servedly, is enlightened by the contemporaries, especially as he freely acknowledges that promise and renewed by the gift regards those extreme cases in love and devotes himself to His of divine life, which will reach which the advances of science Creator’.5 Man, created in the its full realization in eternity (cf. and technology, on the one image of God and preserved in 1 Jn 3:1-2).10 At the same time hand, provoke wonder and grat- life by Him is, therefore, by his this supernatural call emphasis- itude and, on the other, generate nature ‘a dialogic being’ to the es two very important criteria worry about the human species utmost who recognises, first of for ethical needs: the first crite-

DOLENTIUM HOMINUM N. 62-2006 rion concerns relativity and the illuminating at our present his- tion must measure up to the ex- second concerns sacredness. As torical time, when science and plicit will of God. The trans- regards relativity it should be technology have revolutionised mission of a new human life said that the earthly life of man the position of the human being implies a certain participation and woman, in truth, is not an in relation to life, illness and of man in the lordship of God, ‘ultimate’ reality but a ‘penulti- death, and that way of different- which is manifested in the spe- mate’ reality. However, this is ly approaching life, illness and cific responsibility that is en- always a sacred reality that is death that involve innumerable trusted to man as regards entrusted to us for us to steward ethical questions that we cannot specifically human life. This it with a sense of responsibility ignore. I will now address specificity, and this is a point and bring it to perfection in love above all else the beginning of that I want to stress, reaches its and the giving of ourselves to human life and abortion in or- summit in the donation of life God and our brethren.11 This der to point out the presumed through generation by a man gospel of life has been entrusted character of a possible conflict and a woman in marriage. God by the Creator to the Church between science, technology Himself said: ‘It is not good for and to every man of good will, and morality. man to be alone’ (Gen 2:18) above all to theologians, to and Jesus said ‘he who made philosophers, to scientists and them from the beginning made to technologists. As Pope Wo- them male and female’ (Mt jtyla observes: ‘Even in the 19:4). Wanting to communicate midst of difficulties and uncer- to man a certain special partici- tainties, every person sincerely pation in His creative work God open to truth and goodness can, blessed man and woman and by the light of reason and the said to them ‘be fruitful and 37 hidden action of grace, come to multiply’ (Gen 1:28).16 Now, it recognize in the natural law is specifically that certain spe- written in the heart (cf. Rom cial participation of man and 2:14-15) the sacred value of hu- woman in the creative work of man life from its very beginning Man that requires for the gener- until its end, and can affirm the ation of a child be an event that right of every human being to is profoundly human and high- have this primary good respect- ly religious. It involves the ed to the highest degree. Upon spouses who form ‘one flesh’ the recognition of this right, (Gen 2:24) and God Himself every human community and 2. The Presumed Conflict who is present. Each new hu- the political community itself over the Beginning of Life man being is not a product of a are founded’.12 Specifically for certain ‘technique’, not even of this reason, Holy Scripture, Tra- In the field of procreation that technique that unites two dition and the Magisterium of reference has been made for gametes – frozen separately or the Church tells us that the vo- some time now to two alterna- otherwise – he is an unborn cation and the full realisation of tive techniques, indeed tech- child, the fruit of the love of the man lies not in the rejection of niques that substitute each oth- two spouses. A new human be- the law of God but in life ac- er: on the one hand, in vitro fer- ing brings with himself into the cording to the new law. Be- tilisation, with the transfer of world a particular image and tween the law of God and the the embryo into the womb and likeness of God Himself, and freedom of man there is no con- the freezing of embryos; and, thus in the biology of genera- tradiction: the law of God up- on the other, the separate freez- tion is inscribed the genealogy rightly interpreted does not at- ing of two, male and female, of the person. To co-operate as tenuate or eliminate the free- chromosome layettes. parents with God in conceiving dom of man. On the contrary it In this case, given that one is and generating a new human assures it and promotes it.13 In- no longer dealing with an em- being is never a question of ‘bi- deed, ‘freedom…attains its per- bryo and thus with a new hu- ological techniques’ but of a fection when directed towards man life, this technique is said working presence of God Him- God, our beatitude’.14 The moral to the raise the question of the self in human fatherhood and action of man, therefore, is di- overcoming of the rejection of motherhood. A man and a rectly founded on obedience to every form of artificial fertilisa- woman, united in marriage, are the law of God, on union with tion, whether it is homologous associated with a divine work: Christ and on the dwelling of or heterologous. I answer that through their act of generation the Spirit in the soul of the be- from a purely biological point the gift of God is welcomed and liever. The action of man is nev- of view no embryo exists. And a new life opens up to the fu- er action dictated by solely ex- not only this: if the gametes had ture.17 terior rules: it comes from the not been frozen, the female ga- ‘The various techniques of vital relationship that connects mete and the male gamete artificial reproduction, which believers with Christ and with would soon cease to exist. The would seem to be at the service God.15 What has been said hith- question of the overcoming of of life and which are frequently erto in this paper on the reli- the rejection of the artificial used with this intention, actual- gious character of dialogue or transmission of human life con- ly open the door to new threats discussion on human life be- cerns first of all and above all against life’.18 The criterion for tween moral norms and med- else the ethical sphere. Every evaluation of an ethical order ical-technical progress is very technique of artificial fertilisa- derives from the very originali-

DOLENTIUM HOMINUM N. 62-2006 ty of the human person. Pope common vocation of the spous- the moment of conception until Roncalli observed: ‘the trans- es who are called to fatherhood death is a sign and requirement mission of human life is en- and motherhood: it objectively of the very inviolability of the trusted by nature to a personal deprives conjugal fruitfulness; person, to whom the Creator and conscious act and as such it it brings about and manifests a has given the gift of life.’29 ‘No- is subject to the most holy laws rupture between genetic parent- body can attack the life of an in- of God: immutable and invio- hood, gestational parenthood nocent man without going lable laws that should be recog- and responsibility for upbring- against the love of God for him, nised and observed’.19 John ing. Such damage to the per- without violating a fundamen- Paul II makes clear that this sonal relationship within the tal, inescapable and inalienable personal act is the intimate family has repercussions on right’.30 The right to life of union of love of the spouses, civil society’.26 every human being comes im- who in giving of themselves to- mediately from God and not tally to each other give life. from others: neither parents, nor This is a unique and indivisible society nor human authority. act, which is at one and the This is why abortion is always a same time unitive, procreative, defeat. However, and here we conjugal and parental.20 Before encounter the sensitivity and the Roncalli and Wojtyla papa- complexity of the question cies, Pope Pacelli taught that ‘faced with extreme cases such this act, which is the ‘expres- as when a woman has been sub- sion of the mutual gift which, jected to violence, a pregnancy according to the words of Holy in an adolescent of eleven or 38 Scripture, effects the union “in twelve years of age, a woman one flesh”’21, is the spring-cen- who does not have the econom- tre of life. It is by now luce ic means to bring up a child, clarius that one is dealing with what is the approach of the a presumed conflict because Church? If one concedes the procreation is not of a techni- principle of the choice of the cal-biological order, in the lesser evil and, as the Catholic sense that a certain technique 3. The Presumed Conflict Church suggests, that of entrust- ‘would allow the overcoming over Abortion ing the response to the inner- of that rejection of every form most part of one’s conscience of artificial fertilisation, still It is stated that ‘one of the (conscientia perplexa: in that present in by no means few cir- most difficult subjects to ad- condition in which a man and a cles, and which produces a dress, which people ask them- woman at times find that they painful gap between the prac- selves about continually pre- have to face up to situations tice that is commonly admitted cisely because of its sensitivity which make the moral judge- by people and also sanctioned and complexity, is abortion. In ment uncertain and the decision by laws and the at least theoret- Italy the state has passed laws difficult), would it not be ethi- ical approach of many believ- on the matter trying to link the cally correct to openly explain ers’.22 The very dignity of the principle of the self-determina- this point of view? And also human person requires that ‘it tion of women with the freedom sustain it publicly?’31 I will comes into being as a gift of of the conscience of medical quote the answer: ‘it is impor- God and as the fruit of the con- doctors who can choose consci- tant to recognise that the prose- jugal act, which is proper and entious objection’.27 This ap- cution of physical human life is specific to the unitive and pro- proach to the question/problem not in itself the first and ab- creative love between the of abortion immediately de- solute moral principle. Above it spouses, an act which of its notes how much the conflict is a is the principle of human digni- very nature is irreplaceable’.23 presumed one because here, ty, a dignity which in the Christ- The suggestion that we should too, one sets aside the divine ian vision and many religions distinguish between homolo- right to life. ‘The divine lord- involves an openness to the gous and heterologous fertilisa- ship of life is the foundation and eternal life that God promises to tion is, therefore, unsustainable; guarantee of the right to life, man. We may say that here is the radical rejection of every which is not, however, a power the definitive dignity of the per- form of artificial fertilisation is over life. Rather, it is the right son’. The words of Jesus are not based upon the fate of the to live with human dignity, as quoted: ‘Is not life more than embryos.24 The Magisterium al- well as being guaranteed and food, and the body more than lows no doubts on the matter: protected in this fundamental , clothing?’ (Mt 6:25), and also ‘heterologous techniques are primal and insuppressible good his exhortation not to be afraid “burdened’ by the “ethical neg- which is the root and condition ‘of those who kill the body but ativity” of conception outside of every other good-right of the cannot kill the soul (Mt 10:28).32 marriage. Recourse to gametes person’.28 Thus abortion is not I agree: the duty that certain of people other than the spouses first of all or above all else a professionals possess of expos- is contrary to the unity of mar- question of self-determination ing their own lives to danger to riage and the fidelity of the as regards the woman, and/or the point of being able to lose spouses, and it harms the right conscientious objection on the them confirms the thesis. For of the child to be conceived part of the medical doctor. ‘The that matter, martyrdom is the born in and from a marriage’.25 inviolability of the innocent hu- most convincing proof. Howev- Such techniques ‘offends the man being’s right to life from er, later on, in relation to thera-

DOLENTIUM HOMINUM N. 62-2006 peutic abortion, it is asserted cally immoral, and this is the would regulate the beginning that ‘moral theology has always case with a law that allows, at and the end of life. Indeed, sci- supported the principle of legiti- the level of principle, the licit- ence and technology run faster mate defence and the lesser evil, ness of abortion’.40 Indeed, the than the rest of society and even even though this is a reality that Church has always taught that of members of parliaments. demonstrates the dramatic char- the civil law should conform to Thus every scientist and every acter and the fragility of the hu- the moral law. ‘Authority’, de- technologist should, in their man condition’.33 clared John XXIII, ‘is a postu- own field, face up to their own As regards legitimate de- late of the moral order and de- responsibilities but, given that fence, the Catechism of the rives from God. Consequently, rational evaluation is always in- Catholic Church teaches that laws or decrees enacted in con- dispensable, members of parlia- this ‘is not an exception to the travention of the moral order, ments, or rather supra-national prohibition against the murder and hence of the divine will, can institutions, should, it is said, on of the innocent that constitutes have no binding force in con- the basis of the common feel- intentional killing. ‘The act of science…indeed, the passing of ings of citizens, establish rules self-defence can have a double such laws undermines the very of responsibility, balanced by effect : the preservation of one’s nature of authority and results the assessment of risks and con- own life and the killing of the in shameful abuse’41 I would sequences.45 At this point it is aggressor…the first is intended, here like to observe that this is affirmed that researchers must the second is not’’.34 The reason not a ‘confessional’ stance but a always contribute to the good of for this is that ‘Love toward stance that derives from rational life and never the opposite, and oneself remains a fundamental logic. Indeed, any law made by for this reason they must also at principle of morality. Therefore men, because it derives from times halt and not go beyond it is legitimate to insist on re- natural law, has the force of law. the limits but instead respect the 39 spect for one’s own right to life. Thus whenever a law is in con- uncrossable parameters of the Someone who defends his life is trast with natural law it would dignity of every human exis- not guilty of murder even if he not only not be law but would tence. However, this is not a is forced to deal his aggressor a be its corruption.42 For this rea- matter of appealing to faith or lethal blow’.35 Now, and here son conscience requires its pri- religion but of relying on the we encounter the non-applica- mary right and appeals to the ethical sense that each person bility of the principle, the un- primary role of divine law: ‘We has within them. One wants a born child is never an unjust ag- must obey God rather than men’ great effort of conscience and a gressor of his mother. For this (Acts 5:29). I will not enter the good measure of good will to reason, ‘since the first century question of euthanasia because ensure that man does not devour the Church has affirmed the the same approach applies to man but, rather, serves him and moral evil of every procured the termination of life. A law promotes him. As regards the abortion. This teaching has not that authorises or fosters eu- Catholic Church, emphasis changed and remains unchange- thanasia places itself radically should be laid first and foremost able. Direct abortion, that is to not only against the good of the on her task of forming con- say, abortion willed either as an individual but also against the sciences, but prohibitions and end or a means, is gravely con- common good, and thus it is to- otherwise, especially if prema- trary to the moral law: You shall tally without authentic juridical ture, will not be useful. What is not kill the embryo by abortion validity. It follows from this that needed is the formation of and shall not cause the newborn when a civil law legitimises eu- minds and hearts to respect, to perish’.36 The documents of thanasia it ceases, for that very love and serve the dignity of the the Church do not underesti- reason, to be a real civil law that human person in every manifes- mate certain problems, indeed is morally binding’.43 tation, with the certainty that she draws attention to them ex- every human being is destined plicitly.37 However, those who to participate in the fullness of presume to bring to bear on Conclusion divine life and that this also re- these problems solutions that quires sacrifices and renuncia- are not honest, even that of ‘Today, the human race is in- tions.46 One cannot but be in killing, are reminded by the volved in a new stage of history. agreement with these general Second Vatican Council that Profound and rapid changes are indications regarding the task of ‘For God, the Lord of life, has spreading by degrees around the the Catholic Church; indeed, I conferred on men the surpass- whole world. Triggered by the emphasise them. In the whole ing ministry of safeguarding intelligence and creative ener- dialogue, however, I observe life…Therefore from the mo- gies of man, these changes re- the lack of answers to the un- ment of its conception life must coil upon him, upon his deci- derlying theories of subjec- be guarded with the greatest sions and desires, both individ- tivism, relativism and teleolo- care while abortion and infanti- ual and collective, and upon his gism in general,47 but above all cide are unspeakable crimes’.38 manner of thinking and acting in the field of life in particular. I And the Congregation for the with respect to things and to believe that I have provided, Doctrine of the Faith makes people’.44 However much this even per eccessum, the docu- clear that ‘life, in fact, is too statement by the fathers of the ments of the Magisterium ad fundamental a good for it to Second Vatican Council may be rem, which express and explain placed in relation to certain in- more than right, they could not the teaching of the Church with convenient facts, even very yet know about scientific the greatest clarity. I would like grave ones’.39 Thus ‘man must progress and that technological once again, in conclusion, to never obey a law that is intrinsi- advance in the mechanisms that specify the pedagogic value of

DOLENTIUM HOMINUM N. 62-2006 the prohibitions, of the ‘no’s of have a religious character, nor 23 Charter for Health Care Workers, Vatican City, 1995, n. 22. God and thus of the Church: even a Christian one. These are 24 Cf. Ibidem. ‘God’s commandments teach us natural truths and values ex- 25 Ibidem, n. 27. the way of life. The negative pressed in natural law and guar- 26 Congregation for the Doctrine of moral precepts, which declare anteed by natural law. Indeed. the Faith (CDF) Instruction Donum vi- tae, 22 Feb. 1987, in AAS, 80 (1988) , pp. that the choice of certain actions ‘The moral law presupposes the 87-89. is morally unacceptable, have rational order, established 27 Martini-Marino, p. 57. an absolute value for human among creatures for their good 28 Charter for Health Care Workers, n. 46. freedom: they are valid always and to serve their final end, by 29 CDF, Instruction Donum vitae, pp. and everywhere, without excep- the power, wisdom and good- 75-76. tion. They make it clear that the ness of the Creator. All law 30 CDF, ‘Dichiarazione sull’eutana- sia’, 5 May 1980, in AAS 72, 1980. p. choice of certain ways of acting finds its first and ultimate truth 544. is radically incompatible with in the eternal law. Law is de- 31 Martini-Marino, p. 57. the love of God and with the clared and established by reason 32 Ibidem. dignity of the person created in as a participation in the provi- 33 Martini-Marino, p. 58. 34 CCC, n. 2263; see St. Thomas, his image. Such choices cannot dence of the Living God, Cre- Summa theologiae, II-II, 64, 2. be redeemed by the goodness of ator and Redeemer of all. ‘Such 35 CCC, n. 2264. any intention or of any conse- an ordinance of reason is what 36 CCC, n. 2271. see the references: 51 Didache, 2,2; cf. Ep. Barnabae 19, 5; Ad quence; they are irrevocably op- one calls the law’’ . Thus only Diognetum, 5,5; TERTULLIAN, Apologeti- posed to the bond between per- when scientific progress and cus, 9; see B. HONINGS, Miscellanea, sons; they contradict the funda- technological advance accept Iter Fidei et Rationis, vol. II, Moralia and vol. III, Jura/Lateran University mental decision to direct one’s the ordinance of reason do they Press, 48 life to God.’ For this reason I really place themselves at the 37 ‘It is also true that in certain cases, would not refer so much to the service of the dignity of the hu- by refusing an abortion, other important 40 goods – which it is only normal that one limits of science and technolo- man person and of the common would want to safeguard – are put in gy, because man is always a good of society. jeopardy. These could be: danger to the limited being, as to their reli- mother’s health, the burden of another gious-moral direction. In the de- Rev. BONIFACIO HONINGS child, a serious malformation of the fe- tus, a pregnancy caused by rape. These sign of the Divine Creator man OCD, problems cannot be ignored or mini- and woman are called to ‘domi- Emeritus Professor mized, nor the reasons supporting them’ nate’ the earth as its ‘stewards’, of Moral Theology, (Charter for Health Care Workers, n. The Pontifical Lateran University, 141). thus not as arbiters but as partic- Rome, 38 GS, n. 51. ipants in divine Providence to- Consultor to the Pontifical council 39 CDF, ‘Dichiarazione sull’aborto wards other creatures. Hence for Health Pastoral Care, procurato’, 18 June 1974, in AAS The Holy See. 66(1974), p. 739. their responsibility towards the 40 Ibidem, p. 744, n. 22. world that God has entrusted to 41 JOHN XXIII, Pacem in terris, (11 them. This collaboration has a April 1963) II: AAS 55 (1963), p. 271, character all of its own, which is quoted by JOHN PAUL II in Evangelium Notes vitae, n. 72. specific and unique, in the 42 Cf. ST. THOMAS Summa theologiae, transmission of life, when God, 1 BENEDICT XVI, Address to the I-II, q, 93, a. 3 ad secundum. in marriage, unites them to form Members of the Biblical Commission, 43 Cf. JOHN PAUL II, Evangelium vitae, L’Osservatore Romano, Friday 28 April n. 72. a ‘single flesh’ (Gen 2:24). It is 2006, p. 5. 44 GS, n. 4. in this way that a man and a 2 Ibidem. 45 Cf. Marini-Marini, 61. woman co-operate as spouses 3 Cf. the conversation between Carlo 46 Ibidem. MARIA MARTINI AND IGNAZIO MARINO, 47 Cf. JOHN PAUL II, Veritatis splen- and parents in a unique way in Dialogo sulla vita, edited by Daniela dor, 6 August 1993, in AAS 85, 1993. the work of the Creator, obey- Minerva, L’Espresso, 27 Aprile 2006, The moral life ‘has an essential “teleo- ing the divine mandate ‘be fruit- pp. 52-61, hereafter Martini-Marino, p. logical” character, since it consists in the ful and multiply’ (Gen 1:28).49 4 JOHN PAUL II, Evangelium vitae, 25 deliberate ordering of human acts to March 1995, n. 28; hereafter Ev, God, the supreme good and ultimate end In the light of these absolute 5 Ecumenical Second Vatican Coun- (telos) of man. This is attested to once truths about the non-negotiable cil, Gaudium et spes, (GS), n. 19. more by the question posed by the young values of life, the Magisterium 6 Cf. Catechism of the Catholic man to Jesus: “What good must I do to Church (hereafter CCC), n. 31. have eternal life? “. But this ordering to of the Church seeks to help 7 GS, n. 18. one’s ultimate end is not something sub- mankind to advance along the 8 CCC, n. 33. jective, dependent solely upon one’s in- way of life and authentic free- 9 CCC, n. 34: see St. Thomas tention. It presupposes that such acts are dom. ‘In contemporary circum- Aquinas, Summae theologiae, I, 2,3. in themselves capable of being ordered 10 JOHN PAUL II, Evangelium vitae. n. to this end, insofar as they are in confor- stances’, declares Benedict 2. mity with the authentic moral good of XVI, ‘in appealing to the value 11 Ibidem. man, safeguarded by the command- that certain fundamental ethical 12 Ibidem. ments. This is what Jesus himself points 13 Ibidem. out in his reply to the young man: “If you principles that are rooted in the 14 CCC, n. 1731. wish to enter into life, keep the com- great Christian heritage of Eu- 15 Cf. BENEDICT XVI, end of the ad- mandments” (Mt 19:17) (VS, n. 73). Cf. rope have not only for private dress cited above. B. Honings, ‘Il discernimento di alcune 16 Cf. Gaudium et spes, n. 50. dottrine morali ed etiche. Una lettura del- but also for public life…we do 17 Cf. Evangelium vitae, n. 43. la ‘Veritatis splendor’’ in Veritatis not engage in any violation of 18 Evangelium vitae, n. 14. splendor. genesi, elaborazione, signifi- the secularity of the state but 19 JOHN XXIII, Encyclical, Mater et cato, edited by Giovanni Russo (ED, Magistra, III in AAS 53, 1961, p. 447. Rome, 1994), pp. 131-153. contribute, rather, to assuring 20 48 Cf. JOHN PAUL II, ‘Udienza generale Evangelium vitae, n. 75; cf. CCC, and promoting the dignity of the 16 gennaio 1980’, in Insegnamenti III/1 nn. 1753-1755; John Paul II, Veritatis person and the common good of (1980), pp. 148-152. spendor , nn. 81-82. 49 50 21 Cf. PIUS XII. ‘Alle congressiste del- Cf. CCC, nn 372-373. society’. Indeed, at their be- 50 l’Unione Cattolica Italiana Ostetriche’, BENEDICT XVI, L’Osservatore Ro- ginning the truths about life, 29 Oct. 1951, in AAS, p. 43, 1951, 850. mano, Friday 19 March 2006, p.5. marriage and the family do not 22 Martini-Marino, p. 55. 51 CEC, 1951.

DOLENTIUM HOMINUM N. 62-2006 Human Life: a Precious Gift of God

DOCUMENT OF THE BISHOPS’ CONFERENCE OF SPAIN

‘The Gospel of life is at the mandment ‘thou shalt not kill’, human person and thus an invio- heart of Jesus’ message. Loving- which preserved the gift of hu- lable human dignity’. ly received day after day by the man life, is a rule which every As a result ‘the human being Church, it is to be preached with healthy culture has recognised is to be respected and treated as dauntless fidelity as “good as being a fundamental princi- a person from the moment of news” to the people of every age ple. The right to life and respect conception, and therefore from and culture’ (Evangelium Vitae, for the dignity of the person are that very same moment his hereafter EV, n. 1). values that the Universal Decla- rights as a person must be ration of Human Rights presents recognised, among which in the as a foundation for living to- first place is the inviolable right 1. The Preaching gether in society. of every innocent human being of the Gospel of Life This recognition at a univer- to life’ (EV, n. 60). This truth of sal level finds full confirmation the gospel of life is broadly Ten years ago, and more ex- in the revelation of he gospel of shared by many people and in- actly on 25 March 1995, Pope life with the mystery of Christ. stitutions. What the Council of John Paul II published the en- Human life, a precious gift of Europe stated many years ago 41 cyclical Evangelium Vitae. The God, is sacred and inviolable. has been adopted by the United Church, which ever since the ‘Human life is sacred because Nations in its recommendation time of the Apostles has from its beginning it involves in favour of the prohibition of preached the value of human ‘the creative action of God’, and research on embryos and any life, works with ever greater in- it remains forever in a special type of human cloning, whether tensity to defend life and to care relationship with the Creator, reproductive or therapeutic. for those most in need. In this who is its sole end. God alone is service to life, the encyclical the Lord of life from its begin- Evangelum Vitae represents a ning until its end: no one can, in milestone. any circumstance , claim for In continuity with the teach- himself the right to destroy di- ings of John Paul II, we, Pastors rectly an innocent human being’ of the ‘People of Life’, give (EV, n. 53). For this reason, thanks to God the Father for the every attack on human life is an gift of life. In the fullness of attack on reason and on justice time, He sent us His Son, born and is a grave offence against of the Virgin Mary, so that men God. could have life in abundance, a ‘new’ and ‘eternal’ life, ‘which consists in communion with the 3. A Fundamental Continuity Father, to which every person is freely called in the son by the The process of being an em- power of the Sanctifying Spirit’ bryo is a continual process in (EV, n. 1). which, from the very beginning, On the occasion of this an- what we have in front of is a hu- niversary, and following the rec- man life. The embryo is not a 4. At the Service of Life ommendation of the LXXXI mere aggregate of living cells plenary assembly, we extend an but is, rather, the first stage of In the recognition and respect invitation to ensure that the existence of a human being. All for life, as in its promotion, sci- solemnity of the Incarnation – of us were embryos. ence achieves its highest pur- which in the year 2005 is com- From the moment of fertilisa- pose: service to life and to the memorated on 4 April – is cele- tion there is a human life and dignity of the person. The last brated in the right way with var- thus personal dignity. It is a hu- ten years since the publication ious initiatives that act to make man life that develops and expe- of the encyclical Evangelium Vi- known, and preached in our riences important morphologi- tae have been years of great ad- churches, consideration and re- cal changes but we are always vance for science which, indeed, spect for life, which, indeed, dealing with the same continual have opened up new possibili- constitute the heart of the mes- process that goes from the be- ties – full of hope – of preven- sage of this encyclical. ginning of life with fertilisation tion and treatment. until death. ‘The body of course Thanks to these develop- develops, but in a fundamental ments, forms of treatment and 2. The Value of Human Life continuity that does not allow care, and even intra-uterine op- any stage of its development to erations to help the unborn All cultures have universally be defined as pre-human or child, have been made possible. recognised the value and the post-human. Where there is a In addition, the time that is dignity of human life. The com- living human body, there is a needed in a pregnancy to ensure

DOLENTIUM HOMINUM N. 62-2006 that a premature baby can sur- can, indeed one must, place the reason, the celebration of the vive outside the maternal womb question of the presence in this day of life could be a valuable is growing increasingly smaller. case of another ideology of evil, opportunity for families to ac- For that matter, the therapeutic which at times is more insidious quire a deeper awareness of application of mother cells de- and concealed, which seeks to their mission of service to life. rived from adult tissue have ob- attack human rights, against the tained results that give rise to re- family and persons’. alistic hopes. True therapies are 6. Affective-Sexual those that provide treatment Upbringing without causing damage or 5. The Family: and Education eliminating a person’s life. a Sanctuary of Life We cannot forget that these The family is also the context advances are powerful instru- ‘So God created man in his in which children learn about ments that must be used at the own image, in the image of God the meaning of sexuality at the service of man, bearing in mind he created them; male and fe- service of love and the family. ethical principles. Science and male he created them. And God We bishops have often observed technology need ethics so as not blessed them and God said to the need and the urgent necessi- to degrade human dignity but to them: ‘Be fruitful and multiply’ ty for suitable affective-sexual promote it. For this reason, we (Gen 1, 27-28). The gospel of upbringing. This has a privi- call on all researchers and cen- life begins with Adam and Eve, leged position in pastoral care tres of education and training to who were called to conjugal for families because ‘the voca- inculcate respect for life in love and through their love to be tion to love, which is the guid- everyone and to deepen people’s parents, thereby co-operating in ing theme of all pastoral care for 42 knowledge so that this knowl- a singular way with the creative marriage, requires especially edge can be places at the service work of God. careful attention to be paid to of others. Conjugal love between a man education in love’. and a woman, the foundation of In the Directory of Pastoral the family, is the holy context in Care for Families (DPF) of the which a person is conceived Spanish Bishops it was ob- with dignity. A child is born served that ‘parents are the first from the love of the parents and to be responsible for education is invited to share in their com- in sexuality, in the years of munion of love. The family is childhood as during adoles- also the sanctuary in which life cence. They must know how to is received with joy and cele- be able to offer their children, in brated in daily life and is en- a climate of trust, those explana- riched by the rich relationships tions that are suitable for their between parents, children, age so that they can acquire grandchildren, etc. knowledge about, and respect These families are a splendid for, their own sexuality on a proclamation of the gospel of pathway of personalisation. One life and are a reason to render always obtains more by per- thanks to God: families that suading than by prohibiting, es- notwithstanding crises and diffi- pecially when one is dealing cult moments know how to re- with education’ (DPF, n. 81). We thus exhort everyone to main united in love; families At the right moment, the cate- always promote life in the face that despite the difficulties live chesis should also address the of very many threats to it posed in a way that is generously open question of sexuality and the by a ‘culture of death’ which ex- to life; families that support discernment of vocation. ‘In the presses itself in many ways: their weakest and most in need process of the catechesis, during contraception, the widespread members with their time and the distinct moments that char- use of sterilisation, the worrying their best energies, and so forth. acterise this stage, a complete decline in birth rates, abortion, All these families, very many of and profound catechesis on sex- the morning-after pill (which in which are Christian families, are uality in its different dimensions addition to being a contracep- a living magnificent witness to (the anthropological, the moral, tive is also abortion- inducing); the value of life and provide a the spiritual, the social, the psy- the manipulation of language valuable service to society. chological, etc.) is to be present’ where reference is made to ‘pre- This generous witness of very (DPF, n. 62). embryos’ as though they were many families is the best school Schools also have an impor- not already human persons to for children there is by which to tant role to play in this endeav- the full, the selection and the de- learn the sacred value of human our: ‘as a complement to. and a struction of embryos, the manip- life and to respect and promote help for, the task of the parents, ulation and destruction of em- the lives of everyone, and espe- it is absolutely necessary for bryos so as to obtain mother cially the lives of the weakest. Catholic schools to draw up a cells for research, and the al- The joy of a family in receiving programme of affective-sexual ways threatening practice of a new life is the best proclama- education, beginning with meth- cloning. These expressions of tion there is in front of children ods that have been sufficiently the culture against life are an in- of the sacred value of conceived tried and tested and with the su- sidious ideology of the evil con- life and of the life that is still to pervision of the bishop. The demned by John Paul II: ‘One be born of a new child. For this Diocesan Delegation of Pastoral

DOLENTIUM HOMINUM N. 62-2006 Care for the Family must pre- islation. It is a sign of hope to Immaculate Mary, the mother of pare people who are expert in see the presence of family asso- life, the prayer with which Pope this field’ (DPF, n. 93). ciations in the social debate en- John Paul II ended his encycli- We are all aware of the urgent gaged in promoting the values cal: need for this affective-sexual of the family and the values of education and of its relationship life. In doing this they con- ‘O Mary, with the gospel of life. For this tribute in an effective way to the bright dawn reason, we exhort everyone to drawing up of a suitable policy of the new world, implement the indications of the towards the family (which, in- Mother of the living, Directory for Pastoral Care for deed, is very urgently needed) to you do we entrust the Family, ad to pay especial that will promote access to the cause of life attention to the overall training housing, to work and to eco- Look down, O Mother, of expert people to perform this nomic conditions that are com- upon the vast numbers task. patible with motherhood and fa- of babies not allowed therhood, and also bears upon to be born, the availability of that time of the poor whose lives 7. For a Culture of the which is needed to look after a are made difficult, Family and of Life family and after life as a gift of of men and women God. who are victims of brutal In educating young people in It was in this sense that John violence, love and life we will lay the Paul II in his encyclical Evan- of the elderly most solid foundations there are gelium Vitae exhorted us with and the sick killed for a culture of the family and of the following words: ‘To be tru- by indifference life. But this function requires ly a people at the service of life or out of misguided mercy. 43 the commitment and involve- we must propose these truths Grant that all who believe ment of everyone. Scientists in a constantly and courageously in your Son particular way are entrusted from the very first proclamation may proclaim the Gospel with the task of preserving the of the Gospel, and thereafter in of life value of life in the ‘conscience’ catechesis, in the various forms with honesty and love of researchers and society. As of preaching, in personal dia- to the people of our time. people who are experts, they are logue and in all educational ac- Obtain for them the grace listened to by society, by the tivity. Teachers, catechists and to accept that Gospel mass media, and by politicians. theologians have the task of em- as a gift ever new, For this reason, we call on them phasizing the anthropological the joy of celebrating it to proclaim with courage the sa- reasons upon which respect for with gratitude cred value of human life from every human life is based. In throughout their lives the moment of conception and this way, by making the new- and the courage to bear not allow themselves ever to be ness of the Gospel of life shine witness to it seduced by possibilities that are forth, we can also help everyone resolutely, in order to build, contrary to ethics. discover in the light of reason together with all people Health care professionals also and of personal experience how of good will, have an important task. It falls the Christian message fully re- the civilization of truth to them, indeed, to always sup- veals what man is and the mean- and love, port life, and to reject and to ing of his being and existence. to the praise and glory condemn every practice that at- We shall find important points of God, tacks the integrity or the life of of contact and dialogue also the Creator and lover of life’ people, the life of the weakest with non- believers, in our com- (EV, n 105). among us such as embryos, un- mon commitment to the estab- born children, the disabled, the lishment of a new culture of life’ Madrid, 4 April 2005, elderly and the terminally ill. (EV, n. 82). Solemnity of the Incarnation Here we would like to observe once again the advisability of H.E. Msgr JULIAN promoting processes that in- 8. Prayer for Life to BARRIO BARRIO volve adoption and we suggest the Immaculate Mary Archbishop of Santiago this possibility to those people di Compostela, who are considering the possi- We would like to end this President of the Bishops’ Conference bility of engaging in an abor- message on the occasion of the of Spain tion. We also appeal to Catholic tenth anniversary of the encycli- professionals, especially those cal Evangelium Vitae by invok- H.E. Msgr JUAN ANTONIO involved in the world of infor- ing Mary, the mother of Love, in REIG PLA mation, to make their presence this year that the Church of Bishop of Segorbe-Castellón, President of the Sub-committee for felt in the mass media so that in Spain is dedicating to the mys- the Family and the Defence of Life the mass media the message of tery of her Immaculate Concep- the gospel of life is heard and tion. To her we entrust the cause H.E. Msgr JAVIER MARTÍNEZ rings out. of life. Under her protection we FERNÁNDEZ All Christian professionals at place families, the sick, the Archbishop of Granada a personal level or at the level of weakest and the most threat- associations must exercise their ened, while at the same time we H.E. Msgr FRANCISCO influence in a responsible way invite all Christians, and in par- GIL HELLÍN in society and in relation to leg- ticular families, to address to the Archbishop of Burgos

DOLENTIUM HOMINUM N. 62-2006 Modern Society in Conflict Between the Culture of Life and the Culture of Death

Modern society is experienc- for vigorous commitments to derous sports, tragic games, ing conflicts that some people arise in order to respond to the speed and accidents on an as- believe are generational; others needs of redemption and the re- phalt that is often soaked in hu- think that they are the result of quirements of love that one can man blood… differing religious approaches; see emerging in particular in Other millions die, are killed, and yet others attribute them to men oppressed by sadness and out of desperation; because of forms of fundamentalism, to the by mourning. In the recess of hunger; because of thirst; be- so-called hawks who prevail the human heart the culture of cause of a lack of help or be- over the doves. There are also death is fomented by powers cause of late or inadequate med- those people who see an eco- against man; this culture is also ical care and treatment; because nomic opposition: the peoples taught from university teaching of incompetence or neglect; be- of hunger who call on the peo- chairs when they are occupied cause of an insufficiency of ples of opulence: the countries by criminals of the spirit; it pro- health-care staff, of hospital of the East and the countries of vokes the worst forms of behav- beds, or of the necessary equip- the West of the world, the coun- iour in man and peoples. It ment; or because of the removal tries of the North and the coun- achieves scandalous successes vital human organs before the 44 tries of the South of the world. but brings with it ruin and de- patient has died… All of this has an enormous im- stroys itself. When it achieves These tragic situations against pact but the gravest conflict, victories it dissociates hearts, life are in front of the very eyes which today requires to be consciences and peoples. of everyone but there are those solved with wisdom and love, is It is certainly the case that one who pretend that they know of a cultural character. Modern cannot and one must not impose anything about this. They rave society finds itself between the choices of faith: to affirm and to about wanting to legislate or se- culture of life, which makes it defend the right to life and the cure the passing of laws on ex- strong, and the culture of death, value of life is a duty for every- aggerated treatment, or on bio- which destroys it. one, believer and non-believer logical wills, which are not un- Even before the social level, alike. derstood uprightly in a scientific in the heart of man strong duels Experience proves that the way but are seen as instruments between these two opposing non-believer encounters greater of euthanasia, even of passive cultures are fought out. Man can difficulties in honouring this du- euthanasia. use his intelligence and his free- ty. However, it is not right to There are those who in a cyni- dom in a upright way; strong in look for and offer deceitful cul- cal way instead of obtaining God and faithful to His law of tural mediations, which are bread for those who are dying of mercy, he can continue in good gravid in fatuity and compro- hunger and water for those who and the culture of life; meek mises, with inhuman and cyni- are dying of thirst, or providing with divine mercy, he can revisit cal hypocritical forms of selfish- relief to those who suffer, urge himself, desist from choices in ness that camouflage them- them, and want to impose on favour of death, not die, and selves under appearances of re- them by law: not having indi- live. Or he can abuse life as spect for conscience, freedom, gestion…, removing the distur- well; do wrong and go on doing humanity, the defence of bance of not seeing them suf- wrong; he can engage in choices women, sensitivity, delicacy, fer…, allowing to die and being for death; induce others into er- and a kind heart. killed… ror; he can also drag down who It is never licit for anyone to In this perverse approach the is just, but weak. He can make kill, nor, and even worse, is it emphasis is placed on quality of him his victim… ever licit to legalise the killing life and not on its value; on dy- Love for life, a commitment of innocents, especially if they ing with dignity and not on the to defend and affirm its culture, are undefended and defenceless. right to live and being helped to are required for one to be faith- And yet there are millions of un- live in order to carry out, even ful to man, to his history and to defended and defenceless inno- unknowingly, one’s mission. God. The cult and the defence of cents who are treacherously Quality of life is not improved life could be rediscovered as a killed through abortion. Inno- by eliminating life. To die with light that illuminates the counte- cent blood cries out. Even dignity absolutely does not nance of every man of good though one may not be capable mean to condemn oneself or to will, who is commonly called an of listening to the silent cries of be condemned to death and to anonymous Christian. the killed, this reality is more be killed by one’s own will or Every Christian, even an tragic and more impious than by that of others or by law. anonymous Christian, can be the very many wars when taken as a At this point I will consider carrier and the implementer of whole. the patients at Cottolengo in this promise: ‘the land that was Other millions of human per- Turin, the paralysed and those in desolate shall be tilled’.1 It is sons are killed in a large number need of everything, those afflict- comforting to apply this of ways: murder, suicide, infan- ed by progressive multiple scle- promise to the land of the heart ticide, wife-killing, parricide, rosis, those with dementia, those of man. However, it is necessary drugs, alcohol, weapons, mur- afflicted by Alzheimer’s disease,

DOLENTIUM HOMINUM N. 62-2006 old people who are very ad- Blood, especially innocent the separation between law and vanced in years, and those who blood, can purify and fertilise justice with the abuse of power suffer from Parkinson’s disease. this arid land, this land of death; and rigorously restrictive or per- It is certainly the case that in a it can transform it into a land missive methods, to the full ad- conscious or unconscious way where the culture of life buds vantage of the violent and with they do not experience a good and flowers. Indeed, the last the injury of the honest. quality of physical life, nor is word does not lie with those – An economy in line with the there any hope that their physi- who kill the but can no longer principal of the universal desti- cal condition will improve. The do anything2… because the spir- nation of goods and the right to condition of those in comas is it is immortal.3 private property, or with selfish different. Experience teaches us In other contexts as well it is and enslaving possessiveness, in that where there is life there is advisable to see the life in a per- situations not of common well- hope. Many comas, thought to spective that involves: being but imbalanced ones with be irreversible, even after a – The family, created in the impoverishment and enrich- marked number of years have design of the creation, in digni- ment, exploitation and greed, lifted. Only after its negative ty, in fidelity and in fertility, in hunger and miserliness… conclusion can one say in scien- holiness, or betrayed in infideli- tific terms that a coma was irre- ty, violated and undermined in Life, family, homeland, safe- versible. Whatever the case, no tragic, absurd and impious ty, culture, justice, and the econ- person can deprive another per- forms. omy rise up like seven pillars son who has been in a state of for the temple of life. It is neces- coma even for many years or sary to construct that temple and has reached the terminal stage not to dig sepulchres for the of his or her infirmity of a little dead. We are all called to carry 45 oxygen, of water, of the neces- out this work of construction, to sary food. There can be no di- be a people of life and for life. rect or indirect action that accel- In the Church we are all invit- erates the ending of life. ed and committed to the defence But I ask: what criminal can of the culture of life. To follow decide or pass legislation to kill Christ. Those who are standing all of them and accelerate death must be careful not to fall.4 of even only one of our Those who lack strength and brethren? A medical doctor who have fallen should remember is a friend of mine said to me: that with the help of God one ‘well that’s the way it goes. A can renew one’s strength.5 doctor prescribes an injection to Those that lie in the culture of be made when his round had death should feel the urgent ex- finished. The day after that he hortation to shake off this condi- returns and finds that the bed of tion of theirs and rise from the the patient, who has died, is oc- dead and not oppose Christ who cupied by another patient’. That wants to illuminate them and is to say that patient was killed – The homeland and the state, wants to shine forth on them.6 and made to be killed by him! I with structures and institutions, In order to rise up, so as not to advised that doctor to change well rooted in its own culture, fall, in order to defend oneself his ideas or to change his pro- faithful to that culture, or cor- and save oneself from errors and fession. rupted through the worst histori- from the culture of death there is Life is always valuable. Even cal experiences, without roots, the Word of God and the sacra- if it involves suffering, even if without memory, irreverent, ments, there is the Magisterium unconscious, even if economi- with rebels, under the dominion of the Church, and there is the cally unproductive, even if of the culture death. divine force of prayer. The physically disabled and not au- – Safety, that is ready, with Christian witness of men and tonomous. It is always valuable. heroic acts as well, to uphold women, of young people, of el- Nobody, specifically nobody, truth, freedom, justice, and derly people and of children, of can, as Hitler did, see a person peace, or ready to launch into the gifted and of the ignorant, il- as a ‘useless mouth’. Hitler was transgression, induced to justify luminated and made strong by defeated and condemned. It and carry out revolutions, terror- divine grace are heroic Teachers seems, however, that today his ism, armed struggles, with be- and Witnesses, the cultivators criminal ideas against life are trayals as well. and defenders of life, is some- unfortunately triumphant and – Culture in its multiple as- thing that is valuable. These have achieved hegemony! pects, with activities sustained people do not fall, they remain I have avoided presenting sta- in their noble end, freed from standing, or, if they fall, they tistical tables on killed human the culture of death, or servile trust in the mercy of God,7 and lives; they are many, very many, and subjected to that culture, they are immediately risen up, indeed millions in number. The lazily resigned to endure it in or- they rise up, and they remain in- situation is tragic and quantita- der to have a quiet life, and trepid even unto martyrdom. tively striking but even one life without adequate provisions. Everyone can feel that to is a masterpiece that is worth – Law and justice with the ap- them is addressed the biting ex- more than the whole world… plication of just laws for the de- hortation of Herder: ‘let us Can one hope? The answer is fence of the innocent and the re- work, my friends, with coura- ‘yes’. Hope does not disappoint. habilitation of the guilty, or with geous and happy hearts, perhaps

DOLENTIUM HOMINUM N. 62-2006 amongst the clouds, since we the Church once again in a the culture of life and in the tri- work for a great future. And let solemn way has proclaimed that umph of God Christ. us give ourselves a task which Jesus is the Lord,14 and in the In the choices that we are as much as possible is pure, heart of man ‘the Halleluiah of called to make between the cul- clear, without blemishes: now, the Living One, who gave a new ture of life or the culture of in fact, we are running amongst spring to history’15 has found death we are not left abandoned the fatuous fires, in the light of resonance in the hearts of man to ourselves. Christ guides us, twilight, in the mist’8. After and has re-echoed in his home the Blessed Virgin takes us by quoting such striking words one and in the world. Every man is the hand, the Mother of the Liv- should observe that the light of waiting for the new spring, the ing, the Mother of the Church. the Magisterium of the Church spring of the culture life, which In the Church, with the light and always illuminates us with the will achieve its full triumph in the strength of the Holy Spirit, infinite, with the eternal. It the spring of the resurrection of the Pope guides us, the defender strengthens our faith in Christ bodies. of life, together with the Pastors who came to save the world,9 he For resurrection in glory the who are in communion with is the saviour of the world,10 he drawing near to eternal life must him. gave himself for the life of the be well effected. Exemplary world.11 models are not in short supply. Msgr. VINCENZO DI MURO To everyone grace is given Each person can remember Italy for the maturation of the con- them and imitate them. science in relation to life; for ed- I have in my mind the draw- ucation in freedom; to repair ing near of Cardinal Corrado evil that may be done; to en- Ursi to eternal life and I remem- 46 counter Christ who came to give ber what is recommended by the Notes life in abundance: ‘I came so Author of the Letter to the He- 1 Ez 36, :34, that they may have life and have brews: ‘Remember your lead- 2 12 Cf Mt 10, :28; Lk 12: 4. it in abundance’ . ers, those who spoke to you the 3 Cf Wis 2:23; 3, 2-5; Lk 20:35-36; 1 In this mystery of life and sal- word of God; consider the out- Cor 15:53; 2 Tim 1:10. vation everyone should encour- come of their life, and imitate 4 Cf. 1 Cor 10:12. 5 Cf. Is 40:31. age us and honour us. At the lev- their faith. Jesus Christ is the 6 Cf Efph 5:14. el of ideals I here relive what same yesterday, today and for 7 Cf S. BENEDICTI, Regula Monasteri- happened with the Great Jubilee ever. Do not be led astray by di- orum, chap. IV. 8 J. G. HERDER, J. G. HERDER, Ancora of the year 2000, which marked verse and strange teachings; for una filosofia della storia per l’edu- the triumph of the culture of life: it is well that the heart be cazione dell’umanità, translated by. di F. the pilgrims of the Jubilee who strengthened by grace.16 VENTURI, Turin, 1971, p. 118. came to Rome were received The culture of death is a di- 9 Cf Jn 12:47. 10 Cf Jn 4:42. with love by the great John Paul verse and strange teaching. It 11 Cf JN 6:51. II, who thanked them at the lev- agitates and tempts every man, 12 Cf Jn 10:10. el of their different categories of who is often torn between the 13 Cf. Jn 14:6. 14 CONGREGATION FOR TJE DOCTRINE membership, blessed them, and culture of life and the culture of OF THE FAITH, Dominus Iesus, Vatican directed and drew them, all of death. Those who love life are City, 2000. them, near to Jesus Christ God, built up in the omnipotence of 15 C. URSI. (Card.), La morte e la vita 13 in duello, in Una vita in dono, , Way, Truth, Life. the grace and the witness of 1981, p. 457. Thus it is a coherent fact that leaders share in the victory of 16 Eb 13, 7-9.

DOLENTIUM HOMINUM N. 62-2006 Prison and Conditions for Depression

1. Introduction case of the most ruthless crim- Kraepelin, who introduced the inal, is linked to stress and ex- term of ‘maniac-depressive Depression is an illness that istential shock. It does not ap- psychosis’ (later described as has been widely researched, ply to those individuals who cyclophrenia) into clinical psy- particularly in recent years. feel fulfilled in prison condi- chiatry in 1899 (cf. There are, however, certain tions, which, however, is a , 2000, p. 267). Affec-Sule- conditions for this illness matter of certain psy- tivestrowska illnesses are characterised which, basically, are not dis- chopathology. by the emergence of mood dis- cussed. Although every illness Prisoners – as a globally-un- orders such as mood-lowering (i.e. its symptoms) has a uni- derstood population – are (depression) or mood-rise versal nature, this does not characterised by a greater (mania). Among these, one mean that a given illness is not weakening of their instinct for needs to differentiate between conditioned by circumstances self-preservation than other bipolar disorders (maniac-de- that are likely to increase its people (cf. , pressive, i.e. cyclophrenia) and intensification or direct its 1997, p. 117). ThisSzaszkiewicz is connect- monopolar disorders (depres- course. In the case of depres- ed with disturbed socialisation sive). sion, this is specifically condi- and the impact of the criminal Apart from any individual 47 tioned by prison isolation. lifestyle. A young person, forms of conditioning, prison – Consequently, presenting the brought up in a disordered at least in theoretical terms – above relationships is the aim family with daily occurrences seems to be a natural area for of this article. of aggression and violence, be- the development of bipolar, According to the comes accustomed to these maniac-depressive psychosis. (‘Psychologi-‘Słownik circumstances. This, succes- The basic emotions of prison- calpsychologiczny Dictionary’), depression is sively, results in a diminishing ers are aggression, fear (al- ‘an inhibition, to a varying ex- of the meaning of life (and, though this emotion is not eas- tent, of a man’s mental activi- even, of experience). The ily admitted), anger, and anxi- ty, which manifests itself in a above symptom, combined ety (cf. , 1979). feeling of general dejection with depressive symptoms, These may Kosewskiincrease the degree and frequent delusive behav- may constitute a dangerous ac- of mania, particularly in a re- iour’ ( , 1985, p. 56). cumulation (also in the sense venge situation – which is co- A widerSzewczuk description of depres- of suicidal behaviour) which erced directly by prison condi- sion is given by Norbert Sil- will threaten the prisoner’s tions. In the case of revenge- lamy, who defines it as ‘a more life. blocking, the prisoner may fall or less prolonged pathological Various types of depression into depressive states which state, characterised by sadness, may be observed, whose divi- manifest themselves in down- the decrease of tonus and the sions may be agreed on to a heartedness and discourage- loss of energy. Sufferers from higher or lesser extent. It is ment in relation to the current depression are apprehensive, significant, however, that clin- situation (including the need to devitalised and dispirited, in- ical psychiatry lists depression bear the harsh demands of capable of facing even the among the affective illnesses prison reality). slightest difficulty, which is (Kaplan, Sadock, 1990). It appears from the research why they show no initiative of An affective disturbance is I have been conducting for their own. Suffering from in- ‘an emotional reaction of a several years by means of, capacity, they have a simulta- strong intensification’ (Sil- among other things, the neous impression that their in- lamy, 1995, p. 12) which re- method of participatory obser- telligence, and their attention duces control of one’s behav- vation, that rehabilitation in and memory in particular, iour. As a result, an individual prison conditions ought to be have deteriorated’ (1995, p. becomes increasingly aggres- based on a therapy aimed pri- 50). sive, uses vulgar vocabulary, marily at a person’s emotional However, it is not the task of flies into a rage, and, eventual- life – which, consequently, is this paper to define depression. ly, resorts to violence. When linked to the affective aspect The above general definitions being unable to use violence of depression. The treatment are only employed as a refer- towards another person, he is of such disorders has to be pre- ence point for the following likely to make attempts at self- ceded by gaining the necessary discussion. mutilation through laying vio- recognition of the illnesses that lent hands on himself or exist in the family of a given falling into the state of with- prisoner, given that, according 2. Prison Isolation and Types drawal or depression. to the literature (cf. Angst, of Depression When writing about affec- 1966), suffering from affective tive illnesses, psychologists illnesses results in great part Prison isolation, even in the and psychiatrists refer to Emil from genetic factors.

DOLENTIUM HOMINUM N. 62-2006 3. Depression and from depressive disorders 2) a goal – the cessation of Self-aggression in Jail which are committed with the consciousness – in order to intention of applying self-pun- evade thinking about the Self-aggression in prison ishment. B. (1984) hardships of existence; may have a complicated gene- describes a caseSanecka of a male’s 3) a stimulus – resulting in sis and may take various forms self-castration (the individual unendurable psychological ( 1987, pp. 103- was not a prisoner, though). It pain; 121).Szaszkiewicz, The very fact of impris- resulted from his emotional 4) a stressor – frustrated onment, quite apart from the experiences – the aftermath of psychological needs; question of responsibility or a his difficult family situation 5) an emotional state – a just punishment, is sensed as a which led to a deep sense of sense of helplessness and humiliating interference with guilt about the problems that hopelessness; human freedom. Personal had arisen. Eventually, he de- 6) an internal attitude – am- habits become disrupted by the cided that he had to inflict self- bivalence about living, i.e. a need to conform to prison reg- punishment. willingness to ‘play around’ ulations. Monotony, boredom, The individuals that commit accompanied by wishes for the lack of the sense of self-au- acts of self-aggression are gen- death (the ‘toward life’ atti- tonomy and privacy, as well as erally characterised by a tude with a simultaneous sensory depravity – all these pathological weakening of ‘away from life’ approach); factors evoke a depressing their instinct for self-preserva- 7) a cognitive state – the sense of a lack of life opportu- tion, which may also be a constriction of horizons; nities such as satisfying one’s symptom of depression. Nev- 8) a type of action – escape; needs, receiving interesting ertheless, it is certain that self- 9) an interpersonal act – the 48 impressions, and gaining expe- aggression in prison has a communication of suicidal in- riences. All the factors men- much wider psychological tentions; tioned above result in frustra- background and it may not al- 10) consistency – with ways tion, which, in turn, breeds ag- ways be linked to depressive of handling hard situations gression. Several decades ago disorders. There are prisoners throughout life. (cf. Dollard, Doob, Miller, for whom self-aggression is Mowrer, Sears, 1938) a thesis the ultimate end of their Some of these characteris- was formulated which as- masochistic inclinations. They tics may also refer to depres- sumed that aggression – when are generally unaware of these sion and to living in prison it cannot be expressed – is experiences and find them conditions. Psychologists are likely to turn into self-aggres- largely incomprehensible, unanimous in asserting that sion. which is why they seek a pre- suicides are associated with The above-mentioned rea- text for their self-aggressive syndromes of neuroses, char- sons for self-aggression in the acts – the hardest of which is acter disorders, the difficulties conditions of prison isolation suicide. of adolescence, depressive may also be responsible for syndromes, and alcoholism. the deepening of depressive Consequently, a member of the states. Undergoing a state of 4. Depression and Suicides prison population concentrates mania – whose level may fur- in Jail all the above disorders in him- ther be increased by drugs, al- self to a much larger degree cohol, or very strong tea (i.e. Suicide is a very complex than other people do. addictions that are easily phenomenon and happens to Another factor of primary available in jail) – or having people of different races, cul- importance in the isolating the intention to link up with tures, and historical eras. The conditions of prison is the the prison subculture, the pris- subject matter of suicide is type of crime that has been oner commits acts of self-ag- studied by several scientific committed. In point of fact, gression, which, he assumes, disciplines, such as sociology, prisoners display particularly may be effective in overcom- psychology, psychiatry, foren- hostile attitudes towards fel- ing not only his changing sic medicine, criminology, phi- low-prisoners who have com- moods but also his depressive losophy, and theology. Fur- mitted sexual crimes towards states. There are various types thermore, the second half of children. Being put in jail and of self-aggressive acts, all of the twentieth century brought subject to intense persecution, which refer to self-inflicted the emergence of a new scien- the perpetrator of such of- harm such as laceration, the tific discipline – suicidology – fences is likely to be con- swallowing of foreign bodies, whose primary focus has been cerned about his life, which in self-inflicted poisoning, eye- the subject matter of suicides. turn may be one of the reasons ball injuries, bloodletting, self- One of the co-originators of for his depression. The prison- inflicted infections, head in- suicidology, E. Shneidman, ers’ hierarchy of values – es- juries, hunger strikes, and oth- lists ten characteristics that are pecially in the case of prison- er instances of deviated self- common to all people who ers who manifest symptoms inflicted injury. commit suicide ( in of psychopathic disorders – is It is necessary to increase , 1991, pp.Shneidman 128-129), largely based on specific self-awareness of the possible namely:Płużek short-term goals. When the acts of self-aggression in the 1) a purpose – to seek a so- possibility of their fulfilment case of prisoners suffering lution to the problem; becomes blocked, the emer-

DOLENTIUM HOMINUM N. 62-2006 gence of such disorders is also would never do any harm to a penitentiary chaplaincy’ of W. facilitated. child. In this regard, the ‘hu- , which were de- mans’ do possess their own pe- sWoźniakigned specially for this re- culiar ‘morality’. Neverthe- search. The research involved 5. Depression and a less, a lot of prisoners, even four hundred convicts. The re- Prison’s Other Life sexual criminals, choose not to sults, obtained using the ‘scale belong to the ‘human’ catego- of attitudes towards the peni- The prison’s other life can ry, and consider the system as tentiary chaplaincy’, constitut- be described as a system of silly and illogical. By doing so, ed the basis for the division of mutual references between the however, they condemn them- prisoners into two groups – in- prisoners themselves and be- selves to certain pressures, in- dividuals with a high intensity tween the prisoners and the cluding mental pressures, from of positive attitudes towards prison guards ( , the ‘humans’. Being subject to the penitentiary chaplaincy 1997; cf. Szaszkiewicz, such pressure, the individual is (100 people) and those show- 1991). PuttingMoczydłowski aside the dis- likely to suffer frequent break- ing highly-intense negative at- tinctions connected with this downs, which in turn may cor- titudes (100 people). It appears phenomenon as regards indi- relate with the morbidity rate that the prisoners with positive vidual countries, one ought to of depression. attitudes towards the peniten- indicate its main distinguish- tiary chaplaincy seek support ing feature – i.e. the division of from a chaplaincy team in or- prisoners into two categories: 6. Conclusion der to reduce the levels of their the worthy and the worthless, neuroticism, apprehensiveness or, in other words, the so- As a criminological psy- and lack of self-confidence. called ‘humans’ and the ‘sub- chologist, I have been con- The above qualities may be 49 humans’. The prisoners that ducting my research among linked with a very significant belong to the category of ‘hu- man beings’ constitute a group that aims at meeting deter- mined goals. The three higher goals that are formulated by the members of this group are: a) the struggle against the law and its institutions, primarily the police and the prison guards; b) intra-group solidari- ty; c) the protection of ‘hu- man’ dignity and honour. The meeting of these aims is en- sured by rules, i.e. norms with- in a ‘code of human conduct’. The two most important of these norms claim that ‘in- forming on others’ as well as ‘sexual intercourses between the human-rank prisoners’ is prohibited. Although being the object of a homosexual inter- course is not allowed, the prison code allows relation- ships between the ‘humans’ and the ‘sub-humans’ – in prisoners for several years. As factor in a person’s religious which the latter may only take well as that, I work as a prison life – a sense of guilt and re- a passive attitude. The ‘hu- chaplain. These two circum- morse. In the case of prisoners, mans’ make every effort to stances made me include at their sense of guilt is frequent- emulate the model of the least some basic indications to ly disturbed. To relieve the sit- ‘tough man’ – a strong, stead- be used by prison chaplains as uation, the chaplaincy ought to fast and uncompromising con- well as by other prison staff. carry out therapeutic and heal- queror of enemies and the Part of my research has con- ing functions in relation to deeply hated law. cerned the connections be- these prisoners, side by side Not all prisoners may be ad- tween the prisoners’ personali- with their typical functions of mitted into the category of ties and their attitudes towards salvation. The prisoners with a ‘humans’. A paedophile, for the penitentiary chaplaincy high intensity of negative atti- instance, will never be accept- ( , 2002, pp. 105-108). tudes towards the penitentiary ed as a member of this group, TheWoźniak research has employed the chaplaincy, in turn, are charac- while a murderer will. When ‘personality questionnaire’ of terised by strong egos, the talking to me, murderers claim R.B. Catell, the ‘neurotic need to engage in domination frequently they have killed a scale’ of G. Geras, and the and aggression, and the power human but they admit they ‘scale of attitudes towards the of resistance in situations of

DOLENTIUM HOMINUM N. 62-2006 danger. Furthermore, the indi- ought to be acquainted with N. E., MOWRER, O. K., SEARS, R. R. viduals of this type are gener- the conditions that induce de- (1938). Frustration and Aggression, ally cool and distant, and they pression in the prison situa- New Haven: Yale University Press. KAPLAN, H. I., SADOCK, B. J. (1990), display independence of action tion, such as affective disor- Pocket Handbook of Clinical Psychia- and thought. The above quali- ders, attempts to overcome de- try, Baltimore -Hong Kong - London - ties may be indicative of an in- pression through self-aggres- Munich - Philadelphia - Sydney - Tokyo: Williams & Wilkins. dividual’s strong nervous sys- sion, the relations between de- KOSEWSKI, M. (1979), ‘The Prison as tem. pression and suicidal tenden- an Aggressive Social Organisation’. In: The above-mentioned ob- cies, as well as the prison’s S. FESHBACH, A. FRĄCZEK (eds.), Ag- gression and Behavior Change. Biologi- servations may, to some ex- other life. cal and Social Processes, New York: tent, be referred to depressive Finally, there is another im- Praeger. prisoners (i.e. those suscepti- portant point to be made. The MOCZYDŁOWSKI, P. (1991), Secret Life in Polish Prisons, Indiana: Indiana ble to depression). In fact, it is chaplain ought to remain in University Press. wrong to claim that depressive constant touch with the prison PŁUŻEK, Z. (1991), Psychologia pas- prisoners are more religious psychologist and constitute a toralna, Kraków: Instytut Teologiczny Księży Misjonarzy. than the non-depressive ones. I permanent bridge between the SANECKA, B. (1984), ‘Samouszkodze- have not yet engaged in diag- latter and prisoners who are in nia genitaliów u mężczyzn’, Psychiatria nostic research on depression need of professional assis- Polska, 5. SILLAMY, N. (1995), Słownik psy- in conditions of prison isola- tance. chologii, Katowice: Wydawnictwo tion, but, in recent years, I ‘Książnica’. have been conducting research SULESTROWSKA, H. (2000), Choroby Rev. WALDEMAR WOŹNIAK afektywne. In: A. POPIELARSKA, M. among prisoners with the OPIELARSKA Istitute of Psychology P (eds.), Psychiatria wieku method of participatory obser- Cardinal Stefan Wyszyński rozwojowego, Warszawa: Wydawnict- 50 vation. Its results make me feel wo Lekarskie PZWL. University, SZASZKIEWICZ, M. (1997), Tajemnice competent enough to state that Warsaw, Poland grypserki, Kraków: Wydawnictwo In- depressive prisoners (includ- stytutu Ekspertyz Sadowych. SZEWCZUK, W. (ed.) (1985), Słownik ing non-believers) report to psychologii, Warszawa: Wiedza chaplains in search of support Powszechna. and assistance. Yet depression Bibliography WOŹNIAK, W. (2002), Postawy is linked directly to apprehen- więźniów wobec duszpasterstwa peni- ANGST, J. (1966), Zur Ätiologie und tencjarnego a ich osobowość, In: A. siveness, lack of self-confi- nosologie endogener depressiver Psy- GROCHOWSKA (ed.). Wokół psychologii dence, and a disturbed sense of chosen, Berlin - Heidelberg - New York: osobowości, Warszawa: Wydawnictwo guilt. Therefore, the chaplain Springer. Uniwersytetu Kardynała Stefana DOLLARD, J., DOOB, L. V., MILLER, Wyszyńskiego.

DOLENTIUM HOMINUM N. 62-2006 Medical Saints of Our Time: Giuseppe Moscati, Riccardo Pampuri and Gianna Beretta Molla

The relationship between the remained members of the laity, been following for some time, figure of the medical doctor and attained the honour of the altars. and always found some time for the figure of the saint is sum- The three medical doctors prayer or reflection and drew marised in the following way by who are the subject of this arti- near to the sacraments, even Adalberto Pazzini (1898-1975) cle knew how to decline their though he frequented scientific in his work I santi nella Storia religiosity and achieve saintli- circles that were at that time im- della medicina (‘Saints in the ness through existences that mersed in materialism and athe- History of Medicine’) of 1937: were rather ordinary and normal ism. ‘the doctor saints of the early (one was a university lecturer Moscati was awarded his de- centuries, for the history of and a freelance professional, gree on 4 August 1903 with top medicine, were negative enti- one was a medical doctor and marks and discussed his thesis ties, and demonstrated the idea then a hospital friar, and one with Prof. Giuseppe Albini and in the very early Christian psy- was a general practitioner and Prof. Pasquale Malerba. The chology of the uselessness of the mother of a family). thesis was experimental and was human art compared to the pow- on ‘Hepatic Ureogenesis’. The er of grace. Only at a subsequent university thought that it de- psychological moment would an Giuseppe Moscati served the honour of being pub- 51 accommodation take place and lished. Just five months after ob- human science would rise again, This saint was born in Ben- taining his degree, the young not destroyed but corroborated evento on 25 July 1880, the sev- doctor, following a public ex- at many points by the religious enth son of nine children, to amination, became an ‘extraor- element. And thus there would Francesco, a magistrate of noble dinary co-helper’ at the hospital be saints who, in addition to origins, and Rosa de Luca dei for the incurably ill. In particu- their holiness, were of real sci- Marchesi di Roseto. After a lar he looked after people suffer- entific value’. brief stay in Ancone, the family ing from rabies. In the spring of Pazzini, in this work, largely moved definitively to Naples on 1906, at the time of the eruption dwelt upon the saints and 1884 when Franceso Moscati of Vesuvius, he went as a vol- blesseds of the distant past became a Counsellor of the unteer to the geriatric hospital of (those who lived at the time of Court of Appeal in that provin- Torre del Greco, an outlying the Roman Empire, during the cial capital city. As was the cus- part of the hospital for the incur- Middle Ages, or during the Re- tom with well-off families at ably ill, to organise the evacua- naissance), some of whom may that time, the young Giuseppe tion of patients. He worked for be seen as physicians more of received his early education at many hours together with the the soul than of the body, and home at the hands of a tutor. Af- nursing staff to carry all the pa- the biographies of whom tend to ter finishing elementary school tients to safety before the build- slide off into hagiography. This he went to state schools and at- ing collapsed. Moscati in the author also dwelt, finally, on tended a primary school and meantime had published his first some saints who from the six- then high school, obtaining his scientific works and their sub- teenth to the seventeenth cen- leaving certificate in classical ject was the research into physi- turies founded hospital orders, studies in 1897. At the end of ological chemistry that he had such as St. John of God (1495- that year he lost his father who engaged in both in the hospital 1550), or established care-pro- died in December as a result of a wards and in his laboratory. In viding institutions, such as St. cerebral haemorrhage. the spring and summer of 1911 Vincent de Paul (1581-1660), Perhaps influenced by a grave this young medical doctor won a but he totally neglected the most misfortune that had in the mean- public examination at the hospi- recent picture. time befallen one of his older tal for the incurably ill to be- But it was in a more modern brothers (Albert, the second son, come an ‘ordinary helper’ era that there began to emerge after falling from a horse during (equivalent to the role of a con- figures who reached saintliness his military service, had suf- sultant). At the same time he by engaging in medical-scientif- fered a severe head injury which passed his professional exami- ic activity. On the of the first then led to the development nation for teaching and became doctor saints in this sense was Jackson’s epilepsy), Giuseppe an aggregate member of the Niccolò Stenone (1638-1686), enrolled at the Faculty of Medi- Academy of Medicine and the subject of a previous article. cine and Surgery. While he was Surgery of Naples. In the same It was however during a more attending the lectures of the uni- year he worked in the fight recent epoch that medical doc- versity and dedicating himself against an epidemic of cholera tors, who did not demonstrate with energy and success to his that had struck Naples and went their saintliness through won- studies (at the end of the first wherever his help was needed derful and exceptional actions year of his course he received a (from the hygiene-health com- or especial healing capacities, prize for the best exam result in mittees to the homes of the even though they exercised zoology), this young student working-class districts). During charity in a heroic way during continued the pathway of spiri- the First World War he was en- their daily activities, and often tuality which he had already trusted with the military section

DOLENTIUM HOMINUM N. 62-2006 of the hospital for the incurably preted the symptoms as a mani- on the borders of the province of ill after being called up to the festation of a sub-phrenic ab- and the province of Pavia army with the rank of captain. scess but he was unable to save on 2 August 1997. His father, a Beginning in 1911 he had given this opera singer because of the wine seller, was named Inno- lectures in the same hospital as septic condition which had be- cente, and the name of his moth- an untenured lecturer in physio- come well established. er, who came from a well-off logical chemistry in his courses Throughout his life Moscati family, was Angela Campari. As on ‘laboratory research applied conserved a profound religiosity a child he was baptised with the to clinical practice’ and on which was expressed not only in name of Ernino and he was the ‘chemistry applied to clinical practices of devotion (he began tenth of eleven children. Pam- practice’. In 1920 he was called his day by going to mass in the pauri, however, did not have a to give the official course on early morning and taking com- happy childhood. When he was clinical chemistry at the medical munion) and his style of living just three years old he lost his faculty of the University of (he lived very modestly and mother, who died of tuberculo- Naples and in 1922 he qualified paid little attention to honours sis at the age of forty four, and as an untenured lecturer in med- and rewards), but also in his dai- when he was ten years old his ical clinical practice because of ly professional life where he re- father, who drank a lot and had his qualifications. fused to be paid by patients in an irascible character, died in a In the meanwhile Moscati had need, to whom, indeed, he often traffic accident. A little time af- intensified his scholarly output gave medicines and drugs or ter losing his mother, the little by publishing articles in various sums of money. In his relation- boy (who in his family was medical journals, amongst ships with his patients he always called Emilio) was entrusted to which may be cited the publica- conjoined spiritual assistance his maternal aunt who lived in 52 tion Riforma medica. At first he with professional assistance. In the neighbouring village of Tor- was a regular contributor to this the summer of 1923, after re- rino and whose husband was a journal as a reviewer of works turning from a trip to Edin- medical practitioner in Trivo- that appeared in English and burgh, which had been organ- lzio. In his new home, which German journals, but later he be- ised by his Neapolitan col- was in the centre of a large agri- came its editor. One may list leagues in order to take part in cultural estate, there lived, in ad- from his numerous publications an international congress on dition to the maid, also his ma- the following: ‘Indagine chimi- physiology, he left his compan- ternal grandfather and two great co-fisica del peptone nell’urina’ ions to go to Lourdes where he uncles. The little boy, who was (1910), ‘Azione della chinina stayed for two days. brought up in the Christian faith sull’autolisi epatica e splenica’ In the early afternoon of 12 in his new family, had to go to (1910), ‘Peritonite tubercolare April 1927, a little time after ex- two nearby villages to go to ele- sperimentale nei cani sani ed amining a patient in his private mentary school, given that in ipofiso-privi’ (1915), and ‘I La surgery, Giuseppe Moscati died Torrino there was no school determinazione della quantità of a heart attack. His colleague building. At the age of eleven he del sangue con il metodo ottico. Gaetano Quagliarello remem- moved to Milan to attend the II Studio sulla quantità del bered Moscati in the following primary school and here he was sangue in alcune nefriti’ (1922, way in the pages of the journal the guest of his older brother, jointly with his student Giuseppe Archivio di Scienze biologiche: Ferdinando. He was then sent Napoletano). Reference should ‘the faith that illuminated his by his uncle and aunt in Torrino also be made to the obituary he life, which was completely dedi- to Pavia to the College of S. wrote in 1923 of the General Di- cated to science, to learning and Agostino where he was a board- rector of the Joint Hospitals, to the alleviation of human suf- er for six years until he took his Prof. Michele Pietravalle, who fering; the serene happiness of leaving certificate in classical was attacked and killed outside his conscience which was trans- studies. his home by an unknown person lated into the sweetness of his During his years at primary (near to where Moscati lived), smile; and the Christian heights and secondary school the young and a historical essay on the of his feelings, all these con- Pampauri further cultivated his Neapolitan doctor Giovanni Al- ferred on him an especial appeal spirituality (he went to confes- fonso Borelli (1608-1679) enti- which had the power to infuse in sion and took communion every tled ‘Il primo padre della medic- those who turned to him both day) and on more than one occa- ina nuova’ (1924). hope in justice and secure confi- sion he confided to his sister Prof. Moscati also engaged in dence in good’. The mortal re- Longina Maria, a missionary professional medical practice at mains of this doctor saint (he sister in Egypt, about his aspira- his home in Via Cisterna dell’O- was beatified in 1975 and tion to become a priest. He de- lio which was visited by a num- canonised in 1987) have lain cided to enrol at the Faculty of ber of patients who were attract- since 1930 in the Neapolitan Medicine and Surgery of the ed by the fame and the reputa- Church of Gesù Nuovo, and University of Pavia, and in this tion of this acute clinical physi- they have always been the sub- decision he was probably influ- cian. He was visited, amongst ject of intense devotion and con- enced by the fact that his uncle others, by the famous tenor En- stant pilgrimage. was a medical doctor who di- rico Caruso in 1921. Caruso had rected him towards the medical returned to Italy after American profession. However, he was al- doctors had been unable to diag- Riccardo Pampuri so driven forward by the wish to nose the malady he had suffered engage in work that placed him from for a notable period of This saint was born in Trivo- at the service of his neighbour. time. Moscati correctly inter- lzio, a small agricultural town As a university student he con-

DOLENTIUM HOMINUM N. 62-2006 tinued to move in Catholic cir- to patients in response to every placement work during the night cles and marked himself out for call, refused payments from pa- for the medical doctors of the his works of charity and aposto- tients, and often gave them med- hospital and never refused to late until, in the spring of 1917, icines). He also gave sums of perform any health care task or he was called to the army and money to the poor or gave them task of a spiritual nature when it sent to the front as a ‘health ad- what he had in his home (from was requested of him). He was jutant’. As a young man he per- food to clothes). He also gave thus sent by his superiors for a formed his new task with his the comfort of religion to pa- few weeks to their home in Go- usual charitable spirit. He even tients by reading them passages rizia and after this he returned to won a golden medal for valour from the Gospels or some sen- the dental surgery of the hospital and was made a sergeant: during tences from a book of medita- in Brescia. After another relapse the retreat from Caporetto he tions. In his free time he went to he was sent to the home of his managed, in the rain and under church to pray and he was in- aunt and uncle in Torrino for a enemy fire, to load all the health volved in parish activities (the month of convalescence. After- care material that his compan- preparation of children for their wards, in response to a request ions had abandoned onto a cart , the organisa- made by his aunt and uncle, he drawn by a cow and to take it tion of spiritual retreats for was moved from Brescia to Mi- back safely to the rear. In subse- young people and adults, and lan, and was admitted in a very quent months Pampuri, who propaganda for Catholic mis- serious condition on 18 April contracted a lung infection from sions). 1930 to the Hospital of San this episode, had frequent peri- This young medical doctor, Giuseppe where he died on 1 ods of leave and was posted to who continued to feel within May 1930. The mortal remains areas distant from military oper- himself the vocation to the of this doctor saint (who was be- ations. As a result of this he was priesthood, had first asked to be atified in 1981 and canonised in 53 able to follow his university accepted by the Franciscans and 1987) have lain since 1997 in a studies with relative ease. He by the Jesuits, and from both of chapel of the parish church of left the army in the spring of these religious orders he re- Trivolzio, the object of devotion 1920 with the rank of sergeant- ceived a clear rejection on the by a very large number of the major. A year later, on 6 July grounds of his rather precarious faithful. 1921, he was awarded a degree health (he had been given the with the highest possible marks official status of an invalid be- at the University of Pavia with a cause of his lung condition Gianna Beretta Molla thesis on ‘the ascertaining of ar- which had been contracted dur- ing his war service). However This saint was born in Ma- he was accepted by the hospital genta (MI) on 4 October 1897, order of the Fatebenefratelli af- the last child of three. Her father ter spending a summer of trial in was Alberto Beretta, a manager 1927 (officially this was a peri- in industry, and her mother was od of rest for convalescence) in Maria De Micheli. Both parents, the home of Solbiate Comasco. who both came from Lombardy, With the Fatabenfratelli he be- were deeply religious and be- gan that same year his period as longed to the Franciscan Third a novice in their home in Bres- Order. The family moved in cia, and took the name of Friar 1925 to Bergamo, in Città Alta, Riccardo. Both his relatives and where it remained until 1937. It his patients of Morimondo were then moved to Genoa-Quinto, greatly surprised by the decision only to move back to Bergamo taken by Pampuri. This life again in 1941. Gianna went to shaping choice was commented elementary schools in Bergamo on in an article that appeared in and then to primary school until the Corriere della Sera under the fourth year of study. In the heading ‘A Doctor becomes Genoa she went to the fifth year terial pressure with a new sphig- a Friar’. On 24 October 1928 of primary school but interrupt- momanometre’. A few days pre- Friar Riccardo took the vows ed her studies for a year because viously he had become a Fran- typical of the Fatabenefratelli of her bad health. In the mean- ciscan tertiary and received the (poverty, chastity, obedience time she had developed a deep name of Friar Antonio. and hospitality) and he was en- religiosity which had allowed Dr. Pampuri, after a brief in- trusted with running a dental her to overcome such dramatic ternship with his uncle, was surgery connected with the Hos- and painful moments as the made medical practitioner of pital of Sant’Orsola. death of her older sister, who Morimondo, which was about In the spring of 1929 the first had been ill for some time, in fifteen kilometres from Torrino. symptoms of pulmonary tuber- 1937. In Genoa she further de- He thus went to live with his sis- culosis which Pampuri had con- veloped and explored her spiri- ter Margherita in this small town tracted began to appear (fre- tuality under the guidance of a in a home near to a famous Cis- quent low fever and bleedings). spiritual director and began to tercian abbey. In the practice of This illness was probably due to take an active part in Catholic his profession he immediately excessive work undertaken by a Action. In Genoa she continued displayed an attitude of great body that was already weakened her studies at secondary school readiness to help and charity in (in addition to working in the with her sister Virginia, and this relation to his patients (he went dental surgery he also did re- went on even after the outbreak

DOLENTIUM HOMINUM N. 62-2006 of war when her family moved In 1946 her brother Giuseppe (in 1956 Pierluigi was born, in once again to Bergamo and had become a priest and in 1948 1957, Maria Zita, and in 1959, lived in the house of her mater- her pther brother Enrico had al- Laura). In addition, she looked nal grandparents, where, in so been ordained a priest. Enrico after her children and the home, 1940, fourth months apart, both was to be sent to Brazil as a mis- notwithstanding the frequent ab- parents died of illness. In the sionary medical doctor of the sences of her husband who often same year she received her leav- Capuchin order. Her sister Vir- went abroad for reasons of ing certificate from her sec- ginia, who had graduated in work. In the summer of 1961, a ondary school and then moved medicine in 1951, had entered little time after becoming preg- definitively with the rest of her the congregation of Magdalene nant for the fourth time, it was family to Magenta to the home of Canossa and would be sent to discovered that she had a large of her Beretta grandparents. She India as a missionary doctor. uterine growth for which she enrolled in the Faculty of Medi- The young doctor began to was operated on, in line with her cine and Surgery of the Univer- practice her medical profession beliefs, with a view to removing sity of Milan, following in this in Mesero, a small town near to the growth. She managed to car- the example of her brothers Fer- Magenta, where in 1950 she had ry on with the pregnancy and dinando and Enrico. In 1942 opened a clinic with her brother went back to her usual activities two of her brothers set out to be Ferdinando. In 1952 she provid- as the mother of a family and a priests: Giuseppe in the semi- ed paediatric care to the summer medical doctor. nary at Bergamo, and Ferdinan- colony of the town council of Gianna Beretta Molla carried do, who had already become a Magenta; in 1953 she was a on with her difficult pregnancy medical doctor, as a novice of doctor who accompanied sick until the birth on 21 April 1962 the Capuchin Fathers in Lovere. people in the train for Lourdes. of her last child, Gianna 54 During her university studies In the meantime she continued Emanuela. However she was af- Gianni continued to be involved to be active in Catholic Action flicted a little time afterwards in apostolate and works of char- and cultivated the wish to join by a septic peritonitis which, ity, and was active both in her missionary brother in Brazil. despite the treatment she re- Catholic Action and San Vin- However she was advised ceived, became worse to the cenzo. She advised the girls of against this by those who point that she had to be taken the Female Youth of Magenta to thought that her physical consti- back in a dying condition to her engage above all in prayer and tution was not suited to a tropi- home. She died there on 28 meditation. At the end of the cal climate. As a health care pro- April 1962. This saint (she was Second World War, in 1945, Gi- fessional she was especially in- beatified in 1994 and canonised anna moved from the University terested in matters connected in 2004) was buried in the of Milan to the University of with pregnancy, birth and cemetery of Mesero (the place Pavia where she completed her neonatal care (she also worked where she had engaged in the studies in the company of her in the consultancy section of the major part of her activity as a sister Virginia, who had also en- ONMI of Magenta as the head medical doctor), venerated by rolled in the Faculty of Medi- of the nursery section). Pro- the faithful as an example of cine and Surgery. She was foundly convinced of the sa- Christian love for human life in awarded her degree with the credness of human life, she a world that is all too often in- highest marks on 30 November sought to offer spiritual comfort sensitive to that value. 1949. Immediately afterwards to pregnant women who were she enrolled at the University of experiencing difficulties. She Prof. MASSIMO ALIVERTI Milan to study at the School of supported giving birth at home Professor of the History of Medicine, Specialisation in Paediatrics and and only advised hospitalisation The University of Milan-Bicocca, she received her diploma in when there was a risk for the and Lecturer in the History 1952. mother or the child. of Psychiatry at the Psychiatric Clinic of the University Gianna Beretta saw the med- In 1954 Gianna Beretta met of Milan ical profession as a true mission Peltro Molla, an engineer and a of Christian care and apostolate, manager in industry, who lived as is clear from the following in Mesero near to her clinic. Af- thoughts which she expressed ter a few chance meetings the Bibliographical References when she was still a student: two began to spend time in each ‘All of us in the world work in other’s company and discovered A.A.V.V., Bibliotheca Sanctorum, Rome, Istituto Giovanni XXIII della Pon- some way at the service of men. that they were united in sharing tificia Università Lateranense, 1961-69. Medical doctors work directly the same Christian values. At M. BENFATTI, Sanità e santità. Beatifi- on man. Our subject of science the end of a period of a few cazioni e canonizzazioni esemplarmente sociali e umane dal Cinquecento ai nostri and work is the person who in months of engagement they giorni, Mantova, Editoriale Sometti, front of us tells us about himself married in Megenta at the basili- 2005. and asks us to help him, expect- ca of San Martino on 24 Sep- G. INFUSINO, Un santo in Corsia: ing from us the fullness of his tember 1955. After their honey- Giuseppe Moscati, Cinisello Balsamo, Edizioni Paoline, 1987. existence. We medical doctors moon the two newly weds went A. MONTONATI, Il dottor carità: fra have opportunities that the priest to live in a part of Magenta in a Riccardo Pampuri dei Fatebenefratelli, does not have. Our mission is factory where the engineer Liscate, Edizioni Fatebenefratelli, 1996. A. PAZZINI, I Santi nella Storia della not over when the medicines are worked as a director. Dr. Beretta Medicina Rome, Casa Editrice Mediter- no longer of use. The soul is to continued her activities as a ranea della Libreria Cattolica Inter- be brought to God. There is Je- medical doctor in Mesero even nazionale, 1937. G. PILUCCHI, Gianna Beretta Molla: sus who says: ‘who visits a sick after giving birth to three chil- una vita per la vita, Milan, Edizioni Pao- person, helps me…’. dren over a sort period of time line, 1994.

DOLENTIUM HOMINUM N. 62-2006 Testimonies

The Lord has done great things for us: He Has Filled Us with Joy!

Document of the Episcopal Commission for Health of Madagascar

From Athens to Sparta: we are All on a Journey with Terri Schiavo The Lord has Done Great Things for us: He has Filled us with Joy! THE FOURTEENTH WORLD DAY OF THE SICK ON THE TWENTIETH ANNIVERSARY OF THE BIRTH OF THE OFFICE FOR PASTORAL CARE IN HEALTH OF THE ARCHDIOCESE OF BARI-BITONTO

In front of the ‘wonders of sultative Office of the Italian istry in hospitals and the local God’ we members of the dioce- Bishops’ Conference was ac- area, the greater professional san consultative body for pas- tive in this field. Indeed, a few skill and expertise of pastoral toral care in health, like the years later this Consultative workers in health, and a more community of pious Israelites Office published its ‘Pastoral decisive promotion of bodies of Psalm 126 (125), can also Care in Health in the Italian of communion (hospital chap- exclaim: ‘The Lord has done Church’ (1989). The national laincies and pastoral advice). great things for us: he has filled Office only came into being The paper given by Prof. Ar- us with joy!’ This psychologi- many years later (September naldo Pangrazzi, a lecturer at cal and spiritual state of joyous 1996). Structures to train pas- the Istituto Internazionale di feelings, together with grati- toral workers were absent and Telogia Pastorale Sanitaria 56 tude and thanks, accompanied these were only to appear in “Camillianum” of Rome, pro- us during the whole of the pas- later years, structures such as voked a great deal of interest. toral year 2005-2006. The the Camillianum (1987) and His paper was on the subject twentieth anniversary of the the diocesan schools for pas- ‘from the pastoral care of suf- foundation of our diocesan of- toral care in health (in the fering to the pastoral care of fice and its service (1986-2006) 1990s). health’ and he demonstrated was the principal celebratory The commemoration of the with clarity the development of event and the Fourteenth World twentieth anniversary of the such pastoral care over the last Day of the Sick became the birth of the Office was solemn- two decades at the level of convergent and divergent point ly celebrated on 25 March identity, subjects and purpose. of all the initiatives that were 2006 with the holding of the Prof. Pangrazzi indicated the engaged in. The pastoral ap- third diocesan conference on seven ways or directions that pointments were conceived and pastoral care in health. The the new pastoral care in health took place in the light of these subject of this meeting was needs to pursue: from pastoral two special dates. ‘twenty years at the service of care of the sick to pastoral care our local church’. The Arch- of health, from sacramental bishop of the archdiocese, Ms- pastoral care to pastoral care An Office that was Born gr. Francesco Cacucci, together involving evangelisation, from in the Middle of the 1980s: with a numerous group of ex- the pastoral care of compas- a Prophetic Intuition traordinary ministers of holy sion to the pastoral care of jus- communion and associations tice, from the pastoral care of The Bari-Bitonto Office for and bodies of patients or of death to the pastoral care of Pastoral Care in Health was people who care for the suffer- life, from autonomous and iso- one of the first in Italy to be es- ing, took part in this confer- lated pastoral care to co-ordi- tablished thanks to a prophetic ence. nated and harmonious pastoral intuition of the Archbishop, The conference provided an care, from hospital pastoral Msgr. Mariano Magrassi, who opportunity for the director of care to pastoral care of the in 1985 began to think about the Office to give a paper on Christian community, and from entrusting pastoral care for the ‘the journey of the Office un- a pastoral care of improvisa- sick and suffering and the pro- der the banner of research and tion to a pastoral care of pro- motion of health to a new body creativity’ and in this paper he jects. that was different from Caritas identified four pathways that The conference also proved and which, indeed, he created had been followed during this very useful in achieving in 1986, the year when the first long period: the initial and on- greater knowledge about cer- director was appointed. going training of pastoral tain associations that belong to It is helpful to remember the workers, the creation of bodies the Consultative Office: the context of that event: in the for communion and participa- Centre for Voluntary Workers 1980s the letter Salvific doloris tion, attention towards, and the of Suffering (CVS), UNITAL- had been published, a papal promotion of, socio-health care SI, the Pastoral Centre for the work on the Christian meaning voluntary work, and the preser- Deaf ‘Don Filippo Smaldone’, of human suffering (1986), and vation of records on what had the Diocesan Centre for Social there had recently been created been achieved (archives). He Integration (CEDIS), and what is now called the Pontifi- ended his paper by pointing to Fratres. All of the rich material cal Council for Health Pastoral the paths of the imminent fu- produced by the conference Care (1985). At that time few ture: the development of the was put in the proceedings, diocesan consultative offices missionary dimension of pas- which were published by the existed and the national Con- toral care in health, new min- Office in April 2006.

DOLENTIUM HOMINUM N. 62-2006 Two Special Appointments: celebrate it at an international sary of the Office. The Holy the Meetings of level. It is awaited and experi- Mass was animated by singing Chaplaincies and enced creatively by the Office by the diocesan choir; readings of Chaplains and the ecclesial communities from the Bible and the prayers of the parishes and the hospi- of the faithful, involving some The twenty years of exis- tals. members of the Consultative tence of the Office were also As has been the case in previ- Office. Sick people were given celebrated with two important ous years, the World Day of the the front rows in the church and meetings: the meeting of the Sick was celebrated by a day of the deaf in particular were as- pastoral workers of hospital on-going training of the extra- sured the simultaneous ‘transla- chaplaincies and the meeting of ordinary ministers of holy com- tion’ of all the moments of the the hospital chaplains with the munion on 21 January 2006 in celebration. Archbishop. the main hall of the Faculty of The regional newspaper La The experiences undergone Engineering of the Polytechnic Gazetta del Mezzogiorno gave by the hospital chaplaincies, of Bari. In the diocese there are suitable space to this event on which our archdiocese has pro- more than one thousand two the special page for Bitonto, a moted through connections at a hundred such ministers. Don metropolitan area (Sunday 12 national level, are an innovative Armando Aufiero, a priest of February 2006 – ‘The World element as regards pastoral care the Silent Workers of the Cross, Day of the Sick – The Cameras in health. For this reason, on 5 dwelt in an excellent way on of the RAI in the Basilica of November 2005 the ‘first meet- the subject ‘if pain is a school, Our Lady’). ing of pastoral workers’ was the sick person has much to Other initiatives involving held in the hall of the synod. It learn and to teach’, and drew catechesis, fostering and train- gave itself the task of reflecting upon the publication of the na- ing, preceded and followed the 57 on the ecclesiology of commu- tional Office and Consultation memorial of Our Lady of Lour- nion, the basis of this new or- Office which was produced for des of 11 February: the partici- ganism of participation, with a this year – ‘At the School of the pation of the Office with a nu- paper by Msgr. Domenico Sick Person’. At the same meet- merous group of pastoral work- Ciavarella, the vicar general, ing the material to support the ers in the national conference of and also the task of achieving World Day of the Sick was also the Italian Association of Pas- an exchange of views and expe- presented, illustrated and dis- toral Care in Heath (AIPAS) riences between pastoral work- tributed, namely the Message which was held in Collevalenza ers in order to promote greater of the Pope, a large poster and (PG) in October 2005; the personal knowledge and the the publicity poster, a summary lessons at the vicariate’s cours- stimulation of growth in their of the above publication, and es of initial training for the new activity. the prayer of the sick person. MSSCs; the catechesis on the The meeting of the hospital anointing of the sick in the chaplains with their own parish of Our Lady of Consola- pastor, organised at the Home tion in Altamura (BA) and on of the Clergy on 5 December the subject of fragility at the 2005, proved useful because it fourth ecclesial conference of allowed an in-depth exploration Verona on the S. Fara parish of of the subject of mystery, which Bari on the contribution at an is the pastoral choice of the dio- educational level to the schools cese, applied to the communi- of pastoral care in health of the ties of the health-care world. In diocese of Southern Italy. the light of the last universal The Diocesan School of Pas- synod on the Eucharist, reflec- toral Care in Health, directed tion took place on the need to by Dr. Ornella Scaramuzzi, rediscover the dimension of continued its ten-year service to sacrifice of Holy Mass in order the diocese with a rich pro- to propose it to sick people, gramme of subjects on ‘ethics their family relatives and all and humanisation’ that was pre- health-care workers as a means sented in weekly lectures at the by which to participate in the The director of the Office main hall of the parish of St. paschal mystery of Christ, illu- asked and obtained from the Fara in Bari. Amongst others, minated by the theology of the National Office of Social Com- the following subjects were ad- mystic body. munications of the Italian Bish- dressed by the speakers: the ops’ Conference the broadcast- contribution of the Church to ing on television of the concele- the humanisation of the health- The Fourteenth World Day bration of the Eucharist of Sun- care world, identity – horizons of the Sick: a Date day, 12 February 2006, at 11.00 and workers in the world of Experienced Creatively on RAI I, presided over by the pastoral care in health, the Archbishop, Msgr. Francesco parish as a home for commu- The World Day of the Sick in Cacucci, from the sanctuary of nion and charity for ‘difficult’ our local Church is a consoli- Our Lady of the Well of Capur- sick people, enneagram – mod- dated tradition which has been so (BA). In his homily the ule B, AIDS and chastity, celebrated ever since the 1980s, Archbishop commented on both mourning in children, the ethics and thus before the proposal the importance of the World of virtue, depression, and adop- made by John Paul II in 1992 to Day of the Sick and the anniver- tion.

DOLENTIUM HOMINUM N. 62-2006 The World Day of Health: dition to the celebrations of the cal area to the Feast of Our La- Echoes from the Parish Eucharist in church and the say- dy of Lourdes and the World Communities ing of the rosary at the grotto of Day of the Sick with visits to Lourdes, the following were or- the families of sick people, with We can gather certain reso- ganised: a meeting of sick peo- catechesis meetings on the nances from the celebration of ple, a torchlight procession Message of the Pope and on the the Fourteenth World Day of along certain streets of the city, publication of the national Of- the Sick in our parishes from and a pilgrimage to the French fice of the Bishops’ Conference the papers that were sent to the sanctuary during the month of of Italy, and the pinning up of director of the Office. Much August. The Sundays before posters on the event in apart- space was given to liturgical and after the commemoration ment blocks. and sacramental celebrations of 11 February have by tradi- In the seventh vicariate all which were experienced with tion witnessed the organisation the parishes celebrated the intensity in a solemn way, such of a fraternal agape by volun- World Day of the Sick and at as the Eucharist and the anoint- teers for people who are alone, Holy Mass had homilies with ing of the sick administered in a for the poor, and for those who reflections on health and ill- communal way, but initiatives want to spend a day in the com- ness. The parish of Maria SS di involving charity and solidarity pany of others. For those who Monteverde a Grumo Appula towards the suffering were not cannot move from their homes prepared for the feast with ado- absent. a lunch is brought to them. ration of the Eucharist and re- The episcopal vicariate of the In the third vicariate, the flection on the Message of Pope Bitonto-Palp del Colle (BA) World Day of the Sick has by Benedict XVI. area, as had been the case in now become a regular appoint- The eighth vicariate organ- 58 previous years, renewed its in- ment. All the parishes have fol- ised the celebration of the terest in the commemoration of lowed a pathway of training World Day of the Sick at vari- the World Day of the Sick with with moments of catechesis, ous levels with special initia- the especial involvement of home visits to sick people, the tives in the individual parishes members of the laity. At the donating of blood, the adora- (home visits by priests and the Pontifical Basilica of Holy tion of the Eucharist and the MSSCs to sick people, the gift Doctors in Bitonto the repre- sacrament of the anointing of of the Message of the Pope, a sentatives of the brotherhoods the sick. distribution of the image of Our and the various associations of In particular, in the parish of Lady and other small examples voluntary work (UNITALSI, Maria SS. Annunziata in Mod- of care). Volontariato Vincenziano, ‘An- ugno the happy event was ex- At the parish of the Immaco- otrocolo’, UAL, CVS, perienced of the ordination of a lata di Lourdes di Gioia del UVOLA, MAC, Associazione new priest, Fra Gianni Gelato, Colle, a concelebration of the mariana, ‘Arcobaleno’, AISFA, who chose specifically this date Eucharist was held which was Gruppo mariano dei SS. to offer greater visibility and at- presided over by the director of Medici), organised a unique tention to sick people with the the diocesan liturgical office. celebration of the World Day of involvement of the parish com- This was marked by the in- the Sick in which over four munity and the citizens of the volvement and the presence of thousand sick people took part. town. The presence of the all the parish priests. In the af- The commemoration was a joy- Archbishop, who presided over ternoon, and despite the very ful opportunity to experience the celebration of the Eucharist, great cold, a torchlight proces- charity extended to missionary in which numerous priests took sion took place, with a large im- horizons as well: all the offer- part, was also an opportunity age of the Virgin being carried ings of the event were given to for reflection on pastoral care in down the streets. a sister from Bitento who works health. The World Day of the In Mola di Bari, which forms in a mission in New Caledonia, Sick was ended with a rich buf- a part of the eleventh vicariate, an island in Oceania that is near fet offered by the new priest the World Day of the Sick was to Australia. Spectacles, used both to the sick and to all the celebrated together by the five lenses and health care material participants. For some months parish communities of the town were also collected to help the local area has been enriched at the parish of the Sacred those in need. A statuette of Our by a new rest home with sixty Heart. This very large church Lady of Lourdes was given to beds managed by ‘S. Raffaele’ was able to accommodate the all the sick people who were of Milan. large number of sick people and present. The sixth vicariate experi- the people who accompanied In the first vicariate, the enced the World Day of the them. At the end of the mass the parish of San Carlo Borromeo Sick because in its territory is women volunteers of St Vin- organised for 11 February, to be found the great Hospital cent gave a mimosa branch and amongst other things, a Holy of St. Paul and throughout the a medallion of Our Lady of Mass with reflections on the whole liturgical year it organis- Lourdes to those present. message of the World Day of es a multiplicity of initiatives The parish of Our Lady of the Sick, a supplication to Our involving concrete care for the Lourdes (Parchitello-Noicat- Lady of Lourdes and a commu- hospital community, especially taro) organised a exhibition of nal celebration of the anointing at Advent and Lent. sacred art under the heading of the sick for elderly people The parish of the Holy Fami- ‘the colours of faith’ and a con- and suffering people. ly encouraged the MSSC and cert of witness by Giuseppe In the second vicariate, at the the group of Caritas to act to Cionfoli on the subject ‘life is a parish of the Holy Cross, in ad- sensitise all the whole of the lo- gift’.

DOLENTIUM HOMINUM N. 62-2006 In the twelfth vicariate the the diocese. In addition, a large distributed six hundred mis- parish of the Resurrection, as it number of initiatives were or- sionary rosaries with the prayer has done every year, bestowed ganised as part of the annual of the World Day of the Sick to the tonality of a special celebra- programme which had been patients and staff, and in the af- tion on 11 February since sick drawn up in the month of Sep- ternoon the episcopal vicar, people are usually provided tember: monthly training and Don Vito Marotta, presided with the caring service of week- planning meetings, days of over the Eucharistic concele- ly home visits where holy com- spiritual retreat before Advent bration and then led the Eu- munion is never absent. This and Lent, taking part in meet- charistic procession, with the year sick people and their fami- ings on pastoral care in health, display of the host in all the lies were offered the opportuni- Sante Quanrantore, a via crucis wards, including the resuscita- ty to celebrate the Eucharist, along the corridors of the hospi- tion unit. The participation of and this was followed by a so- tal, and a day dedicated to a fi- the patients and their family rel- cial moment when the sick peo- nal assessment. At the time of atives, who were understand- ple were able to spend some the World Day of the Sick spe- ably very moved, was very time together, to talk about cial liturgical celebrations in great. themselves and to express their clinics were organised which The hospital chaplaincy of joy at seeing each other again. were accompanied by gifts to the oncological hospital and the The young people of the youth the nurses and other specific Mater Dei hospital organised a group entertained those cele- initiatives. series of events in preparation brating the day with songs, little In the hospital of St. Paul of for the feast of Our Lady of plays, riddles and other forms the ASL BA/4 the World Day of Lourdes: a thoughtful saying of of entertainment. The parish the Sick had the task of renew- the rosary, and a procession of priest ended the meeting by ing the commitment of daily the Eucharist which witnessed 59 inviting all those present to feel services by the pastoral workers the passing of the Risen One that they were active subjects of of the chaplaincy: a visit to the through all the rooms of the pa- the community and to offer patients of the seventeen wards tients with the involvement of their own specific individual of the hospital centre with the some lay faithful of the parish form of co-operation. gift of the Eucharist-Jesus, the of St. Francis of Assisi of Japi-

A Day that Lasts a Year: Resonances from the Hospitals and the Associations

In the hospital and health- care structures the World Day of the Sick has become a spe- cial opportunity to increase the awareness of chaplains and pas- toral workers about their pas- toral role which, indeed, lasts the whole year. It thus also acts to call the attention of the hos- pital community to its responsi- bilities of service towards those who suffer and their family rel- atives through special initia- immediate response of the gia. For its part, the administra- tives of encouragement and chaplain to the requests for con- tion of the oncological hospital, training. fession or anointing of the sick, as was reported in L’Osserva- In the great polyclinic of Bari a via crucis at the time of Lent, tore Romano (Friday, 10 Febru- the hospital chaplaincy, which vocal-instrumental concerts in ary, p. 10), ‘decided to dedicate is made up of twenty-five pas- church, taking part in meetings the name of the health-care cen- toral workers, carried on with of the vicariate and the diocese tre to the John the implementation of projects level as a concrete sign of com- Paul II’ because of ‘the care that were already engaged in munion with the local church that Karol Wojtyla always man- previously: a listening centre, and the bishop, working with aged to express towards the receiving the family relatives of the Association of Hospital Vol- weakest part of human society’. sick people, an Internet site, unteers (AVO), synergic work This proposal met with the ap- support for people experiencing with the social worker in cases proval of the metropolitan mourning, training activity, of special and urgent need on Archbishop of Bari-Bitento, help in the form of food for the part of sick people, and the Msgr. Francesco Cacucci, who families in need, helping in pro- promotion of the donating of expressed ‘his strong apprecia- viding care to the homeless at blood with the Frates in the lo- tion and pleasure, fully agree- the central railway station of cal area. ing with the reasons for the pro- the city, and hours every month In the hospital centre ‘Di posal’. dedicated to the adoration of Venere’of the same ASL BA/4 in At the hospital of Bitonto the the Eucharist and encouraged Carbonara (BA) on the morn- chaplain and the members of and prepared by the parishes of ing of 11 February the MSSCs the chaplaincy managed to in-

DOLENTIUM HOMINUM N. 62-2006 volve the medical and nursing Gabriele dell’Addolorata in the advance in harmony with re- staff as well in the celebration neighbourhood of St. Paul with gional and national ecclesial of the Eucharist during the their assistant and experienced bodies. The new Note on pas- World Day of the Sick, which a moment of intense spirituality toral care in health, which was was transformed into a moment with the saying of the holy recently approved by the per- of intense human and spiritual rosary, the celebration of the manent Council of the Italian communion between all those Eucharist, and the torchlight Bishops’ Conference (March who were present. procession within the grounds 2006), will constitute a secure In the hospital centre of Gru- of the church. point of reference through the mo Appula (BA) the adoration The Centre for the Volun- study and the implementation of the Eucharist was organised, teers of Suffering (CVS) took of the working guidelines that enriched by the catechesis. The part in the celebrations and in it contains. commemoration of the World the initiatives of the parishes, The celebration of the World Day of the Sick was an oppor- where it is present in the form Day of the Sick turned out to be tunity for the general manage- of small apostolate groups increasingly rich in initiatives ment of the hospital company (called ‘advanced groups’), in- in the individual parish com- to renew its promise of immi- deed in fifteen parishes! Some munities and in hospitals. We nent work to build a chapel, specific initiatives may be re- would like to emphasise the se- which is indispensable for litur- ferred to here: some disabled riousness with which this annu- gical celebrations. At the Padre people offered their contribu- al appointment is experienced Semeria nursing home and the tion in the liturgy as readers of (some communities prepare for Villa Lucia nursing home mo- the Word or during the prayer it with a special meeting or en- ments of spirituality and joyful of the faithful or by animating counter!). In addition to the 60 fraternity were also organised the procession involving the more common initiatives of for the residents thanks to the giving of gifts or with songs. prayer and liturgical and sacra- contribution of youth groups The publication of the associa- mental celebrations, the cre- from the parish area. tion ‘The Sick Person is Me!’ ativity and the originality of In Triggiano (BA) the com- was used, together with the ini- commitments that spring from munity of the F. Fallacara Hos- tiatives suggested in that publi- pital experienced the World cation. Day of the Sick with creativity At the parish of St. Mary the thanks to the role of the chap- feet of a disabled person and of lain and the sisters. In the an elderly person were washed morning the MSSCs visited the during the celebration of the patients and gave each one of Eucharist. In the parish of the them a copy of the gospels, and Good Shepherd the MSSCs the parish priests of the individ- wrote to each sick person who ual parishes concelebrated in had received a visit certain re- the church of the hospital with flections addressed to the the participation of all the hos- parish community, which were pital staff, the volunteers and then written on large posters the faithful. In the afternoon a placed in the church for the at- statue of Our Lady was carried tention of all the faithful. in procession through the vari- ous wards and the next day a theatrical performance was or- In Walking One Opens up ganised in memory of Mother a Pathway: One Goes Theresa of Calcutta and the on Towards New Goals work that she engaged in for the imaginative capacities of marginalised people. In the In conclusion we can really love are not absent. The same town a citizens’ commit- state that we are grateful to proposing of initiatives of soli- tee for the revival of the hospi- God both for the commemora- darity, the pastoral encounter tal drew up and distributed a tion of achieving twenty years between chaplains and the leaflet to explain to the citizens of life for the Office and for the parish priests of the local area, the reasons for the need for a Fourteenth World Day of the the co-operation between Cari- renewal of their health-care Sick. We would like to stress tas workers and workers in pas- centre at the level of an im- certain significant aspects of toral care in health, and the provement in services through both events. pastoral initiatives taken and professional skills and exper- The long journey walked by implemented communally by tise, humanisation and hope, the Office has not stopped. In- the parish priests of a city, are for the benefit of the south Bari deed, specifically because of all very striking. They are shin- area. the work that has been carried ing examples of a future that is For all those connected with out and the successes that have rich in hope. the UNITALSI, the World Day been achieved it must continue of the Sick had a dual spiritual with renewed enthusiasm to- Rev. LEONARDO NUNZIO value: the annual appointment wards the new goals outlined DI TARANTO for the suffering wanted by by the Church in Italy and by Director of the Office John Paul II and the feast of the new needs of society. Natu- for Pastoral Care in Health, Our Lady of Lourdes. This year rally enough, one cannot walk the Archdiocese of Bari-Bitonto, they met at the parish of S. alone. It is always necessary to Italy

DOLENTIUM HOMINUM N. 62-2006 Activity in the Field of Health and Health Care DOCUMENT OF THE EPISCOPAL COMMISSION FOR HEALTH OF MADAGASCAR

You will find enclosed a copy 3. Catholic hospital chaplains. opening a Catholic health-care of the Statutes of the Episcopal 4. Catholic medical doctors. centre. Commission for Health (ECH) Most of the activity that is of Madagascar which will pro- Thanks to a sum that we re- carried out in the field of health vide you with an idea of the ac- ceive from Missio, we are able and health care in all the dioce- tivities that have been carried to organise twice-yearly meet- ses of the country is engaged in out in this field. ings for each category. These at the level of leper hospitals We know that the bishop is are above all meetings for the and dispensaries. The Catholic the first person responsible for exchange of information and Church has twenty-eight centres health and health care in his views with speakers who give which have this purpose. De- diocese. For this reason, such papers on medical subjects and spite the difficulties that exist in pastoral care varies notably on Catholic teaching on medical convincing the World Health from diocese to diocese. For us, ethics. In general, at each meet- Organisation that leprosy still the members of the ECH, it is ing at least seventeen dioceses exists in Madagascar and that important to be in contact with out of twenty are represented, these centres have to be main- the Diocesan Commissions for and we publish a detailed report tained, women religious do a Health (DCHs) that were creat- on the proceedings of these wonderful job for these sick 61 ed by the bishops of various meetings which are then distrib- people. There has always been a dioceses to help them in rela- uted to the participants. misunderstanding between our tion to the activities that are In Madagascar there are few centres and the World Health carried out in this field. These Catholic hospitals for the simple Organisation because the WHO commissions are present in sev- reason that the costs of a hospi- would like us to close them. enteen of the twenty dioceses of tal are very high and in such However, in Madagascar these Madagascar and about ten of them function very well. The DCHs organise and co-ordinate activity at a diocesan level, and this is the reason why there is great diversity within the coun- try. Since 2004 we have decid- ed to hold meetings every year with the presidents of all the DCHs of the national territory. At these meetings the presi- dents present a report on the ac- tivities that have been engaged in and on the problems that have to be addressed in the per- formance of the health-care ministry. These meetings are very important and with time cases a very substantial financial centres are needed. There are al- they will allow us to closely contribution from Europe is re- so Catholic dispensaries and we follow the activities that are en- quired. Otherwise, hospitals can hope to have statistics on how gaged in in the field of health only be used by rich people. many there are of these on the and health care in the country. Given that we want to serve island soon. The needs in the The ECH knows the Catholic poor people who do not have the field of health and health care institutions that operate in the money to pay for health care it are immense and this is why the health-care field at a diocesan is very difficult to have a hospi- religious Congregations do not level. We will gradually man- tal. The FMM sisters have a hesitate to organise this min- age to obtain complete data on clinic in Tananarive and there istry. Thanks to the nursing the situation in Madagascar. are hospitals in Ambanja, Fia- school of Ankadifotsy, every Some dioceses are already well narantsoa and Farafangana. In year we have new women nurs- organised in the field of pas- the other dioceses, on the other es to work in these dispensaries. toral care in health. hand, Catholic hospitals do not We should not minimise the We have divided pastoral exist. Many of these dioceses work of women religious in the workers in health into four cate- are studying the possibility of state hospitals. In this difficult gories: creating a hospital in the name context they bear witness to the 1. State religious nurses (both of the Bishops’ Conference of charity of Christ and to service men and women). There are Madagascar but many efforts to the poor. Even though they about 250 of these. are required for such a project to are employees of the state, they 2. Catholic obstetric nurses be implemented. Other congre- are able to serve the poor and to (both men and women). gations have the possibility of avoid the abuses of corruption.

DOLENTIUM HOMINUM N. 62-2006 However, in Madagascar STATUTES Structure there are few women religious Respective Functions with degrees in medicine and al- EPISCOPAL COMMISSION so here, despite the difficulties FOR PASTORAL CARE Structure at the level of training, various IN HEALTH Congregations do not hesitate to Article 5 send out women religious to be- The ECH is presided over by come doctors. Preamble a titular diocesan bishop, ac- The ECAR has diagnostic cording to the Statutes of the centres for AIDS, which are fi- Article 1 BCM, who is elected by the ple- nanced by the CRS, but because In response to an express re- nary assembly of the BCM for a the number of people with AIDS quest from the Pontifical Coun- mandate that lasts two years is difficult to determine we have cil for Health Pastoral Care and which can be renewed twice. no centre which treats such peo- Health Care Workers, the BCM ple. (Bishops’ Conference of Mada- Article 6 This year the Commission for gascar) hereby establishes In addition to the Bishop- Pastoral Care in Health signed within its own orbit the President, the ECH has two vol- an agreement with the Ministry ECPCH (the Episcopal Com- untary members who represent for Health to strengthen the fight mission for Pastoral Care in the various categories of health- against tuberculosis. Thirty- Health) in order to animate, co- care workers: three centres in our twenty dio- ordinate and inspire pastoral – A hospital chaplain. ceses will receive financial help care in health. This Commis- – A medical consultant. to carry out this new pro- sion is placed amongst the vari- – A woman religious nurse. 62 gramme. Because this is beyond ous Episcopal Commissions of – A representative of the the responsibilities of the Com- the BCM. UMWR (Union of the Women mission, we have formed a Religious of Madagascar). group to manage this pro- Article 2 – A man or woman state gramme. The Ministry of Health The purpose of the Commis- nurse. increasingly wants to organise a sion is to express the care and – An obstetrician. partnership with the ECAR for concern of the Church towards – A general secretary. these programmes financed by sick people, the suffering and – A priest who is a delegate of the Global Fund. the elderly. ‘Ny marary man- the Bishop. Thanks to the Camillian Fa- driana sady andrianina’ and to thers and the hospitals in Tana- help health care workers so that Article 7 narive, we hope to organised the apostolate of mercy in The Bishop-President ap- this ministry in a better way in which they are engaged re- points the members of the Com- all the health-care centres in the sponds in an increasingly better mission after consultation. It is country. Progress has already way to the new needs and re- preferable for these members to been made and sixteen of the quirements of the times. reside in Antananarivo so as to twenty diocese send participants facilitate the periodic meetings to the meeting for hospital chap- Article 3 of the Commission. lains. National associations for The work of the Commission these chaplains do not as yet ex- covers four areas: Article 8 ist but we are working in this di- 3.a. To make known the After consulting the members rection. Christian meaning of health, of the ECH, the choice of the Each diocese has its own pas- life, illness, suffering and death General Secretary will be pre- toral care in health and specific in conformity with the age we sented for the approval of the activities that are very interest- live in. Permanent Council of the ing but too much space would 3.b. To take part in the on- BCM. The General Secretary be required here to list them and going training of health-care will be chosen according to his to explain what they are. The re- workers at a national level. professional qualifications in port on the last meeting of the 3.c. To work with national the field of health and health DCH of January 2005 explains and diocesan organisations for care, his capacities to adminis- some of these activities. pastoral care in health in both ter the secretariat, and his spiri- There is a great deal to be their theoretical and their prac- tual qualities. done in the health and health- tical activities.. care field in Madagascar. 3.d. To keep abreast of news Article 9 Women religious are in the front in the scientific and legislative The ECH, the secretariat and line in this service of the fields in order to illuminate a delegate of the DCH (Dioce- Church. The Episcopal Com- them through the pastoral ac- san Commission for Health) mission for Health, through its tion of the Church in the make up the General Assembly. support, wants to be a sign of health-care field. this work of the Church. The Bishop President Article 4 H.E. Msgr. DONALD According to its possibilities, Article 10 PELLETIER MS, the ECH strives to help bishops It is the task of the Bishop- Bishop of Morondava, and the dioceses through the President to convene the ECH President of the Episcopal Com- promotion, the co-ordination, and the General Assembly, to mission for Health, the inspiration and the direction preside over meetings, to pro- Madagascar. of pastoral care in health. vide general guidelines for its

DOLENTIUM HOMINUM N. 62-2006 activity, and to provide an ac- of the ECH are held regularly of health-care workers: count of its activities to the Per- and correctly. – Hospital chaplains. manent Council of the BCM and – Men and women religious where necessary to the Plenary Article 14 nurses. Assembly of Bishops. It is the task of the Secretariat – Catholic state men and to maintain: women nurses. Article 11 – Communication with the – Catholic medical doctors. The Bishop-President can ap- Ministry of Health in Madagas- – Catholic obstetricians. point a priest as a delegate to car. – DCHs. second him in the work of the – Co-operation with NGOs. The frequency of the sessions Commission or to act on his be- depends on the financial re- half in his absence. Article 15 sources of the ECH. The secretariat is also respon- Article 12 sible for: Article 19 It is the task of the Bishop- – Communications with the Under the responsibility of the President to approve the moral other Episcopal Commissions Bishop-President, the ECH at- and financial report on his of- that are responsible for social- tends to the accounts and works fice, which is drawn up by the charitable matters. closely with the Administrative secretariat, and to present it to – Communications with the Secretary of the BCM. The Gen- the permanent office of the BCM and its Permanent Office. eral Secretary is the first person BCM, with a view to the distrib- – Communications with the responsible for the finances. ution of the sums agreed with Pontifical Council for Health the Nuncio’s office or ‘extraor- Pastoral Care in Rome. Article 20 dinary’ councils of external bod- – All correspondence, in All of his activities are carried 63 ies, such as Missio, the CRS, the agreement with the Bishop-Pres- out with reference to the Bishop- CEI or the annual communica- ident. President and must receive the tion with the Pontifical Council approval of the Bishop-Presi- for Health Pastoral Care in Article 16 dent. Rome. The ECH employs a secretary to ensure the working of the of- The General Assembly The Secretariat fice and to carry out the work of the secretariat. A contract will be Article 21 Article 13 drawn up according to the provi- The General Assembly meets The secretariat, guided by the sions of the Labour Code. once a year to: General Secretary, is responsi- – Assess the activities that ble for: The Episcopal Commission have been engaged in. – The communication and the fot pastoral care in health – Assess the sessions. translation of the documents of – See how the dioceses can be the Magisterium and the Pontifi- Article 17 served in a better way. cal Council for Health Pastoral This Commissions meets or- Care in matters relating to health dinarily three times a year but it Where necessary, it can hold and health care. can meet extraordinarily to pre- an extraordinary meeting. – A report on all meetings: pare a session. In the absence of ECH, the Plenary Assembly. the Bishop-President the Gener- Article 22 – A report on the sessions, al Secretary will convene the The General Assembly de- which will then be published meeting under the presidency of cides on the Statutes which will and sold to the participants. the priest who is a delegate of be presented by the Bishop- – The sending out of corre- the Bishop-President. President to the BCM for its ap- spondence to the DCH, the proval. Every change to the diocesan bishops, hospital chap- Article 18 Statutes will be presented to the lains and the various partners of It is the task of the Commis- General Assembly for its ap- the ECAR. sion to plan and organise ses- proval and then presented to the – Ensuring that the meetings sions for the various categories BCM for its approval.

DOLENTIUM HOMINUM N. 62-2006 From Athens to Sparta: we are all on a Journey with Terri Schiavo*

Now that the sad story of make clear what the bound- that the absence of evidence Terri Schindler Schiavo is aries of things are by calling constitutes evidence of the ab- coming to an end, some reflec- them by their name for those sence of all pain. tions are urgently required to people who have only heard of Patients in a vegetative state face up to the devastating cases such as that of Terri on are not all equal. The images wave that will inevitably hit television. that explore their anatomy our country beginning with A patient in a vegetative (such as RMN) or the func- this case, cancelling consoli- state is not in a state of cere- tionality of their brain (such as dated values and violently bral death because his or her PET and functional RMB) modifying the topography of brain, with varying degrees of demonstrate a wide variability the beliefs of a people. Warn- imperfection, has never in responses from case to case. ings about this cultural Tsuna- stopped functioning. He or For these reasons, as well, the mi have already been seen in she is not even in a coma; in- diagnosis of a vegetative state the sea of idiocies published in deed, he or she remains awake is not easy and important stud- recent days by authoritative with his or her eyes open. His ies indicate margins of error 64 opinion leaders and upheld or her electroencephalogram that are higher than 30% even with disarming detachment on is not flat. Indeed, periods of in qualified centres. television talk shows. being awake can alternate Another myth that has to be It has been said that the poor with periods of being asleep. exploded is that of the tubes Terri was in a ‘vegetative co- No plug exists which should by which alimentation is given ma’, that she no longer had a be taken out for the simple to the patient. They are depict- brain, that it was necessary to reason that the patient is not ed as infernal instruments that take out the plug, that she was connected to a machine. He or are not very respectful of the kept alive thanks to machines, she is not a terminally ill pa- dignity of the patient. In reali- that it was necessary to stop tient given that with basic ty, the nasal-gastric tube is a the exaggerated treatment help alone (above all hydra- procedure of care that is practiced on a patient who was tion and alimentation) he or broadly used and is usually terminal and whatever the she can live for many years. practiced only during the ini- case could not be cured. There He or she is not necessarily a tial stages of the vegetative have been those who com- patient that cannot be cured if state, whereas in the case of pared the life of Terri to that of one takes into account that the PEG this is a procedure that is a vegetable, unable to feel definition ‘permanent vegeta- very easily tolerated by the pa- anything or any pain. Indeed, tive state’ does not have a di- tient. It is also easy to use and there have even been televi- agnostic value but only one manage at home, even in the sion philosophers who have that is exclusively diagnostic hands of non-health care per- stated that this was no longer a and indicates only that the sonnel, and it is invisible to human life and former govern- possibilities of recovery be- onlookers and lies under the ment ministers have referred come reduced with the pass- clothes of the patient. There to a condition between life and ing of time. He or she is not a are patients with non-cerebral death. Some authoritative sci- patient without feelings given illnesses that have to be nour- entific journals even fell into that the evoked potentials can ished with the PEG tube for the trap of sensationalism by demonstrate the arrival of a years without this impeding a stating that we were faced stimulus to the cortex. Al- life of work and of relation- with a patient with a flat elec- though there is often a lack of ships. troencephalogram – the condi- indications of further cortical Lastly, a reflection on the tion that is to be observed with elaborations of such signals, beautiful death inflicted on brain death. There were many there have also been well doc- poor Terri, a death that is de- maîtres à penser for this pa- umented scientific cases in fined as being serene, peaceful tient who were scandalised at which a rudimental process of and without suffering, effected the inhuman and invasive discrimination and recogni- by making an organism die of tubes with which the patient tion was nonetheless possible. starvation and thirst defined in was said to be kept artificially A patient in a vegetative state a priori terms as an organism alive and invoked for her a does not tells us if he or she that cannot feel any pain. In compassionate death ‘without feels pain but a pain stimulus reality death by starvation and suffering’ brought about by reaches his or her brain and thirst is a slow process of dy- the suspension of alimentation our knowledge about the ing which slowly devastates and hydration. physiology of pain is still in- the whole of the organism. It is necessary to begin to sufficient for us to be certain The patient in a vegetative

* Article written by Prof. Gigli at the time of the event, which ended in March 2005.

DOLENTIUM HOMINUM N. 62-2006 state can suffer in ways that discreet eye could assess the so when one is dealing with we do not know, and to such suffering caused by the sus- putting to death a woman who an extent that the promoters pension of nutrition and hy- is certainly innocent! themselves of the procedure dration. When such an idea of the practice in parallel a total se- Terri Schiavo was put to autonomy of patients is sub- dation of the patient with mor- death on the basis of three jected to criticism, those that phine so as to avoid the risk falsehoods. The first is that as- established that Terri, whatev- that his or her organism mani- sisted nutrition and hydration er the case, had to die invoke fests physical signs of a rebel- are a form of ‘medical treat- the last falsehood of this dirty lion to the pain that may be ment’ and not a fundamental story: the suspension of basic felt. This is such an inhuman element of basic care for the help (hydration and nutrition) death that if some of us were patient (together with mobili- is said to be not only justified to inflict it on a dog we would sation and hygiene). The sec- but something that should be be condemned for cruelty and ond lie is that Terri Schiavo done on the basis of the princi- ill-treatment. should have been killed so as ples of futility, extraordinari- I say this at a general level to respect her wish not to re- ness (disproportionality) and to throw the most realistic ceive the ‘medical treatment’ excessive burdens, which are light possible on the vegeta- of artificial nutrition and hy- the basis of every ethical tive state and before going on dration. This was a matter, it is judgement on care and treat- to examine the consequences asserted, of respect for the ment. It is a pity that a treat- of this disgraceful story it is principle of the autonomy of ment that can achieve for necessary to clarify that the patients. A discussion on the years in an effective way its deliberate and barbaric murder limits of prior directives goes task of nourishing a person costs very little, does not re- 65 quire machines, and is very well tolerated by millions of patients in relation to the most varying pathologies, can cer- tainly not be defined as futile, unless at the price of falsifying truth. Why, then, does such a large part of American society agree with a bad husband such as Michel Schiavo in wanting to bring about the death of Terri at all costs? Behind the story of Terri Schiavo disturbing truths are concealed which go beyond this specific case and take on a universal value. It is advisable to reflect on these dramatic truths before it is too late for our society. of Terri Schindler Schiavo was beyond the intentions of this It is not the hydration and carried out on a poor patient brief paper. However, one can- the nutrition that are futile: it who was not even in a vegeta- not avoid emphasising how in is the lives of patients such as tive state. From an examina- this specific case the ascertain- Terri that are considered futile tion of the films and according ing of the presumed wish of and without meaning. It is not to the opinion of distinguished the patient is based solely on the PEG that is disproportion- American colleagues, the pa- general declarations made ate but having to look after pa- tient could at the utmost be de- during an informal conversa- tients who will not go back to fined as being in a condition tion that took place many being ‘healthy and beautiful’. of minimal consciousness years ago, declarations re- It is not the ‘treatment’ that is (MCS) or in a low level neuro- counted by a husband who is excessively burdensome for logical state (LLNS), and ca- somewhat to be suspected of a the patient but the lives them- pable of certain elementary conflict of interests and decla- selves of so many subjects movements, of rudimentary rations in contrast with the with chronic disabilities who mimesis, and of a partial ca- presumed wish of Terri as in- are seen by our society as a pacity to swallow. This patient dicated by her parents and sib- burden of which it would will- has been denied detailed diag- lings. How can one entrust de- ingly free itself. nostic examinations (such as cisions about human life to a In order to mask the intrin- PET and f-RMN) and rehabili- general conversation of some sic immorality of such conclu- tative interventions over the years ago on the subject of nu- sions, recourse is made to very last ten years, and this to the trition administered through a dangerous divagations on the point of denying her receiving tube? This would be adjudged insufficient quality of life that communion during days of insufficient evidence even in a is said to characterise patients hunger and thirst so that no in- criminal trial, and even more in a vegetative state and those

DOLENTIUM HOMINUM N. 62-2006 patients, such as Terri, who re- all, starting with the day after such a discriminatory princi- semble them. On the basis of a the death of Terri, the same ple can be extended to many judgement that cannot be ap- groups of opinion that had re- other categories of patients pealed against and which quested the suspension of hy- who are equally without au- comes from outside, the quali- dration and nutrition will re- tonomy, lives with relation- ty of life is deemed insuffi- quest the possibility of achiev- ships, awareness, and the ca- cient to defend life itself when ing death in a quicker and less pacity to communicate their the patient is not able to main- painful way (without having decisions. I am referring here tain a sufficient capacity for to fill the patient with mor- to the demented, to the men- relationships, when he or she phine). This will be a decisive tally retarded, to people in does not demonstrate suffi- argument for the legalisation long comas, and to gravely de- cient awareness, when he or of euthanasia in the United formed newly born children. she does not have any hope of States of America, and after In the name of a high court of an acceptable recovery, when the United States of America, human dignity a discriminato- he or she is not able to express in the whole world. In addi- ry regime will be installed that an autonomous will, and when tion, if an opulent society such will be in net opposition to the he or she is not able to com- as American society by now Universal Declaration of the municate his or her own deci- believes that care for patients Human Rights and will con- sions. In these conditions one without any hope of recovery tain further dangerous democ- is said to be dealing with a life is a waste of money, then it is ratic negative tendencies. Af- that is no longer human or, the overall level of care for ter leaving Athens and human- employing a more subtle fragility that is called into ism we will return to Sparta sophism, we are said to have question, and with irreversible and the selection of the best. 66 before us human beings who damage to the principle of sol- are by now without the mini- idarity in care. Lastly, if pa- Prof. GIAN LUIGI GIGLI mum requirements that are tients in a vegetative state Director of the SOC of the Neurology said to characterise a human should be seen as human be- and Neurophysiopathology, person. ings whose life is no longer The Hospital of ‘Santa Maria della Misericordia’, It is easy at this stage to worthy of being lived, and Udine, draw conclusions and realise who are no longer recognised Former President of the International why the Schiavo case opens as having the status or the Federation of the Association up worrying prospects. First of rights of a human person, then of Catholic Doctors (FIAMC)

DOLENTIUM HOMINUM N. 62-2006 The World Congress of the International Federation of Associations of Catholic Doctors FIAMC

Barcelona, Spain 11-14 May 2006 The World Congress of the International Federation of Associations of Catholic Doctors (FIAMC) BARCELONA, SPAIN, 11-14 MAY 2006

From 1 May to 14 May 2006, struction of a more just world, The International Federation at the Palace of Congresses in beginning with their specific of Associations of Catholic Barcelona (Montjuïc), the professional tasks. Over one Doctors is made up of about World Congress of the Interna- thousand participants and an seventy national associations of tional Federation of Associa- important echo in the mass me- Catholic doctors from all over tions of Catholic Doctors (FI- dia at an international level the world. The Federation is AMC) was celebrated. This or- gave prominence and lustre to present in six regions: Africa, ganisation brings together forty the event. The previous con- Asia, Australia and New thousand medical doctors from gresses had been celebrated in Zealand, Europe, North Ameri- seventy professional associa- New York (1998), Rome (the ca, and Latin America, and its tions from all over the world. extraordinary Congress of mission is the safeguarding and This Congress, which meets 2000) and Seoul (2002). the promotion of human life in every four years, had returned The subject of the session the different cultures of the to Spain after thirty-two years. was divided into five parts: the world, as well as the profes- The primary subject of the first dealt with access to health sional, human and spiritual im- 68 Congress was ‘Catholic Doc- care: the rights of the poorest, a provement of its associates. tors and the Challenge of question of justice; the second, Metges Cristians de Catalun- Poverty in the Era of Globalisa- focused in upon distance learn- ya, an association of profes- tion’ and the Congress focused ing in medicine: opportunities sional doctors that has worked on the challenge that the elimi- and risks; the third was dedicat- for many years in Catatonia and nation of poverty represents for ed to international health-care is a part of the FIAMC, was en- a society such as ours. Together associations and institutions trusted with organising the with scientific sessions and ses- and their approach to poor Congress in Barcelona. sions of a general character, as countries; the fourth addressed During the proceedings of well as testimony and the paral- the subject of Catholic medical the Congress a new world Pres- lel work groups, various initia- doctors and professionals of ident of the FISMC was elect- tives were presented designed other religious confessions: re- ed, namely the Catalan doctor to eradicate the phenomenon of spect for life and the dignity of José M. Simón. material and health-care pover- man; and, lastly, the fifth part A Holy Mass, presided over ty in various regions of the dealt with medical doctors at by His Excellency Msgr. José world. the service of peace. Luis Redrado and concelebrat- The Congress offered com- The NGOs and other institu- ed by sixteen and panies and institutions belong- tions that work to eradicate bishops and thirty-five priests ing to the health-care world or poverty were presented, as from all the continents of the otherwise the possibility of were over forty initiatives. A world, was celebrated in the working with this event of a cultural circle was organised cathedral of the city as the final global importance which would for those people who accompa- act of the Congress. have major repercussions. In nied the participants. Parallel In his homily, Bishop Redra- addition, the aim was to pro- symposia took pace that dealt do, the first bishop in the histo- mote a concrete initiative of with various specialisations. ry of the Hospital Order of St. health-care practice in those And, lastly, there was the gen- John of God, expressed the less favoured regions of the eral assembly of the FIAMC, emotion that had been pro- planet to be found in the north with the presentation of activi- voked in him by presiding over of Kenya. Mater Care is the in- ties that had been engaged in, this Eucharistic celebration in ternational agency dealing with the guidelines for action over the cathedral of Barcelona. For mother-child care belonging to the next years, and the election this reason, he thanked H.E. the FIAMC to which will be of the new office-holders. Msgr. Martínez Sistach for given the contributions made The symposia and work wanting to concede to him the by the Congress. groups on various subjects were honour of presiding over the The wish of the organisers of many in number: mother-child Holy Mass that closed the Con- the meeting was that this event care in the Third World (Mater gress. These two prelates are would be a sort of ideal forum Care International); the natural long-standing friends from the for the exchange of knowledge regulation of fertility (RE- time when they worked togeth- and experiences. They also NAFER); Catholic psycholo- er in the sector of pastoral care wanted everything that the gists (the DIF Foundation); in health in the Ciudad Condal. Church does in the world for medicine in the field of sport ‘Let us thank God’, said Ms- the less fortunate to be known (Fundación Árbol de la Vida); a gr. Redrado, ‘for the Congress about. Lastly, the Congress study group on affective-sexual that we have celebrated and for wanted to encourage Catholic education and upbringing; and the fruits that we expect from it. health-care professionals to be- natural family planning Thank you, Lord, for every- come committed to the con- (TEENSTAR). thing that helps us to be better

DOLENTIUM HOMINUM N. 62-2006 servants of the sick.’ This ject the kind of globalisation List of the new prelate, when referring to the which results in the exploitation office-holders elected readings of the fifth Sunday of of disadvantaged peoples, during the General Easter (which were read in vari- which exploits their natural re- Assembly, May 2006 ous languages), guided the par- sources, and which results in ticipants in their work as Chris- environmental destruction. We tian medical doctors. ‘We are also reject the exploitation of President: celebrating a paschal feast in cheap labor in some countries. José M. Simón Castellvi, MD honour of the Risen Christ. In 3. We reject those aspects of C/Calábria, 273, entresol 4a imitating the women and the Western medicine which pro- 08029 Barcelona (Spain) tel. + 34 93 3630364 apostles of the time, Christ in- mote treatment of desires whilst fax + 34 93 4104009 vites us today to be witnesses to a large part of the world is con- [email protected] resurrection. And we can be demned to remain without basic such if we remain united to him health care, leading to high Vicepresident: through the gift of Faith. We rates of maternal and infant John Lee, MD take leave, therefore, from this mortality and shortened life ex- 482A East Coast Road Congress and from this celebra- pectancy. 429051 Singapore tion ready to be, at every mo- 4 We condemn pressures ex- tel. + 65 63446231(res) cell. + 65 97327137 ment and for everyone, wit- erted by international organiza- fax + 65 62418827 nesses to Christian joy, men tions which link aid to the ac- [email protected] and women full of a life dedi- ceptance of unethical reproduc- cated to service to sick people. tive health practices, such as Secretary General: Also sensitive to pain but al- abortion, contraception, and Salvino Leone, MD PhD ways open to hope and to joy sterilization. Via D’Annunzio 9 69 because pain and joy always 5. We applaud the kind of 90144 Palermo (Italy) walk together in our lives (Cf. globalisation which promotes tel. +39 091 6259680 Catalunya cristiana, 25 May positive values, such as respect fax +39 0918889681 cell. +39 335406363 2006). for life, and solidarity between [email protected] peoples, countries, and classes. This results in breaking down Treasurer: CONCLUSIONS the barriers of marginalization Francisco Diaz Herrera, MD OF THE 22nd CONGRESS. and leads to the true promotion Av. Tabancura 1091 of. 210 OF FIAMC of health. Vitacura, Santiago de Chile 14 MAY 2006, Barcelona 6. We acknowledge that tel. e fax + 56 2 2173281 many developing countries [email protected] The 22nd. Congress of the have cultural and family values World Federation of Catholic and respect for life which Ecclesiastical Assistant: Medical Associations (FIAMC) should be accepted by Western Msgr Maurizio Calipari Via Aurelia Antica 284 met in Barcelona, representing culture. 00165 Roma (Italy) 78 countries. 7. FIAMC intends to cooper- tel. +39 06 39377177 The subject of the congress ate with international bodies, cell. + 39 332993072 was ‘Catholic physicians, glob- distance learning programs, and fax +39 06 39377177 alisation, and poverty. We pro- health education programs [email protected] pose the following conclusions: which promote positive globali- 1. The current international sation, which leads to true equi- Past president: order condemns entire popula- ty among nations. Gianluigi Gigli, MD Osp. S. Maria della Misericordia tions to remain in poverty and 8. We will continue to exert 33100 Udine (Italy) misery, which is unjust and pressure on international orga- tel. +39 0432 552721 against the will of God. nizations so that they truly re- fax +39 0432 552719 2. We, Catholic doctors, re- spect human rights. [email protected]

DOLENTIUM HOMINUM N. 62-2006 Catholic Doctors: Love Your Profession!

1. I address a special greeting technology and that he cannot Christian commitment, under- from Cardinal Javier Lozano be extraneous to it. He knows taken and carried out not only Barragán, the President of the how much the development of as a technical activity but also Pontifical Council for Heath technology has changed life, as one of dedication to and love Pastoral Care, and also from philosophy, language and men- of neighbour. It is “a form of me, to the President of the FI- tality and to what point one can Christian witness”. “Their pro- AMC, Prof. Gian Luigi Gigli, end up by thinking that man is fession calls for them to be to the chairman of the organis- able to change man. For this guardians and servants of hu- ing committee, Dr. José M. reason it is necessary to search man life”’ (n. 1). Simón, to the organisers of this for a balance between techno- congress, and to all the partici- logical development and ethical 5. In an interview Fra. Pier- pants. values, the ultimate and overall luigi Marchesi, the former Su- meaning of life (Fides et ratio, perior General of the Order of 2. I would like to thank the n. 81), and the sapiential di- St. John of God, a pioneer and organisers of this congress for mension, in which side by side prophet of humanisation, their invitation to the Pontifical with scientific and technologi- replied to a question that had Council to take part in this con- cal advances there are also been posed to him about the gress, to speak a few words by those of philosophical and ethi- contemporary role of medicine 70 way of an introductory greet- cal character (Fides et ratio, n. in the following terms: ‘Medi- ing, and to celebrate Holy Mass 106). cine is at a critical crossroads as an action of grace at the end The Second Vatican Council under the pressure of technolo- of the meeting. says: ‘our epoch...needs this gy and politicisation, and it de- wisdom to humanise all of its bates its future between two ex- 3.The subject of the congress new discoveries. Indeed, the fu- tremes: whether to be an in- has a global aspect that charac- ture of the world is imperilled creasingly ‘scientific’ medicine terises our society, namely that unless wiser men are not or whether to be an increasingly of poverty, which is not extra- brought forth’ (GS, n. 15). In human medicine. We could be neous to the health-care world the same way, John Paul II in satisfied with the fact that med- because, as we know, poverty is his Redemptor hominis (n. 16) icine remains the way it is, un- the cause of a significant num- tells us that dominion over the derstanding by medicine that ber of few illnesses. However, world is based upon the prima- discipline which goes beyond this is not what I want to under- cy of the spirit over matter; of the contemporary technological line in my greeting because the the person over things; and of impact of science and mass and speakers that are listed in the morality over technology. state care: that medicine which programme of the congress will A lack of anthropological, down the ages has drawn near perform this function in a very philosophical and bioethical to affective, cordial and human appropriate way. grounding in health-care profes- protection; that medicine whose sionals in relation to matters root has been the Greek concept 4. What I would like to speak that bear upon the mystery of of ‘philanthropy’ and the about, instead, is the responsi- life – whether this is a matter of Christian concept of ‘charity’, bility, today, of medical doctors the beginning or the end of life that is to say love for man. – and I would here like to em- – provokes outrage and the ma- How can I render authentic phasise Catholic medical doc- nipulation of the human person. my way of living out my ser- tors – in the whole of the I am referring here in particular vice if to begin with I have not process of change that is being to medical doctors and leave measured myself to needs, produced in our society and aside other professionals: doc- hopes and the service itself? If I bears upon medicine and the tors are at the service of life and did not engage in such an un- work of medical doctors them- must be very good advisers who dertaking I would transmit a selves. One need only look at should guide us as to how to sort of counterfeit coin, I would everything brought about by the make life healthier. A medical carry out an action that is im- secularisation of medicine, the doctor is at the service of life, posed on me by work, by a con- values that are abandoned, and he or she is a minister of life tract, by a law which makes me relativism in questions that con- who must defend, educate and do it. I would place my hands cern life. All of this calls med- serve. The Charter for Health on a sick person as though he or ical doctors to greater responsi- Care Workers, which was pub- she were absorbent paper im- bility in the study and the ex- lished by our Pontifical Council pregnated with water and I ploration of their profession. In for Health Pastoral Care, de- would end up by destroying it this era of technology, indeed, votes its first ten sections to this because I would, beyond that the temptation is strong to en- subject. I would like to quote paper, be looking for a pay- trust everything to machines. here only the beginning, which ment, a prize, a small quantity The medical doctor knows, in- reads as follows: ‘The work of of happiness. However, in reali- deed more than anyone else, health care persons is a very ty, I myself should immerse how much he needs technology valuable service to life. It ex- myself in this wet absorbent pa- and information and computer presses a profoundly human and per and transform myself into

DOLENTIUM HOMINUM N. 62-2006 one thing with it, at the same Care has not hesitated to call pad for, and the beginning of, a time, however, remaining mys- health-care professionals ‘Min- new spring for the FIAMC. teriously myself while it contin- isters of life’. Lastly, I would like to take ues to be itself’. In one of its documents, the advantage of this celebratory Bishops’ Conference of Spain occasion to extend cordial and 6. Health-care professionals: made the following observa- sincere thanks to the President love your profession! You have tions about ‘Catholics and the of the Federation, Prof. Gian a great task ahead of you, one profession’: ‘The profession ac- Luigi Gigli, for the work of that is technical in character, quires a truly vocational and thought and reflection engaged certainly, but your profession at even spiritual dimension. But in by the FIAMC during his the service of man poses a chal- this will be true only if the exer- presidency, and for the con- lenge to you: am I able to care cise of the profession is inter- stant, active, expert and gener- and treat man with humanity nally animated by the spirit and ous presence on his part which and in an overall way? supported in its development by has characterised that work. With your welcome you will the moral criteria of the Gospel For this reason, on behalf of build a ‘new home’ for the sick and in imitation of Christ. the President of the Pontifical person, that ‘new home’ that he These requirements must not be Council for Health Pastoral or she needs; you will build a limited solely to an economic Care, His Eminence Javier suitable place, intended for the order, as is the case, for exam- Lozano Barragán, we hereby sick person, the place that he or ple, with justice in remunera- give to him the medal of the she needs. Go to the heart of the tions. The Christian life and Good Samaritan, the symbol matter, look for the good of the Christian morality have broader and expression of our Pontifical patient and you will see how re- requirements. Respect for life, Council, Together with that lations, communications and faithfulness to the truth, respon- medal go our thanks and our 71 power change. sibility and good training, hard hope, and I repeat the point, for Look for the good of the pa- work and honesty, the rejection a new spring for the FIAMC. tient and you will inject into of all fraud, a social sense, and Thank you once again. you profession more science, generosity as well, must always more readiness to help, more inspire the Christian in the ex- H.E. Msgr. JOSÉ L. dialogue, less discrimination ercise of his or her work and REDRADO, OH and greater presence. professional activity’. Secretary of the Pontifical Council When speaking about the In the programme of the con- for Health Pastoral Care, health-care profession, Cardinal gress I see many subjects which the Holy See Tarancón declared that ‘medi- emphasise with expertise what, cine, education and the priest- in a rapid and schematic form, I hood require something more have drawn attention to in my than technical help, even speech of greeting: rights, edu- though such help is necessary. cation, the various religious tra- Notes They need the human warmth ditions, respect for life, evange- 1 Cardinal ENRIQUE TARANCON, ‘La of those who provide technical lisation, and an infinity of testi- profesión sanitaria’, Humanizar, Febru- help. For this reason, they have monies which have made a re- ary 1994. 2 Pontifical Council for Pastoral Assis- a special greatness and a human ality of all of this through the tance to Health Care Workers, Charter fullness’. practice of medicine, and a hu- for Health Care Workers, nn. 1-10. This greatness of health-care manitarian and globalised med- 3 Comision permanente de la conferen- cia episcopal española, Inst. Past. Los professionals is why our Pontif- icine. I hope and wish that this católicos en la vida pública, 22-IV-1986, ical Council for Health Pastoral congress will be a launching n. 113-114.

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