Charter For Health Care Workers


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  • Charter For Health Care Workers

    1. 1. The Perspective of the Theology of Suffering in the Vatican’s “Charter for Health Care Workers” < /library/CURIA/PCPAHEAL.HTM >
    2. 2. Varying Perspectives on Suffering
    3. 3. < >
    4. 4. Putting Suffering Into Perspective <ul><li>“ The meaning of pain defines suffering. An athlete may expect and even embrace pain during a game but may suffer if his injury disables him or causes his team to lose. A person who is injured intentionally and ignored is likely to suffer more than one who is hurt accidentally and treated with care…. </li></ul><ul><li>“ The task of putting profound suffering into perspective can require grappling with larger questions. For example, serious physical illness often prompts individuals to reassess what gives their lives significance. Survivors of childhood sexual abuse may need to rebuild their shattered assumptive worlds so as to achieve a new take on themselves, on their hopes, and on reality…. </li></ul><ul><li>“ in recent years mental health professionals have increasingly recognized the clinical relevance of spirituality…. However, relatively little attention has been directed to the implications of different belief systems embraced by patients for accomplishing basic psychotherapeutic tasks such as integrating suffering.” </li></ul>
    5. 5. Putting Suffering Into Perspective <ul><li>“ A person’s world view helps to shape the meaning of her painful experience. </li></ul><ul><li>“ An individual who trusts in God as a protector of good people may feel cheated, if not punished, by a dx of cancer. </li></ul><ul><li>“ A believer with a different understanding of God may wonder if the same illness is intended to discipline him or bring him closer. </li></ul><ul><li>“ Cancer may remind a Buddhist of the need to transcend desire & attachment, </li></ul><ul><li>“ an atheist of his most important accomplishments or values. </li></ul><ul><li>“ suffering can also influence one’s world view….In a survey of 350 members of the American Association for the Advancement of Atheism, they found that ½ of the younger atheists had lost one or both parents before the age of 20. A large # of this group also described themselves as unhappy in childhood & adolescence.” </li></ul>The Relationship Between Suffering & World View
    6. 6. Putting Suffering Into Perspective <ul><li>“ Jews can find in the Psalms & in the story of Job precedent for the sufferer to call out to and question God. </li></ul><ul><li>“ Christians can also see in Christ’s suffering evidence that God cares about their suffering because he has taken it on himself—thus dignifying suffering on behalf of others. </li></ul><ul><li>“ Buddhists find in the dharma support for detaching from the desire that leads to suffering. </li></ul><ul><li>“ Atheists faced with suffering may instead take pride in their own integrity, intellectual honesty, or stoicism…. </li></ul><ul><li>“ Individuals with a spiritual or theistic world view often feel that someone cares about their pain and that they are not ultimately alone. However, </li></ul><ul><li>they may also be struggling with the concept that a God who is powerful enough to have spared them illness did not choose to do so…. </li></ul><ul><li>“ Clinicians will usually find that believing patients (like nonbelievers) …most often want a chance to be heard & to talk about their concerns….They may also need to reflect on, & to think through, their own beliefs & doubts. The account by the Christian apologist C. S. Lewis of his experience of his wife’s death, A Grief Observed , is a compelling description of this process…. </li></ul>The Therapist’s Role
    7. 7. Putting Suffering Into Perspective <ul><li>“ Individuals with a naturalistic or atheistic world view consciously reject a purposeful explanation for the universe….they may feel ultimately alone and anxious in bearing pain….they see illness as no one’s fault, except perhaps their own through mistakes they made in bringing it on or failing to detect it in its early forms. Instead, they often struggle to achieve a kind of Eriksonian integrity, or ability to live and die consistent with who they are…. </li></ul><ul><li>“ Suffering makes many patients realize that they are uncertain or ambivalent about their philosophy of life. They may consider themselves as ‘lapsed’ churchgoers or skeptics who have rejected organized religion but retained a strong sense of personal spirituality. </li></ul><ul><li>A number of challenges face clinicians in attempting to help agnostic patients clarify their beliefs about what matters most, think through their questions, and consolidate their values so as to live in accord with their deepest commitments…. </li></ul><ul><li>“ Perhaps the most difficult challenge is presented by those agnostic patients (often character-disordered, with narcissistic traits or substance abuse) who lack both a framework of meaning and the insight that they need direction. The psychologist and philosopher Søren Kierkegaard would have diagnosed them with ‘the sickness unto death,’ or ‘the despair that does not know it is in despair’…. </li></ul>The Therapist’s Role
    8. 8. Suffering from a Hindu Perspective
    9. 9. Suffering from a Hindu Perspective <ul><li>Hinduism encourages “ a resigned attitude based upon the belief that there is nothing much one can do about what happened in the past or what is happening now & what is going to happen in the immediate future…. </li></ul><ul><li>[It] “provides an opportunity to every individual to shape his future & he is inclined spiritually, to liberate himself from the world of births & deaths…. </li></ul><ul><li>“ True liberation comes when one achieves self realization and becomes free from the cycle of births and deaths.” </li></ul>
    10. 10. Suffering from a Buddhist Perspective
    11. 11. <ul><ul><li>“’… .The essence of life is suffering, said the Buddha. At first glance this seems exceedingly morbid and pessimistic….Take any moment when you feel really fulfilled and examine it closely. Down under the joy, you will find that subtle, all-pervasive undercurrent of tension, that no matter how great this moment is, it is going to end. No matter how much you just gained, you are either going to lose some of it or spend the rest of your days guarding what you have got and scheming how to get more. And in the end, you are going to die. In the end, you lose everything. It is all transitory.’ Henepola Gunaratana, from ' Mindfulness in Plain English '. </li></ul></ul><ul><li>“ The reason that we experience suffering comes ultimately from our mind. According to Buddhism, our main mental problems or root delusions are: attachment , anger and ignorance . Because of these delusions, we engage in actions that cause problems to ourselves and others. With every negative action (karma) we do, we create a potential for negative experiences….If we can control our body and mind in a way that we help others instead of doing them harm, and generating wisdom in our own mind, we can end our suffering and problems. </li></ul><ul><li>“ The Buddha summarised the correct attitude and actions in the Eight-fold Noble Path: </li></ul><ul><ul><li>(The first 3 are avoiding the 10 non-virtues of mind, speech and body:) </li></ul></ul><ul><ul><li>Correct thought : avoiding covetousness, the wish to harm others and wrong views (like thinking: actions have no consequences, I never have any problems, there are no ways to end suffering etc.) </li></ul></ul><ul><ul><li>Correct speech : avoid lying, divisive and harsh speech and idle gossip. </li></ul></ul><ul><ul><li>Correct actions : avoid killing, stealing and sexual misconduct </li></ul></ul><ul><ul><li>Correct livelihood : try to make a living with the above attitude of thought, speech and actions. </li></ul></ul><ul><ul><li>Correct understanding : developing genuine wisdom. </li></ul></ul><ul><ul><li>(The last three aspects refer mainly to the practice of meditation :) </li></ul></ul><ul><ul><li>Correct effort : after the first real step we need joyful perseverance to continue. </li></ul></ul><ul><ul><li>Correct mindfulness : try to be aware of the ‘here and now’, instead of dreaming in the ‘there and then’. </li></ul></ul><ul><ul><li>Correct concentration : to keep a steady, calm and attentive state of mind.” </li></ul></ul>Suffering from a Buddhist Perspective
    12. 12. Suffering from the Perspectiveof Confucianism
    13. 13. <ul><li>“ In all the greatest cultures of the world, there have been prominent teachers, leaders and reformers who are still honoured and revered to this day. From amongst those of the Chinese tradition, one man stands foremost, and that is Confucius, the great sage, teacher & reformer…. </li></ul><ul><li>“ In his teaching he emphasised righteousness - correct behaviour based on duty, which in turn is based on one's situation in society….Confucius was the rare combination of an idealist and practical business man…. </li></ul><ul><li>“ earthly minded, [He] never acknowledged a personal God. Confucius was neither interested in where man came from or where his soul departed to after death. </li></ul><ul><li>“ Of himself he said, ‘I have striven to become a man of perfect virtue and to teach others without weariness,’ His ideal was ‘the superior man carrying out in his conduct what he professes’…. </li></ul><ul><li>“ Since the death of Confucius, a whole school of philosophy has developed from his teachings, and his fame and reputation have spread throughout the world. To some he was a God, to others a remarkable administrator, a great reformer, the first teacher or the supreme teacher.“ </li></ul>Suffering from the Perspectiveof Confucianism
    14. 14. Suffering from an Islamic Perspective
    15. 15. <ul><li>“ our present life, with all its joys and sufferings, is merely transitory & illusionary…. Death may be the ultimate human suffering in this world, but it is certainly not the end of life….the 2 nd phase of human life is reflective of how we conduct ourselves in the first phase of life.  The joys as well as the sufferings shall continue in the life Hereafter…. </li></ul><ul><li>“ Islam acknowledges that life is full of suffering, starting as early as the very process of human conception in a mother's womb and during the process of childbirth….. </li></ul><ul><ul><li>… .the disasters that are caused by natural laws are no reflection of the Creator's cruelty over humans. According to the Holy Quran, the study of natural phenomenon makes us understand that, despite the devastation suffered by some humans, God's Mercy (rahmah) is the most overwhelming attribute in Nature that creates, maintains and evolves all forms of life including human life. </li></ul></ul><ul><ul><li>“ there are the man-made infliction that cause other humans to suffer….causing suffering, pain and death to others through the misuse and abuse of one's free will, humans remain responsible to God, & not God to humans….to establish, a JUST society is one of the most important obligations taught by Islam. Those who may escape the corporal punishment in this world, for them God's punishment shall be waiting in the life to come….. </li></ul></ul><ul><ul><li>“ there are acts of ‘self-inflicted suffering’:….The Holy Quran prohibits inflicting self-injuries, specifically committing of suicide…. </li></ul></ul><ul><li>“ it does not matter how much a person suffers in this world, as long as he or she is engaged, according to his or her capacity, in repelling the evil and doing the good works. The joys and comforts of the life yet to come are far greater, unparalleled and everlasting as compared with human sufferings of this life!….for us Muslims and all others, the important thing should be is to learn how to handle human sufferings retaining full faith in a loving God!” </li></ul>Suffering from an Islamic Perspective
    16. 16. Suffering from a Jewish Perspective?
    17. 17.
    18. 18. “ I believe in God. But I do not believe the same things about Him that I did years ago, when I was growing up or when I was a theological student.” “ I recognize His limitations. He is limited in what He can do by laws of nature and by the evolution of human nature and human moral freedom.”
    19. 19. &quot;We could bear nearly any pain or disappointment if we thought there was a reason behind it, a purpose, to it. But even a lesser burden becomes too much for us if we feel it makes no sense…. “ Let me suggest that the bad things that happen to us in our lives do not have a meaning when they happen to us. They do not happen for any good reason which would cause us to accept them willingly. But we can give them a meaning. “
    20. 20. Not Very Satisfying!
    21. 21.
    22. 22.
    23. 23. (from Peter Kreeft’s web site)
    24. 24. Reasons to Believe: First Cause Argument <ul><li>Four of Aquinas' 5 proofs are variations. Whether it be </li></ul><ul><li>motion, </li></ul><ul><li>the beginning of existence; </li></ul><ul><li>present existence or </li></ul><ul><li>goodness/value, </li></ul><ul><li>everything needs an explanation. </li></ul>
    25. 25. Reasons to Believe: Argument from Design <ul><li>Monkeys could have banged out the greatest musical masterpieces. Common sense instead points us to great composers. </li></ul><ul><li>The existence of the universe points to a creator. </li></ul>
    26. 26. Reasons to Believe: Argument from Desire <ul><li>&quot; Creatures are not born with desires unless satisfaction for these desires exists.... If I find in myself a desire which no experience in this world can satisfy, the most probable explanation is that I was made for another world&quot; (C.S. Lewis) </li></ul>
    27. 27. Reasons to Believe: Pascal’s Wager <ul><li>If you've got everything to gain and nothing to lose, why not believe? </li></ul><ul><li>If there is a God, don't we want to give Him His due? </li></ul>
    28. 28. Reasons to Believe: Arguments from History <ul><li>Similar to the argument from design, we could argue </li></ul><ul><li>1 st , that humanity's story is meaningful. </li></ul><ul><li>2 nd , that God's justice is revealed in this story. </li></ul><ul><li>3 rd , that various &quot;coincidences&quot; testify to Providence, </li></ul><ul><li>as do miracles (which is 4 th ). </li></ul><ul><li>5 th , that honest examination of evidence forces the question of Christ's identity: </li></ul><ul><li>Lord, lunatic, or liar? </li></ul><ul><li>6 th , that if not God, what causes martyrs' joy? </li></ul><ul><li>7 th , that if not for God, how would Christianity have been so successful at winning converts? </li></ul><ul><li>8 th , what happens when you pray the prayer of the sceptic? </li></ul>
    29. 29. Reasons to Believe: Argument from Conscience <ul><li>Some basic beliefs about right & wrong enjoy universal agreement. Who but God gives the inner &quot;still, small voice&quot; telling us to do good? </li></ul>
    30. 30. John Haas, Ph.D., STL President of the National Catholic Bioethics Center
    31. 31. Some Very, Very Basic Beliefs about Right & Wrong Enjoy Universal Agreement Dr. John haas notes that &quot; the ancient Babylonian code, the Code of Hammurabi, [and] .... other ancient pagan religions,... have rules against adultery, murder, theft, & bearing false witness .&quot; Because there truly are objective moral standards, Dr. Haas says we can &quot; dialog with other peoples who may not share our...religious beliefs.... basic moral teachings ...apply to everybody.... we all share the same human nature . &quot; Traditionally, this has been called the “Natural Law” or “Natural Moral Law.” In his letter to the Romans, the Apostle Paul said the &quot; demands of the law are written in their hearts . &quot; The &quot; Natural Law &quot; or &quot; Natural Moral Law &quot; is concerned with universal & unchanging principles of morality. Who but God gives the inner &quot;still, small voice&quot; telling us to do good?
    32. 32. So, What is this “Natural Law” (aka, “Natural Moral Law”?
    33. 33. Norms of Christian Decision Making in Bioethics are consistent with the &quot;Natural Law,&quot; that applies to all: &quot;NATURAL LAW&quot; is not the same as the &quot;LAWS OF NATURE&quot; (prescriptive) (descriptive) the road map to true human happiness (&quot;...demands of the law are written in their hearts...&quot; (Romans 2: 15)) &quot;Natural Law“ (prescriptive) is also not the same as the &quot;Might is Right&quot; nor &quot;Morals Are Mores&quot; nor &quot;Right Is What Brings Pleasure&quot; nor &quot;Right is the Greatest Good for the Greatest Number&quot; (Utilitarianism) First Principle of Morality: Choose the goods which will promote the true good of humanity (Do not impede, damage, or destroy a &quot; Basic Human Good. &quot;) (&quot; God looked at everything he had made, & He found it very good .&quot; (Genesis 1:31)) Life, Knowledge , Skillful performance/ aesthetic appreciation Integrity Authenticity, Friendship , Religion , & Marriage. l l We always choose &quot;goods;&quot; l we are concerned with how l we choose. l l Arguments about how l to choose BHGs l get confused . l
    34. 34. According to authors/Dominican priests Benedict Ashley & Kevin O'Rourke, &quot;Christian ethics might be specified by the priority it gives to certain values....St. Paul, summarized these Christian priorities as faith , hope , and love (Rm 13)....
    35. 35.
    36. 36.
    37. 37. Norms of Christian Decision-Making in Bioethics Norms of Christian Hope Norms of Christian Love Norms of Christian Faith & Prudence Principle of Well-Formed Conscience Principle of Free and Informed Consent Principle of Moral Discrimination Principle of Double Effect Principle of Legitimate Cooperation Principle of Professional Communication Principle of Human Dignity in Community Principle of Participation ( aka, subsidiarity ) Principle of Totality & Integrity Principle of Stewardship and Creativity Principle of Inner Freedom Principle of Personalized Sexuality ( aka, The Principle of Family-Oriented Sexuality ) Principle of Growth through Suffering
    38. 38. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) <ul><li>Principle of Well-Formed Conscience </li></ul><ul><li>Good, decent, well intentioned people can “follow their conscience” and still be objectively wrong. In any ethical decision-making, I have the responsibility to “step to the plate” equipped with facts, as well as a conscience well-formed by the relevant ethical principles. </li></ul>
    39. 39. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) <ul><li>Principle of Free & Informed Consent </li></ul><ul><li>This principle is sometimes misinterpreted as meaning that my health care provider is morally free to perform any procedure which is agreed-to by the patient. </li></ul>
    40. 40. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) <ul><li>Principle of Moral Discrimination </li></ul><ul><li>According to the Natural Law’s “ First Principal of Morality ,” I should always make my moral choices in a manner which will promote “Integral Human Fulfillment,” the true good of humanity ( This should NOT be confused with other types of moral decision-making, such as the notions of &quot;Might is Right,&quot; &quot;Morals are Cultural Mores,&quot; &quot;Right Is What Brings Pleasure&quot; or &quot;Right is the Greatest Good for the Greatest Number&quot; (aka, Utilitarianism )). In making choices, I should NEVER impede, damage or destroy a “basic human good” ( i.e., Human Life, Knowledge, Skillful performance/aesthetic appreciation, Integrity, Authenticity, Friendship, Religion, & Marriage .). Along the lines of this principle, provision of nutrition/hydration ( even if via an “artificial” means ) would ordinarily constitute obligatory “care,” rather than “treatment” ( which MAY not always be obligatory ). </li></ul>
    41. 41. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) <ul><li>Principle of Double Effect </li></ul><ul><li>In a situation where I am choosing a good action , but in which my action will have both good & bad effects, my intention must be the good effects and the avoidance of the bad effects. The anticipated good effects must outweigh or at least equal the bad effects; the anticipated good effects must NOT be products of the bad effects. My action must produce those good effects at least as immediately as the bad. This principle would absolutely NOT justify doing an inherently bad action, so that good may come of it. </li></ul>
    42. 42. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) <ul><li>Principle of Legitimate Cooperation </li></ul><ul><li>This principle concerns “ cooperation ” with the immoral act of another person. It is really an extension of Double Effect. </li></ul><ul><ul><li>To “ formally cooperate ” in an immoral act means to assist without moral reservation; formal cooperation is always wrong . </li></ul></ul><ul><ul><li>Any other type of cooperation with the immoral act of another is called “ material cooperation .” If my material cooperation with the immoral act is “ immediate ” (i.e., if I am “an instrumental agent of the principal agent”), it is also always wrong . </li></ul></ul><ul><ul><li>When my my material cooperation is not immediate, it is called “ mediate .” If my mediate, material cooperation with the immoral act is “ remote ” (rather than “proximate”), it may be acceptable – “depending on the degree of the good to be achieved or evil avoided by the cooperation&quot; (Ashley & O’Rourke, pp.193 - 199). Even with remote, mediate material cooperation, I should consider the d danger of scandal that my cooperation may entail. </li></ul></ul><ul><li>Formal Cooperation v. Material Cooperation </li></ul><ul><li>(always wrong) immediate v. mediate </li></ul><ul><li>(always wrong) proximate v. remote </li></ul><ul><li>Making a referral for a morally excluded service would be an example of formal cooperation or immediate, material cooperation in the immoral act of another. </li></ul>
    43. 43. NORMS OF CHRISTIAN FAITH & PRUDENCE (6) <ul><li>Principle of Professional Communication </li></ul><ul><li>This principle entails trust, and honest/ appropriate sharing of information: “For the Christian ...confidentiality is not only professional; it expresses respect for the dignity of the human person, whom only God has a right to judge (Mt 7:1-5)&quot; (Ashley & O’Rourke, pp. 199, 200). This principle would NOT necessarily exclude sharing information with the Center for Disease Control. </li></ul>
    44. 44. NORMS OF CHRISTIAN LOVE (3) <ul><li>Principle of Human Dignity in Community </li></ul><ul><li>According to the Natural Law’s “ First Principal of Morality ,” I should always make my moral choices in a manner which will promote “Integral Human Fulfillment,” the true good of humanity In making choices, I should NEVER impede, damage or destroy a “basic human good” ( i.e., Human Life, Knowledge, Skillful performance/aesthetic appreciation, Integrity, Authenticity, Friendship, Religion, & Marriage .). </li></ul>
    45. 45. NORMS OF CHRISTIAN LOVE (3) <ul><li>Principle of Participation ( aka, subsidiarity ) </li></ul><ul><li>This principle seems best understood with an illustrative example: The family is the basic unit of society. The government would be wrong to interfere in a parent's relationship with her/his child, other than for very serious reasons, such as the abuse of the child . </li></ul>
    46. 46. NORMS OF CHRISTIAN LOVE (3) <ul><li>Principle of Totality & Integrity </li></ul><ul><li>“ Everyday clinical practice generally accepts a limited form of disposing of the body and certain mental functions in order to preserve life, as for example in the case of the amputation of limbs or the removal of organs. Such practice is permitted by the principle of totality and integrity (also known as the therapeutic principle). The meaning of this principle is that the human person develops, cares for, and preserves all his physical and mental functions in such a way that </li></ul><ul><li>(1) lower functions are never sacrificed except for the better functioning of the total person, & even then with an effort to compensate for what is being sacrificed; & </li></ul><ul><li>(2) the fundamental faculties which essentially belong to being human are never sacrificed, except when necessary to save life…. </li></ul><ul><li>“ For the application of the principle of totality & integrity, the following conditions must be met: </li></ul><ul><li>(1) there must be a question of an intervention in the part of the body that is either affected or is the direct cause of the life-threatening situation; </li></ul><ul><li>(2) there can be no other alternatives for preserving life; </li></ul><ul><li>(3) there is a proportionate chance of success in comparison with drawbacks; & </li></ul><ul><li>(4) the patient must give assent to the intervention” </li></ul><ul><li><> </li></ul>
    47. 47. NORMS OF CHRISTIAN HOPE (4) <ul><li>Principle of Stewardship & Creativity </li></ul><ul><li>While Genesis teaches that humans were given dominion over God's creation, we are to have the mentality of a creative steward. We are NOT free to thoughtlessly use worldly resources. </li></ul>
    48. 48. NORMS OF CHRISTIAN HOPE (4) <ul><li>Principle of Inner Freedom </li></ul><ul><li>Obsessions we experience are not simply crosses to bear passively. We have moral responsibility to seek treatment for an obsession. </li></ul>
    49. 49. NORMS OF CHRISTIAN HOPE (4) <ul><li>Principle of Personalized Sexuality ( aka, Family-Oriented Sexuality ) </li></ul><ul><li>Sexual acts have &quot; unitive &quot; & &quot; procreative &quot; dimensions. </li></ul><ul><li>Reserved for marriage, they unite a couple. </li></ul><ul><li>Each act is to be open to the transmission of new life. </li></ul>
    50. 50. NORMS OF CHRISTIAN HOPE (4) <ul><li>Principle of Growth through Suffering </li></ul><ul><li>For the Christian, pain is a sharing in Christ's own suffering and a uniting with Him in His redemptive sacrifice, offered in obedience to His father. This does NOT mean that all suffering/pain must be accepted, & that all efforts to alleviate suffering/pain should be foregone. </li></ul>
    51. 51. and
    52. 52.
    53. 53. SALVIFICI DOLORIS - ON THE CHRISTIAN MEANING OF HUMAN SUFFERING Encyclical letter of Pope John Paul II INTRODUCTION &quot;'In my flesh I complete what is lacking in Christ's afflictions for the sake of his body, that is, the Church'.... &quot;Now I rejoice in my sufferings for your sake&quot; ....the Redemption was accomplished through the Cross of Christ, that is, through his suffering.....
    54. 54. The World of Human Suffering…. <ul><li>“ Sacred Scripture is a great book about suffering ....above all moral suffering: </li></ul><ul><ul><ul><ul><li>danger of death... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>death of one's own children...especially...the firstborn & only son... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>the lack of offspring... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>nostalgia for the homeland... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Persecution & hostility of the environment... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>mockery & scorn of the one who suffers... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>loneliness and abandonment... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>the remorse of conscience... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>difficulty of understanding why the wicked prosper & the just suffer... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>unfaithfulness and ingratitude... </li></ul></ul></ul></ul><ul><ul><ul><ul><li>misfortunes of one's own nation..... </li></ul></ul></ul></ul><ul><li>“ the reality of suffering prompts the question about the essence of evil: what is evil?.... </li></ul><ul><li>“ The Christian different...[from] traditions which hold that existence is an evil from which one needs to be liberated. Christianity proclaims the essential good of existence & the good of that which exists, acknowledges the goodness of the Creator & proclaims the good of creatures. </li></ul><ul><li>“ Man suffers on account of evil, which is a certain lack, limitation or distortion of good..... </li></ul>
    55. 55. The Quest for an Answer to the Question of the Meaning of Suffering <ul><li>&quot;pain, especially physical pain, is widespread in the animal world....But only the suffering human being knows that he is suffering & wonders why…. </li></ul><ul><li>“ whereas the existence of the world opens...the eyes of the human soul to the existence of God, to his wisdom, power & greatness, evil & suffering seem to obscure this…. </li></ul><ul><li>“ it is not true that all suffering is a consequence of a fault and has the nature of a punishment. The figure of the just man Job is a special proof of this.... </li></ul><ul><li>“ The Book of Job is not the last word on this subject in Revelation. In a certain way it is a foretelling of the Passion of Christ.... </li></ul>
    56. 56. Jesus Christ Suffering Conquered by Love <ul><li>&quot;For God so loved the world that he gave his only Son, that whoever believes in him should not perish but have eternal life&quot; </li></ul><ul><li>....the very essence of Christian soteriology, that is, of the theology of salvation.....When one says that Christ by his mission strikes at evil at its very roots, we have in mind not only evil & definitive, eschatological suffering ..., but also - at least indirectly toil and suffering in their temporal and historical dimension.... </li></ul><ul><li>Though it is not licit to apply here the narrow criterion of direct dependance (as Job's three friends did), it is equally true that one cannot reject the criterion that, at the basis of human suffering, there is a complex involvement with sin..... </li></ul><ul><li>As a result of Christ's salvific work, man exists on earth with the hope of eternal life and holiness. And even though the victory over sin and death achieved by Christ in his Cross and Resurrection does not abolish temporal suffering from human life, nor free from suffering the whole historical dimension of human existence, it nevertheless throws a new light upon this dimension and upon every suffering: the light of salvation..... </li></ul>
    57. 57. Jesus Christ Suffering Conquered by Love <ul><li>In his messianic activity in the midst of Israel, Christ drew increasingly closer to the world of human suffering. &quot;He went about doing good” (32), & his actions concerned primarily those who were suffering and seeking help. </li></ul><ul><ul><ul><ul><ul><li>He healed the sick, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>consoled the afflicted, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>fed the hungry, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>freed people from deafness, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>from blindness, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>from leprosy, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>from the devil & </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>from various physical disabilities, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>three times he restored the dead to life..... </li></ul></ul></ul></ul></ul><ul><li>at the heart of his teaching there are the eight beatitudes.... </li></ul><ul><li>Christ severely reproves Peter when the latter wants to make him abandon the thoughts of suffering & of death on the Cross...The Scriptures had to be fulfilled .....Among all these, particularly touching is the.... Fourth Song of the Suffering Servant, in the Book of Isaiah..... </li></ul><ul><li>.... Christ suffers voluntarily and suffers innocently. With his suffering he accepts that question which - posed by people many times - has been expressed, in a certain sense, in a radical way by the Book of Job. </li></ul>
    58. 58. Jesus Christ Suffering Conquered by Love <ul><li>Christ, however, not only carries with himself the same question..., but he also carries the greatest possible answer.... And this is the final, definitive word of this teaching: &quot;the word of the Cross&quot;, as Saint Paul one day will say.... the prayer in Gethsemane becomes a definitive point here. The words: </li></ul><ul><ul><li>&quot;My Father, if it be possible, let this cup pass from me; nevertheless, not as I will, but as thou wilt&quot;, </li></ul></ul><ul><ul><li>and later: </li></ul></ul><ul><ul><li>&quot;My Father, if this cannot pass unless I drink it, thy will be done&quot;.... </li></ul></ul><ul><ul><li>But precisely through this suffering he accomplishes the Redemption, and can say as he breathes his last: </li></ul></ul><ul><ul><li>&quot;It is finished&quot;.... </li></ul></ul><ul><li>Human suffering has reached its culmination in the Passion of Christ..... </li></ul><ul><li>it has entered into a completely new dimension and a new order: it has been linked to love.... </li></ul><ul><li>The Cross of Christ has become a source from which flow rivers of living water.... </li></ul>
    59. 59. Sharers in the Suffering of Christ <ul><li>“ ....In the Cross of Christ not only is the Redemption accomplished through suffering, but also human suffering itself has been redeemed .....each man, in his suffering, can also become a sharer in the redemptive suffering of Christ.... </li></ul><ul><li>“ In the eyes of the just God, before his judgment, those who share in the suffering of Christ become worthy of this Kingdom....Those who share in the sufferings of Christ are also called, through their own sufferings, to share in glory.... </li></ul><ul><li>“ Suffering is also an invitation to manifest the moral greatness of man, his spiritual maturity..... not only in the martyrs for the faith but in many others also who, at times, even without belief in Christ, suffer & give their lives for the truth and for a just cause....The gospel paradox of weakness & strength often speaks to us....In such a concept, to suffer means to become particularly susceptible, particularly open to the working of the salvific powers of God, offered to humanity in Christ..... </li></ul><ul><li>“ 'More than that, we rejoice in our sufferings, knowing that suffering produces endurance, & endurance produces character, & character produces hope, & hope does not disappoint us, because God's love has been poured into our hearts through the Holy Spirit which has been given to us' </li></ul>
    60. 60. Sharers in the Suffering of Christ <ul><li>“ ....Suffering as it were contains a special call to the virtue... of perseverance.... a dignity linked to awareness of the meaning of life. And indeed this meaning makes itself known together with the working of God's love, which is the supreme gift of the Holy Spirit. </li></ul><ul><li>“ The more he shares in this love, man rediscovers himself more & more fully in suffering: he rediscovers the 'soul' which he thought he had 'lost'...because of suffering.... </li></ul><ul><ul><li>'Now I rejoice in my sufferings for your sake, & in my flesh I complete what is lacking in Christ's afflictions for the sake of his body, that is, the Church‘…. </li></ul></ul><ul><li>“ In this Body, Christ wishes to be united with every individual, and in a special way he is united with those who suffer..... </li></ul><ul><li>“ The sufferings of Christ created the good of the world's redemption. This good in itself is inexhaustible &infinite. No man can add anything to it. But at the same time, in the mystery of the Church as his Body, Christ has in a sense opened his own redemptive suffering to all human suffering. In so far as man becomes a sharer in Christ's that extent he in his own way completes the suffering through which Christ accomplished the Redemption of the world. </li></ul>
    61. 61. Sharers in the Suffering of Christ <ul><li>“ Does this mean that the Redemption achieved by Christ is not complete? No. It only means that the Redemption, accomplished through satisfactory love, remains always open to all love expressed in human suffering. In this dimension - the dimension of love - the Redemption which has already been completely accomplished is, in a certain sense, constantly being accomplished.... </li></ul><ul><li>“ this Redemption, even though it was completely achieved by Christ's suffering, lives on and in its own special way develops in the history of man. It lives and develops as the body of Christ, the Church, and in this dimension every human suffering, by reason of the loving union with Christ, completes the suffering of Christ. It completes that suffering just as the Church completes the redemptive work of Christ. ... </li></ul>
    62. 62. The Gospel of Suffering <ul><li>“ The witnesses of the Cross & Resurrection of Christ have handed on to the Church & to mankind a specific Gospel of suffering the side of Christ, in the first and most exalted place, there is always his Mother through the exemplary testimony that she bears by her whole life to this particular Gospel of suffering..... </li></ul><ul><li>“ Christ did not conceal from his listeners the need for suffering.... The way that leads to the Kingdom of heaven is 'hard & narrow', and Christ contrasts it to the 'wide and easy' way that 'leads to destruction'.... </li></ul><ul><li>“ The Master does not conceal the prospect of suffering from his disciples & followers….he reveals it with all frankness, indicating…the supernatural assistance that will accompany them in the midst of persecutions & tribulations 'for his name's sake'. These persecutions & tribulations will also be, as it were, a particular proof of likeness to Christ and union with him.... </li></ul>
    63. 63. The Gospel of Suffering <ul><li>“ This first chapter of the Gospel of suffering, which speaks of persecutions, namely of tribulations experienced because of Christ, contains in itself a special call to courage & fortitude, sustained by the eloquence of the Resurrection.... </li></ul><ul><li>“ Down through the centuries & generation it has been seen that in suffering there is concealed a particular power that draws a person interiorly close to Christ, a special grace.... </li></ul><ul><li>“ When this body is gravely ill, totally incapacitated, & the person is almost incapable of living and acting, all the more do interior maturity and spiritual greatness become evident, constituting a touching lesson to those who are healthy and normal. </li></ul><ul><li>“ This interior maturity & spiritual greatness in suffering are certainly the result of a particular conversion and cooperation with the grace of the Crucified Redeemer…. </li></ul>
    64. 64. The Gospel of Suffering <ul><li>“ This is not all: the Divine Redeemer wishes to penetrate the soul of every sufferer through the heart of his holy Mother, the first and the most exalted of all the redeemed..... so that every form of suffering, given fresh life by the power of this Cross, should become no longer the weakness of man but the power of God.... </li></ul><ul><li>“ in general it can be said that almost always the individual enters suffering with a typically human protest & with the question &quot;why“ .... he cannot help noticing that the one to whom he puts the question is himself suffering and wishes to answer him from the Cross, from the heart of his own suffering. Nevertheless, it often takes time, even a long time, for this answer to begin to be interiorly perceived..... </li></ul><ul><li>“ Man hears Christ's saving answer as he himself gradually becomes a sharer in the sufferings of Christ. The answer which comes through this sharing…is in itself something more than the mere abstract answer to the question about the meaning of suffering. For it is above all a call. It is a vocation..... </li></ul>
    65. 65. The Gospel of Suffering <ul><li>“ Saint Paul speaks of such joy in the Letter to the Colossians: 'I rejoice in my sufferings for your sake'.... </li></ul><ul><li>“ It is suffering, more than anything else, which clears the way for the grace which transforms human souls.... </li></ul><ul><li>“ the Church sees in all Christ's suffering brothers & sisters…a multiple subject of his supernatural power. How often is it precisely to them that the pastors of the Church appeal, and precisely from them that they seek help and support! The Gospel of suffering is being written unceasingly, &it speaks unceasingly with the words of this strange paradox: the springs of divine power gush forth precisely in the midst of human weakness..... </li></ul>
    66. 66. The Good Samaritan <ul><li>&quot;The name 'Good Samaritan' fits every individual who is sensitive to the sufferings of others, who &quot;is moved&quot; by the misfortune of another.... </li></ul><ul><li>“ the Good Samaritan of Christ's parable does not stop at sympathy and compassion alone. They become for him an incentive to actions aimed at bringing help to the injured man.... </li></ul><ul><li>“ a Good Samaritan is one who brings help in suffering, whatever its nature may be. Help which is, as far as possible, effective. He puts his whole heart into it, nor does he spare material means. We can say that he gives himself, his very 'I', opening this 'I' to the other person. Here we touch upon one of the key-points of all Christian anthropology. Man cannot &quot;fully find himself except through a sincere gift of himself&quot;....A Good Samaritan is the person capable of exactly such a gift of self.... </li></ul><ul><li>“ also present in order to unleash love in the human person, that unselfish gift of one's &quot;I&quot; on behalf of other people, especially those who suffer. </li></ul><ul><li>“ The world of human suffering unceasingly calls for, so to speak, another world: the world of human love; and in a certain sense man owes to suffering that unselfish love which stirs in his heart and actions..... </li></ul>
    67. 67. The Good Samaritan <ul><li>&quot; How much there is of &quot;the Good Samaritan&quot; in the profession of the doctor, or the nurse, or others similar! Considering its &quot;evangelical&quot; content, we are inclined to think here of a vocation rather than simply a profession…. </li></ul><ul><li>” The family, the school &other education institutions must, if only for humanitarian reasons, work perseveringly for the reawakening and refining of that sensitivity towards one's neighbour and his suffering of which the figure of the Good Samaritan in the Gospel has become a symbol. Obviously the Church must do the same.... </li></ul><ul><li>“ The eloquence of the parable of the Good Samaritan, and of the whole Gospel, is especially this: every individual must feel as if called personally to bear witness to love in suffering.... </li></ul><ul><li>“ Christ's revelation of the salvific meaning of suffering is in no way identified with an attitude of passivity . Completely the reverse is true..... </li></ul><ul><li>“ this parable...will enter into those disturbing words of the Final Judgment, noted by Matthew in his Gospel.... Christ said: 'You did it to me'. He himself is the one who in each individual experiences love; he himself is the one who receives help, when this is given to every suffering person without exception....At one & the same time Christ has taught man to do good by his suffering & to do good to those who suffer. In this double aspect he has completely revealed the meaning of suffering. </li></ul>
    68. 68. Conclusion <ul><li>&quot;This is the meaning of suffering, which is truly supernatural and at the same time human. </li></ul><ul><li>“ It is supernatural because it is rooted in the divine mystery of the Redemption of the world, and </li></ul><ul><li>“ it is likewise deeply human, because in it the person discovers himself, his own humanity, his own dignity, his own mission. </li></ul><ul><li>'Through Christ and in Christ, the riddles of sorrow and death grow meaningful' </li></ul>
    69. 69. The Vatican’s “Charter for Health Care Workers” Charter for Health Care Workers
    70. 70. Ministers of Life <ul><li>Scientific & professional expertise is not enough; personal empathy with the concrete situations of each patient is required. </li></ul><ul><ul><li>Health care is a type of Christian witness. </li></ul></ul><ul><ul><li>The health care worker is a &quot;good Samaritan.&quot; </li></ul></ul><ul><ul><li>The health care worker is &quot;a collaborator with God in restoring health to the sick body. </li></ul></ul><ul><ul><li>Health care is a therapeutic ministry, sharing the Church's pastoral & evangelizing work. </li></ul></ul><ul><li>All health care workers should be taught morality and bioethics. </li></ul><ul><ul><li>The Charter supports establishment of ethical committees in principal medical centers. </li></ul></ul><ul><li>Catholic or not, health care workers are absolutely obliged to be faithful to the natural moral law which recognizes human dignity. </li></ul><ul><ul><li>The Church provides specialized teaching, the bioethical magisterium , to provide guidance. </li></ul></ul><ul><li>The Charter is organized around the stages of human existence: procreation, living, dying. </li></ul><ul><li>The Bible indicates that only humans are made in God's image and likeness. </li></ul><ul><ul><li>We are unique in the animal world. </li></ul></ul><ul><ul><li>Human procreation itself is rich with religious meaning. </li></ul></ul>Charter for Health Care Workers
    71. 71. Procreation Charter for Health Care Workers
    72. 72. Fertility Control <ul><li>In conceiving & giving birth, spouses &quot;cooperate&quot; with God's work of creation! </li></ul><ul><li>There is an &quot;indissoluble bond&quot; between the &quot;unitive&quot; & &quot;procreative&quot; meanings of sexual acts in marriage (Yet, few American Catholics seem to accept this.). </li></ul><ul><li>In terms of moral judgment, intentions and motives are insufficient. People are encouraged to delve into a deeper understanding of human persons & human acts. </li></ul><ul><li>For serious reasons, spouses may utilize NFP (Natural Family Planning) to gain knowledge of the woman's fertility & forego marital relations in fertile times. </li></ul><ul><li>Unlike with contraceptives, the use of NFP does not aim to close the marital act off to the possibility of procreation. Health care workers are encouraged provide information on natural family planning. The pro-abortion culture is especially strong, where this teaching on contraception has been rejected. </li></ul>Charter for Health Care Workers
    73. 73. Hugh Heffner . . Wilhelm Reich Once upon a time, it went without saying that childbearing went with sexual relations and sexual relations went with marriage…. In the 20 th Century, it became popular to try to divorce sexual pleasure from marriage and procreation.
    74. 74. The so-called Sexual Revolution & Some of Its Generals <ul><li>Wilhelm Reich </li></ul><ul><li>Hugh Heffner </li></ul><ul><li>Alfred Kinsey </li></ul><ul><li>Margaret Sanger </li></ul>
    75. 75. Wilhelm Reich <ul><li>“ At the end of the Second World War, Wilhelm Reich introduced American readers to some of his earlier writings under the title The Sexual Revolution (1945) </li></ul><ul><li>… .The truth, according to Reich, was that Western civilization had made people sick by imposing on them an unnatural, destructive sexual morality…. </li></ul><ul><li>even if we assume that in actual fact our ancestors behaved very much as we do, one very important difference remains: When they violated traditional sexual standards, they usually suffered from guilt…. </li></ul><ul><li>we now decide for ourselves what sexual activity is proper….there is nothing eternal or sacred about our sexual morality ” (Haeberle, The Sex Atlas, New York: Continuum, 1983). </li></ul>
    76. 76. Alfred Kinsey <ul><li>“ Alfred C. Kinsey's work has had a profound effect on American culture…. his studies in the late 1940s and early 1950s, heralded as the first ‘scientific’ look at sex, became the foundation of the sexual revolution…. </li></ul><ul><li>much of Kinsey's work has been revealed as junk science and even fraud… </li></ul><ul><li>he aided and abetted the molestation of hundreds of children in order to obtain data on ‘child sexuality’ ” < >. </li></ul>
    77. 77. Hugh Heffner <ul><li>Hugh Heffner, founded Playboy Magazine in 1953: </li></ul><ul><li>“ In the first issue, Playboy identified its philosophy as anti-marriage…. </li></ul><ul><li>“ Playboy attacked women as gold-diggers who bartered sex for a marriage license…. </li></ul><ul><li>“ When the Pill gave women the freedom to join men in their sexual rebellion, cultural attitudes shifted radically. Junk sex was no better than junk food, but millions of men and women greedily devoured the empty calories…. </li></ul><ul><li>“ [Playboy] vulgarized what most men and women in their deepest sentiments hold dear ….It turned courtship away from the patient pleasures of a gourmet meal with many courses and replaced it with a cheesy burger ” </li></ul><ul><li>< >. </li></ul>
    78. 78. Margaret Sanger <ul><li>As per Planned Parenthood’s description of its founder, “ Margaret Sanger gained worldwide renown, respect, & admiration ….Sanger also entertained some popular ideas of her own time…. </li></ul><ul><ul><ul><ul><li>arguments continue about whether or not her outreach to the black community was racially motivated…. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>[Sanger] clearly identified with the broader issues of health and fitness that concerned the early 20th-century eugenics movement, which was enormously popular and well-respected during the 1920s and '30s — decades in which treatments for many hereditary and disabling conditions were unknown….she agreed with the &quot;progressives&quot; of her day who favored </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>incentives for the voluntary hospitalization and/or sterilization of people with untreatable, disabling, hereditary conditions </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>the adoption and enforcement of stringent regulations to prevent the immigration of the diseased and &quot;feebleminded&quot; into the U.S. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>placing so-called illiterates, paupers, unemployables, criminals, prostitutes, and dope-fiends on farms and open spaces as long as necessary for the strengthening & development of moral conduct…. </li></ul></ul></ul></ul></ul><ul><li>< >. </li></ul>
    79. 79. On Sept 21, 1957, Mike Wallace (of “60 Minutes” fame) interviewed Margaret Sanger…. < wallace/sanger_margaret.html >
    80. 80. Incredible changes in a 1/2 century… <ul><li>In 1957, Time Magazine seemed to gush with the excitement of a junior high student: “ Some of the most hush-hush medical research has been pursued in dozens of laboratories in the effort to find a contraceptive pill ”<,9171, 809446,00.html?promoid= googlep > </li></ul><ul><li>According to Planned Parenthood, the “pill” is now the most widely used of various contraceptive methods < _ contr_use.html > (Note: The “pill” is known to work in an abortifacient manner.). In an age of increased awareness about the foods we consume, people seem to be relatively unconcerned about ingesting chemicals and placing foreign objects on or in their bodies to &quot;protect&quot; themselves against their natural fertility. </li></ul><ul><li>While contraceptives are supposedly a panacea for &quot; unwanted pregnancies ,&quot;  the CDC reports that one of every three pregnancies ends in an induced abortion < >. </li></ul>
    81. 81. <ul><li>There are now 56 times more new STD infections each year, than there were overall STD infections in 1957: </li></ul><ul><li>As per the Centers for Disease Control, 340,687 cases of STDs were reported by state health departments in 1957 < >. </li></ul><ul><li>Currently, “The CDC estimates that 19 million new [STD] infections occur each year, almost half of them among young people ages 15 to 24” < >. </li></ul>Incredible changes in a 1/2 century…
    82. 82. <ul><li>In the past half century, the rate of forcible rape of women has tripled: </li></ul><ul><li>In 1960, there were 17,190 forcible rapes of women (9.6 per 100,000 people) < >. </li></ul><ul><li>The FBI now reports 92,455 annual forcible rapes of women (30.9 per 100,000 people) < >. </li></ul>Incredible changes in a 1/2 century…
    83. 83. <ul><li>Over the past half century, Americans have become less likely to marry. Of those fewer who do marry, they are more likely to divorce: </li></ul><ul><li>In 1957, there was a marriage rate of 8.9 per 1000 people < > and a divorce rate of 2.2 per 1000 people < >. </li></ul><ul><li>Currently, there is a marriage rate of 7.4 per 1000 people and a divorce rate of 3.6 per 1000 people < >. </li></ul>Incredible changes in a 1/2 century…
    84. 84. Pornography &quot; Son, you shouldn't watch that other channel. It's only for mommies & daddies who love each other very much “ (Homer J. Simpson) As reported in Bishop Robert Finn’s February 2007 pastoral letter, “Blessed Are The Pure In Heart”< >. . <ul><li>“ U.S. porn revenue exceeds the combined revenues of ABC, CBS, and NBC (6.2 billion). Porn revenue is larger than all combined revenues of all professional football, baseball and basketball franchises. The pornography industry, according to conservative estimates, brings in $57 billion per year, of which the United States is responsible for $12 billion .” </li></ul><ul><ul><ul><ul><li>“ The Internet accounted for US $2.5 billion of </li></ul></ul></ul></ul><ul><ul><ul><ul><li>the adult industry’s revenues .” </li></ul></ul></ul></ul><ul><ul><ul><ul><li>“ Cable pay per view amounted to $2.5 billion .” </li></ul></ul></ul></ul><ul><ul><ul><ul><li>“ Magazines accounted for $7.5 billion .” </li></ul></ul></ul></ul>
    85. 85. Pornography &quot; Son, you shouldn't watch that other channel. It's only for mommies & daddies who love each other very much “ (Homer J. Simpson) <ul><li>“ </li></ul><ul><li>There are 100 thousand websites offering illegal child pornography (U.S. Customs Service estimate) .” </li></ul><ul><li>“ Child Pornography generates $3 billion annually .” </li></ul>As reported in Bishop Robert Finn’s February 2007 pastoral letter, “Blessed Are The Pure In Heart”< >. .
    86. 86. Pornography &quot; Son, you shouldn't watch that other channel. It's only for mommies & daddies who love each other very much “ (Homer J. Simpson) <ul><li>“ 70% of 18 to 24 year old men visit pornographic sites in a typical month. 66% of men in their 20s and 30s also report being regular users of pornography .” </li></ul><ul><li>“ One out of three visitors to all adult web sites are women .” </li></ul><ul><li>“ Eleven years old is the average age of first Internet exposure to pornography .” </li></ul>As reported in Bishop Robert Finn’s February 2007 pastoral letter, “Blessed Are The Pure In Heart”< >. .
    87. 87. Somehow, the Idea that Pornography is “Victimless” Seems to Remain Popular…. from the U.S. State Department’s “Trafficking in Persons Report 2007” < >. “ Annually, according to U.S. Government-sponsored research completed in 2006, approximately 800,000 people are trafficked across national borders, which does not include millions trafficked within their own countries. Approximately 80 percent of transnational victims are women and girls and up to 50 percent are minors. The majority of transnational victims are females trafficked into commercial sexual exploitation.”
    88. 88. Was Wilhelm Reich correct, in that people had been made sick by the imposition of such an unnatural sexual morality? Has there been a benefit to marriage itself from the “Sexual Revolution”’s divorce of sexual pleasure from marriage and procreation?
    89. 89. “ The State of Our Unions: The Social Health of Marriage in America 2007” Rutgers University’s National Marriage Project < > <ul><li>“ The American divorce rate today is nearly twice that of 1960….For the average couple marrying for the first time in recent years, the lifetime probability of divorce or separation remains between 40 and 50 percent” </li></ul><ul><li>An oft overlooked caveat: “if you are a reasonably well-educated person with a decent income, come from an intact family and are religious, and marry after age twenty five without having a baby first, your chances of divorce are very low indeed.” </li></ul>
    90. 90. “ The State of Our Unions: The Social Health of Marriage in America 2007” Rutgers University’s National Marriage Project < > <ul><li>“ </li></ul><ul><li>“ Most younger Americans now spend some time living together outside of marriage, and unmarried cohabitation commonly precedes marriage” </li></ul><ul><li>“ a substantial body of evidence indicates that those who live together before marriage are more likely to break up after marriage.” </li></ul>
    91. 91. “ The State of Our Unions: The Social Health of Marriage in America 2007” Rutgers University’s National Marriage Project < > <ul><li>“ marriage has a tremendous economic impact on society. It is a major contributor to family income levels & inequality…. </li></ul><ul><li>“ divorce & unmarried child-bearing increase child poverty…. </li></ul><ul><li>“ a single divorce costs state & federal governments about $30,000, based on such things as the higher use of food stamps & public housing as well as increased bankruptcies & juvenile delinquency. The nation’s 1.4 million divorces in 2002 are estimated to have cost the taxpayers more than $30 billion.” </li></ul>
    92. 92. “ The State of Our Unions: The Social Health of Marriage in America 2007” Rutgers University’s National Marriage Project < > <ul><li>“ The percentage of children who grow up in fragile—typically fatherless—families has grown enormously over the past four decades. This is mainly due to increases in divorce, out-of-wedlock births, and unmarried cohabitation.” </li></ul><ul><li>In single-parent families, children “have negative life outcomes at two to three times the rate of children in married, two-parent families” </li></ul>
    93. 93. “ The Fragile Families & Child Wellbeing Study is a joint effort by Princeton University ‘s Center for Research on Child Wellbeing (CRCW) & the Center for Health and Wellbeing, & Columbia University ‘s Social Indicators Survey Center & the National Center for Children and Families (NCCF).“ < http:// >
    94. 94. “ Although it was once possible to believe that the nation’s high rates of divorce, cohabitation, & nonmarital childbearing represented little more than lifestyle alternatives brought about by the freedom to pursue individual self-fulfillment, many analysts now believe that these individual choices can be damaging to the children who have no say in them and to the society that enables them” < >
    95. 95. <ul><li>“ if the same share of children lived with their biological parents today as did in 1980, </li></ul><ul><ul><ul><ul><ul><li>about 300,000 fewer children between the ages of twelve and eighteen would repeat a grade, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>485,000 fewer would be suspended from school, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>250,000 fewer would need psychotherapy, </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>210,000 fewer would be involved in violence, and </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>30,000 fewer would attempt suicide every year. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>In addition, child poverty would be much lower. </li></ul></ul></ul></ul></ul><ul><li>The total savings to society from greater marital stability would be considerable” < > </li></ul>
    96. 96. Review - So,… “ if you are a reasonably well-educated person with a decent income , come from an intact family and are religious , and marry after age twenty five without having a baby first , your chances of divorce are very low indeed “ (Rutgers National Marriage Project 2005)
    97. 97. <ul><li>Except for the marrying at 25+ part, isn’t this what your great grandparents would have told – or expected from - your grandparents? </li></ul><ul><ul><ul><ul><li>Be prepared & ready to properly support your family! </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Check that your intended has a good example of solid marriage from her/his own family! </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Honor God always! </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Sexual intimacy is only for marriage! </li></ul></ul></ul></ul></ul>
    98. 98. <ul><li>Couples who reject contraceptives and adhere to methods of &quot; Natural Family Planning &quot; enjoy phenomenal success. In an era of an almost 50% divorce rate, estimates are that only 0 - 4% of couples using NFP end up divorced < >. </li></ul>
    99. 99. “ lower rates of…divorce (0.2%)…. “ a high level of success in family life…, as well as strong religious faith. (“LINKAGE OF ARTIFICIAL BIRTH CONTROL TO SEXUAL PROMISCUITY, ABORTION & DIVORCE”, < >) In 2002, Mercedes Arzú Wilson presented fascinating sociological evidence, concerning women who utilize NFP. She found them to have…
    100. 100. Interview of Dr. Thomas Hilgers of the Pope Paul VI Institute, developer of NaPro Technology, by Raymond Arroyo (2/2/07 episode of “The World Over”) < >
    101. 101. Genetic Manipulation <ul><li>Genetic therapy is not outright condemned. Certain genetic therapies truly aim to cure illness, while respecting human dignity. Genetic manipulations that do not aim to directly cure illness are illicit. </li></ul><ul><li>Moral evaluations must be enlightened by proper perspective on the dignity of the beginning of human life. </li></ul><ul><li>Sexual acts are reserved for marriage & each sexual act must be open to human life. Each new human being has the absolute right to life, to this type of origin, and to be born into a family with a mother and a father. </li></ul>Charter for Health Care Workers
    102. 102. On 12/12/08, the Vatican released an instruction, focused on human life at its origins – “Dignitas Personae.”
    103. 103. Dignitas Personae further discusses gene therapy… <ul><li>&quot;25....In theory, it is possible to use gene therapy on two levels: somatic cell gene therapy and germ line cell therapy. </li></ul><ul><ul><li>Somatic cell gene therapy seeks to eliminate or reduce genetic defects on the level of somatic cells, that is, cells other than the reproductive cells, but which make up the tissue and organs of the body. It involves procedures aimed at certain individual cells with effects that are limited to a single person. </li></ul></ul><ul><ul><li>Germ line cell therapy aims instead at correcting genetic defects present in germ line cells with the purpose of transmitting the therapeutic effects to the offspring of the individual. Such methods of gene therapy, whether somatic or germ line cell therapy, can be undertaken on a fetus before his or her birth as gene therapy in the uterus or after birth on a child or adult.” </li></ul></ul>
    104. 104. Dignitas Personae further discusses gene therapy… <ul><li>&quot;26....Procedures used on somatic cells for strictly therapeutic purposes are in principle morally licit.... </li></ul><ul><li>&quot;Because the risks connected to any genetic manipulation are considerable and as yet not fully controllable, in the present state of research, it is not morally permissible to act in a way that may cause possible harm to the resulting progeny. In the hypothesis of gene therapy on the embryo, it needs to be added that this only takes place in the context of in vitro fertilization and thus runs up against all the ethical objections to such procedures. For these reasons, therefore, it must be stated that, in its current state, germ line cell therapy in all its forms is morally illicit. </li></ul>
    105. 105. Dignitas Personae further discusses gene therapy… <ul><li>&quot;27. The question of using genetic engineering for purposes other than medical treatment also calls for consideration....the prospect of such an intervention would end sooner or later by harming the common good, by favouring the will of some over the freedom of others. Finally it must also be noted that in the attempt to create a new type of human being one can recognize an ideological element in which man tries to take the place of his Creator.... &quot;the Church also recalls the need to return to an attitude of care for people and of education in accepting human life in its concrete historical finite nature.&quot; </li></ul>
    106. 106. Artificial Procreation <ul><li>&quot;Nature itself dictates that the transmission of human life be a personal & conscious act and, as such, subject to the most holy laws of God: immutable & inviolable laws which must be acknowledged & observed.&quot; &quot; The dignity of the human person demands that it come into being as a gift of God & as the fruit of the conjugal act .&quot; </li></ul><ul><li>While there may be &quot;sincere and intense&quot; desire for children, this &quot;does not legitimize recourse to techniques which are contrary to the truth of human procreation & to the dignity of the new human being.....the child has the right to be conceived only with full respect for its personhood.&quot; </li></ul><ul><li>While some artificial means can be used to aid the marital act, those which replace the marital act must be rejected. Any artificial means to help unmarried people achieve pregnancy are unacceptable. </li></ul><ul><li>“ Homologous artificial insemination&quot; is not necessarily forbidden. The aim must be to aid the marital act or help it reach its proper end. The husband's semen must be obtained through a normal act of sexual intercourse. </li></ul><ul><li>In homologous FIVET (Fertilization in vitro with embryo transfer), fertilization takes place outside the wife's body. FIVET &quot;is illicit because conception is not the result of a conjugal act....the child is not born as a 'gift' of love, but as a laboratory 'product.'&quot; </li></ul><ul><li>There are further aggravating factors with FIVET: </li></ul><ul><ul><li>&quot;numerous embryonal losses, which are procured abortions....[& </li></ul></ul><ul><ul><li>possible] congealment, which means suspension of life, of the so-called 'spare' embryos, & often even their destruction. </li></ul></ul><ul><li>Unacceptable is 'post mortem' insemination&quot; </li></ul>Charter for Health Care Workers
    107. 107. Artificial Procreation (continued) <ul><li>&quot;Heterologous techniques&quot; involve conception outside of marriage. Recourse to gametes of people other than the spouses is contrary to the unity of marriage & the fidelity of the spouses, & it harms the right of the child to be conceived & born in & from a marriage.... </li></ul><ul><li>&quot;A further reason for unlawfulness is the commercialization & eugenic selection of the gametes.&quot; </li></ul><ul><li>&quot;Surrogate&quot; motherhood is &quot;contrary to the dignity of the woman, to the unity of marriage & to the dignity of the procreation of a human&quot; </li></ul><ul><li>A child who has been conceived by illicit means is still made in God's image & likeness. </li></ul><ul><li>Down the road, we may see illicit efforts, such as </li></ul><ul><ul><li>&quot;fertilization between human & animal gametes... </li></ul></ul><ul><ul><li>gestation of human embryos in animal or artificial wombs... </li></ul></ul><ul><ul><li>sexless reproduction of human beings through twinning fission, cloning, parthenogenesis.&quot; </li></ul></ul><ul><ul><li>&quot;Medicine directed to the integral good of the person cannot prescind from the ethical principles governing human procreation&quot; </li></ul></ul>Charter for Health Care Workers
    108. 108. Life Charter for Health Care Workers
    109. 109. Beginning of Life & Birth <ul><li>There is new life at the moment that the ovum is fertilized, even before implantation. With respect to prenatal life, &quot;health care workers owe it the same respect, the same protection and the same care as that given to a human person.&quot; </li></ul><ul><li>&quot;If, despite every effort, the life of the child is at serious risk, health care workers should see to the child's baptism....If an ordinary minister of the sacrament is unavailable - a priest or a deacon - the health care worker has the faculty to confer it.&quot; </li></ul>Charter for Health Care Workers
    110. 110. The Vatican’s 10/31/000 “ STATEMENT ON THE SO-CALLED  &quot;MORNING-AFTER PILL&quot;
    111. 111. The Vatican’s 10/31/000 “ STATEMENT ON THE SO-CALLED ’MORNING-AFTER PILL’&quot; <ul><li>“ a predominantly ‘anti-implantation’ function” </li></ul><ul><li>“ it can never be legitimate to decide arbitrarily that the human individual has greater or lesser value…according to its stage of development…. </li></ul><ul><li>“ the proven ‘anti-implantation’ action of the morning-after pill is really nothing other than a chemically induced abortion…. </li></ul><ul><li>“ All who, whether sharing the intention or not, directly co-operate with this procedure are also morally responsible for it. </li></ul><ul><li>“ we strongly urge everyone who works in this sector to make a firm objection of moral conscience, which will bear courageous and practical witness to the inalienable value of human life, especially in view of the new hidden forms of aggression against the weakest and most defenceless individuals, as is the case with a human embryo.” </li></ul>
    112. 112. Pope Benedict XVI’s 10/29/07 address to the International Congress of Catholic Pharmacists
    113. 113. Pope Benedict XVI’s 10/29/07 address to the International Congress of Catholic Pharmacists <ul><li>“ it is not possible to anaesthetize consciences, for example, concerning the effects of particles whose purpose is to prevent an embryo's implantation or to shorten a person's life. ” </li></ul><ul><li>“ In the moral domain, your Federation is invited to address the issue of conscientious objection, which is a right your profession must recognize, permitting you not to collaborate either directly or indirectly by supplying products for the purpose of decisions that are clearly immoral such as, for example, abortion or euthanasia.” </li></ul><ul><li>“ it is important that all Catholic health-care professionals and people of good will join forces…. </li></ul><ul><li>“ The biomedical sciences are at the service of the human being; if this were not the case, they would have a cold and inhuman character. All scientific knowledge in the health sector and every therapeutic procedure is at the service of the sick person, viewed in his integral being, who must be an active partner in his treatment and whose autonomy must be respected. ” </li></ul>
    114. 114. On 12/12/08, the Vatican released an instruction, focused on human life at its origins – Dignitas Personae.
    115. 115. Dignitas Personae proclaims… <ul><li>human dignity from the first moment of fertilization until natural death & </li></ul><ul><li>the right of everyone to originate in the loving embrace of a mom and dad, who are wife and husband. </li></ul><ul><li>each human being is owed uncompromising respect, no matter how she came to be </li></ul><ul><li>we must stand with the weak and powerless against exploitation. </li></ul>
    116. 116. Dignitas Personae. <ul><li>Recent years have seen a vast increase in reports of infertility and interest in reproductive technology. </li></ul><ul><li>When employed by a husband and wife, Dignitas Personae says assistance to AID the “marital act” toward procreation can be moral. </li></ul><ul><li>However, even when used by a husband and wife, Dignitas Personae says that methods REPLACING the marital act - such as IVF - are immoral. </li></ul><ul><li>Exacerbating IVF’s immorality is the discarding or freezing of “extra”, unwanted embryos. </li></ul><ul><li>Dignitas Personae forbids using these new humans as research material or implanting one in the womb of a woman other than her mom. </li></ul>
    117. 117. Also recognized as immoral by Dignitas Personae are… <ul><li>human cloning, </li></ul><ul><li>the mixing of human with animal genetic material (Yup, some “scientists” are doing that!), </li></ul><ul><li>germ line cell therapy, </li></ul><ul><li>“ genetic engineering for purposes other than medical treatment” (# 27), </li></ul><ul><li>research using illicitly obtained cell lines. </li></ul>
    118. 118. Dignitas Personae is NOT to be dismissed as a laundry list of prohibitions. <ul><li>“ Behind every ‘no’ in the difficult task of discerning between good and evil, there shines a great ‘yes’ to the recognition of the dignity and inalienable value of every single and unique human being called into existence [# 37]. </li></ul>
    119. 119. My own examples of “a great ‘yes’ to the recognition of the dignity and inalienable value of every single and unique human being”: <ul><li>NaProTechnology < / > strikes me as a “great yes” – a fabulous alternative to the immorality of IVF, as well as IVF’s incredible expense and low &quot;success&quot; rate. </li></ul>
    120. 120. My own examples of “a great ‘yes’ to the recognition of the dignity and inalienable value of every single and unique human being”: <ul><li>Another “great yes” is that stem cells can be obtained in manners, which are not morally objectionable! Obtaining stem cells from embryos results in the death of the embryo. Despite the research “science” presented to us by celebrities, this is NEITHER the only way NOR the most promising way to obtain stem cells. Stem cells can be morally obtained from adults and umbilical cord blood. </li></ul>
    121. 121. Dignitas Personae, Section 23 <ul><li>This appears to require change at Catholic hospitals, regarding treatment of women identified as victims of sexual assault. </li></ul><ul><li>After trying to rule out pregnancy (&/or ovulation), so-called &quot;emergency contraception&quot; (aka, &quot;morning after pills&quot;) HAS been allowed (Note: Some say it’s IMPOSSIBLE to ensure &quot;emergency contraception&quot; is NOT abortifacient. In fact, the FDA says that &quot;If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation)“ < >). </li></ul><ul><li>&quot;Such methods are interceptive if they interfere with the embryo before implantation & contragestative if they cause the elimination of the embryo once implanted....the use of means of interception & contragestation fall within the sin of abortion and are gravely immoral.&quot; </li></ul><ul><li>NO guidelines are offered for supposed &quot;moral&quot; use of a potential interceptive or contragestative. </li></ul>
    122. 122. Treatment of an Ectopic Pregnancy <ul><li>Citing the principle of “double effect,” Catholic health care has allowed the removal of a fallopian tube to save a mother’s life, in the case of an ectopic pregnancy. This unintentionally results in the death of the preborn child. </li></ul><ul><li>In the July/August 1998 issue of Health Progress (i.e., the official journal of the Catholic Health Association of the United States), Father Kevin O’Rourke seemed to indicate that a Salpingostomy (i.e., removal of the child from the fallopian tube) and use of the chemical Methotrexate might also be acceptable < / Archive/1998/07JulyAug/Articles/Features >. It appears that Catholic thinking is moving decidedly away from the position of Father O’Rourke. </li></ul><ul><li>To the best of my knowledge, however, there has been no definitive Catholic teaching on the use of a Salpingostomy and Methotrexate. In the meantime, Catholic hospitals are apparently employing Salpingostomies and the chemical Methotrexate </li></ul>
    123. 123. Treatment of an Ectopic Pregnancy <ul><li>Writing in the February 1999 Linacre Quarterly (i.e., the official journal of the Catholic Medical Association), Dr. John E. Foran bemoans “toleration of salpinotomy(ostomy) & pharmacologic (methotrexate) treatment of ectopic pregnancy in Catholic health facilities….since the immediate effect of methotrexate and saplingotomy(ostomy) is the death of the fetus, the principle of double effect is not applicable because the act is evil. In The Management of Ectopic Pregnancies: A Moral Analysis, William E. May points out that ‘it is morally imperative today to make every effort possible to discover and transplant into the uterus those unborn babies who have, unfortunately, implanted in the fallopian tube or other ectopic site’…. no matter how good the intention, salpingotomy/ ostomy and the use of methotrexate or similar pharmacologic agents result in the death of the infant as a direct effect of the action and culminates in the good effect. The death is the means chosen to the end. To willfully choose to terminate innocent human life, no matter how good the intent, is anywhere and everywhere morally wrong” < >. </li></ul>
    124. 124. Treatment of an Ectopic Pregnancy <ul><li>In the July 1999 Homiletic & Pastoral Review, Msgr. William Smith explains that “All Catholic authors agree that salpingectomy is a licit application of the principle of double effect. That is, full salpingectomy—the entire fallopian tube (together with the ectopic pregnancy) is surgically removed; or, partial salpingectomy—only the damaged segment of the tube enveloping the ectopic pregnancy is removed, and then the severed ends of the tube are brought together and sutured….[By contrast] salpingostomy and this administration of MTX are direct abortions ….Since the procedures are not necessary to protect the mother’s life (salpingectomy can preserve that) but allegedly to preserve future fertility, I would judge that the final condition of double effect, proportion, is also not verified here and thus is not a legitimate application of double effect and is a direct abortion” < >. </li></ul>
    125. 125. Treatment of an Ectopic Pregnancy <ul><li>As per # 48 of the 2001 Ethical and Religious Directives for Catholic Health Care Services, Fourth Edition, “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion” < >. </li></ul><ul><li>As per the March 2006 issue of Ethics and Medics (the official journal of the National Catholic Bioethics Center), Dr. Eugene Diamond writes: “The consensus among Catholic theologians and practicing obstetricians is that the use of methotrexate in ectopic pregnancy is a direct abortion of a developing embryo or fetus….[However] The proscription against the use of methotrexate and against surgical procedures such as salpingostomy (the opening of the fallopian tube) with evacuation of the tubal contents (in favor of the use of salpingectomy, the removal of the fallopian tube, instead), do not apply if the ectopic pregnancy has terminated with fetal demise” < >. </li></ul>
    126. 126. The Value of Life: Unity of Body & Soul <ul><li>The Bible indicates that humans are made in God's own image & likeness. We are unique in the animal world. &quot;Human life is irreducibly both corporeal & spiritual.&quot; It is our souls & bodies which God wants in Heaven. </li></ul><ul><li>At a time when medical science is moving towards greater specialization, we cannot isolate particular treatments from care &quot;to the person of the patient in all his dimensions.&quot; </li></ul>Charter for Health Care Workers
    127. 127. Indisposability & Inviolability of Life <ul><li>&quot;The body cannot be....dealt with as a thing or an object of which one is the owner & arbiter. Every abusive intervention on the body is an insult to the dignity of the person & thus to God who is its only and absolute Lord&quot; </li></ul><ul><li>Life belongs to God & not the human being, giving life a &quot;sacred character.&quot; Right reason can recognize this sacredness, even without religious faith. </li></ul><ul><li>Just because an action is technically possible, it need not be &quot;morally admissible.&quot; </li></ul>Charter for Health Care Workers
    128. 128. Right to Life <ul><li>From conception to natural death, whether healthy or sick, able bodied or disabled, rich or poor, every human being has the right to life - &quot;the right to live with human dignity.&quot; </li></ul><ul><li>Neither the health care worker nor the patient himself has the right to power over the life which is receiving care. No person has the right to &quot;arbitrarily choose whether to live or die.&quot; That decision is for God, alone. </li></ul><ul><li>The employment rights claims of health workers - just though they may be - must be subordinated to the care of the patient. </li></ul>Charter for Health Care Workers
    129. 129. Prevention <ul><li>Health care workers can play a role in society's addressing special problems of groups, such as adolescents, </li></ul><ul><li>people with disabilities, </li></ul><ul><li>older people, etc., </li></ul><ul><li>as well as with health risks tied to modern living. </li></ul><ul><li>Prevention involves rediscovering & applying forgotten values. </li></ul>Charter for Health Care Workers
    130. 130. Sickness <ul><li>&quot;Sickness and suffering are not experiences which affect only the physical substance of the human being, but they affect him in his entirety and in his somatic-spiritual unity.&quot; </li></ul><ul><li>The Charter presents counter-cultural notions about suffering: </li></ul><ul><ul><li>&quot;The Christian knows by faith that sickness and suffering share in the salvific efficacy of the Redeemer's cross.... the sick person can say with the Apostle: 'I fill up in my body what is wanting to the sufferings of Christ, for the sake of his body which is the Church' (Col 1:24). From this new Christian meaning, the sick person can be helped to develop a triple salutary attitude to the illness: </li></ul></ul><ul><ul><ul><li>an'<awareness>' of its reality 'without minimizing it or exaggerating it'; </li></ul></ul></ul><ul><ul><ul><li>'<acceptance>,' 'not with a more or less blind resignation' but in the serene knowledge that 'the Lord can & wishes to draw good from evil'; </li></ul></ul></ul><ul><ul><ul><li>'<the oblation>,' 'made out of love for the Lord and one's brothers and sisters.'&quot; </li></ul></ul></ul><ul><li>&quot;Helping the relatives, and their cooperation with health care workers are a valuable component of health care.&quot; </li></ul>Charter for Health Care Workers
    131. 131. Diagnosis <ul><li>&quot;the health care worker should seek, first & foremost, to find the illness & analyze it in the patient: this is the <diagnosis> & related <prognosis>.&quot; Both &quot;hopeless&quot; & &quot;tenacious&quot; diagnosis should be avoided: </li></ul><ul><ul><li>&quot;In the first case the patient is forced to go from one specialist or health care service to another, without finding the doctor or diagnostic center capable & willing to treat his illness. Overspecialization & fragmentation of clinical competencies & divisions, while ensuring professional expertise, is damaging to the patient when health services in the place prevent a caring and global approach to his illness. </li></ul></ul><ul><ul><li>&quot;In the second case, instead, one persists until some illness is found at any cost....[and] treated as medical when, in fact, they are not medical-health in nature.... the person is not helped to perceive the exact nature of their problem, thus misleading them about themselves & their responsibilities.&quot; </li></ul></ul><ul><li>When diagnosis avoids these pitfalls & is conducted with &quot; full respect for the dignity & integrity of the person, particularly with regard to the use of instrumentally invasive techniques ,&quot; it does not generally pose ethical problems </li></ul><ul><li>&quot;However, particular problems are posed by predictive diagnosis, because of the possible repercussions at a psychological level & the discriminations it could lead to and to prenatal diagnosis.&quot; </li></ul>Charter for Health Care Workers
    132. 132. Prenatal Diagnosis <ul><li>Prenatal diagnosis is licit, when its aim is to benefit the baby and the baby's mother - &quot;if the methods used, with the consent of the parents who have been adequately instructed, safeguard the life & integrity of the embryo & its mother & does not subject them to disproportionate risks.&quot; </li></ul><ul><li>Prenatal diagnosis is absolutely illicit, when it is carried out with the possibility of opting for abortion. </li></ul>Charter for Health Care Workers
    133. 133. Therapy & Rehabilitation <ul><li>&quot;Therapy is a medical action&quot; & &quot; amalgam of medical, physiotherapeutic, psychological measures & functional exercises.&quot; </li></ul><ul><li>A patient has a right to any treatment from which he can receive curative or salutary benefit. </li></ul><ul><li>All &quot;proportionate&quot; treatments must be applied, while it is acceptable to forego &quot;disproportionate&quot; treatments. </li></ul><ul><li>A principle of &quot;appropriate medical treatment in the remedies&quot;: As a last resort & with the patient's consent, it is acceptable to use methods from advanced medicine that are still experimental stage and not without some risk. It can be acceptable to interrupt the use of such experimental, risky methods when the results are disappointing & these methods show themselves to be disproportionate. </li></ul><ul><li>It is not suicidal for a patient to forego disproportionate treatment. </li></ul><ul><li>&quot;Therapeutic manipulation of the organism,&quot; involving &quot;modification, mutilation or removal of organs&quot; is justified by the &quot;principle of totality&quot; or the &quot;principle of therapeuticity.&quot; </li></ul><ul><li>While physical or &quot;corporeal&quot; life is a fundamental good, &quot;there are higher values for which it could be legitimate or even necessary to expose oneself to the danger of losing it.&quot; </li></ul>Charter for Health Care Workers
    134. 134. Analgesia & Anasthesia <ul><li>Pain has a therapeutic function: </li></ul><ul><ul><li>&quot;it eases the confluence of the physical and psychic reaction of the person to a bout of illness,&quot; &... </li></ul></ul><ul><ul><li>it appeals to medicine for an alleviating and healing therapy. </li></ul></ul><ul><li>While not calling it by this name, the Charter discusses the &quot;Theology of Suffering&quot;: For the Christian, pain is a sharing in Christ's own suffering & a uniting with Christ in His redemptive sacrifice, offered in obedience to His father. Some Christians may opt to forego some painkiller medication, trying to consciously associate with Christ's sufferings. This does not mean that all suffering/pain must be accepted & that efforts to alleviate suffering/pain should be foregone. </li></ul><ul><li>&quot;beyond certain limits of endurance it is...a duty for the health care worker to prevent, alleviate and eliminate pain.&quot; </li></ul><ul><li>&quot;analgesic & anaesthesic techniques & medicines&quot; can sometimes suppress or diminish &quot;consciousness & the use of the higher faculties.&quot; Where &quot;loss of consciousness & freedom&quot; is merely an unintended side effect of efforts &quot;at dulling sensitivity to pain, & are limited to the clinical need alone,&quot; they can &quot;be considered ethically legitimate.&quot; </li></ul>Charter for Health Care Workers
    135. 135. The Informed Consent of the Patient <ul><li>The &quot;express or tacit consent of the patient&quot; is a necessity for medical intervention. A patient should receive &quot;a precise idea of his illness & the therapeutic possibilities, with the risks, the problems & the consequences that they entail.&quot; </li></ul><ul><li>Consent cannot be presumed for a &quot;patient who is in a condition to know.“ For a patient who is not &quot;in a condition to know,&quot; &quot;the health care worker can, & in extreme situations must, presume the consent to therapeutic interventions, which from his knowledge & in conscience he thinks should be made. </li></ul><ul><li>&quot;If there is a temporary loss of knowing and willing, the health care worker can act in virtue of < the principle of therapeutic trust >.... </li></ul><ul><li>&quot;Should there be a permanent loss of knowing and willing, the health care worker can act in virtue of < the principle of responsibility for health care >, which obliges the health care worker to assume responsibility for the patient's health.&quot; </li></ul><ul><li>The &quot;relatives...should be informed about ordinary interventions, & involved in the decision making when there is question of extraordinary & optional interventions.&quot; </li></ul>Charter for Health Care Workers
    136. 136. Research & Experimentation <ul><li>Human dignity restricts biomedical sciences from the same investigative freedom which they have with mere things. &quot;Any research contrary to the true good of the person is immoral.&quot; </li></ul><ul><li>When a patient is unable to expressly provide it, consent can be presumed for truly therapeutic experimentation. While experimental danger & risk cannot be completely avoided, consent cannot be presumed - or even explicitly given - for certain procedures. A patient is forbidden &quot;to endanger his life, his equilibrium. his health, or to aggravate his illness.“ </li></ul><ul><li>It can be proper to first test new pharmaceutical products/ techniques on animals. </li></ul><ul><li>A sick person's condition & the foreseeable effects of experimental treatment must be compared, to assess whether a treatment is proportionate: </li></ul><ul><ul><li>In desperate cases, when the patient will die if there is no intervention, if there is a medication available, or a method or an operation which, though not excluding all danger, still has some possibility of success, any right-thinking person would concede that the doctor could certainly, with the explicit or tacit consent of the patient, proceed with the application of the treatment.&quot; </li></ul></ul><ul><li>There are circumstances, for humanitarian reasons, under which a healthy person could legitimately volunteer for an experiment, when his &quot;own substantial integrity is safeguarded&quot; & the experiment would be interrupted upon disappointing results. </li></ul>Charter for Health Care Workers
    137. 137. Research & Experimentation (continued) <ul><li>&quot;Research on human embryos & fetuses can only be allowed only when </li></ul><ul><ul><li>&quot;there is moral certainty that there will be no harm either to the life or the integrity of the expected child & the mother, & on condition that the parents have given their consent.&quot; </li></ul></ul><ul><li>Experimentation is only licit &quot; for clearly therapeutic purposes, when no other possible remedy is available .“ Otherwise, this &quot; is a crime against their dignity as human beings &quot;; parents cannot consent to such. To keep &quot;human embryos alive, actually or in vitro, for experimental or commercial reasons,' is especially & 'altogether contrary to human dignity.'&quot; </li></ul>Charter for Health Care Workers
    138. 138. Donation & Transplanting of Organs <ul><li>While donation & transplant of organs can be an incredible &quot;service to life,&quot; there are concerns. </li></ul>Charter for Health Care Workers
    139. 139. Donation & Transplanting of Organs (continued) <ul><li>In &quot; Autoplastic transplants ,&quot; the donor of the explant & the recipient of the implant are the same person. The &quot; principle of totality &quot; can justify disposing &quot;a part for the integral good of the organism.&quot; Removal of organs should &quot;not constitute a serious & irreparable impairment for the donor.&quot; </li></ul>Charter for Health Care Workers
    140. 140. Donation & Transplanting of Organs (continued) <ul><li>In &quot; Homoplastic transplants ,&quot; the donor of the explant & the recipient of the implant are of the same species - both human beings. The donor may or may not be still alive. These can be justified by the principle of solidarity and by charity . Where there is removal of an organ from a corpse, there must be certainty the corpse really is a corpse! There must be safeguards that &quot;the removal of organs does not cause or even hasten death.“ As per the the Charter (1995), &quot;When total cerebral death is verified with is licit to remove organs & also to surrogate organic functions artificially in order to keep the organs alive with a view to a transplant“ [ Note : In William May's more recent (i.e., 2000) &quot;Catholic Bioethics & the Gift of Human Life,&quot; he discusses D. Allan Shewmon's challenge to brain death criteria.].” </li></ul>Charter for Health Care Workers
    141. 141. <ul><li>&quot;With regard to the parameters used today for ascertaining death -- whether the 'encephalic' signs or the more traditional cardio-respiratory signs -- the Church does not make technical decisions. She limits herself to the Gospel duty of comparing the data offered by medical science with the Christian understanding of the unity of the person, bringing out the similarities and the possible conflicts capable of endangering respect for human dignity.... </li></ul><ul><li>&quot;the criterion adopted in more recent times for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict.... </li></ul><ul><li>&quot;Only where such certainty exists, & where informed consent has already been given by the donor or the donor's legitimate representatives, is it morally right to initiate the technical procedures...for the removal of organs for transplant&quot; . </li></ul>What Pope John Paul II said about “brain death criteria” in his 8/29/00 address to the International Congress on Transplants...
    142. 142. Is John Paul II’s 8/29/00 Guidance Implemented? <ul><li>A large number of physicians & others - including Fr. David Albert Jones of the Linacre Centre for Healthcare Ethics & Bishops Fabian Bruskewitz & Robert F. Vasa - comment on the Pope's address in a 2000 Statement Opposing Brain Death Criteria (&quot;'Brain Death' - Enemy of Life and Truth“; < >). They maintain </li></ul><ul><li>“ None of the shifting sets of 'so-called neurological criterion' for determining death fulfills the Pope's requirement that they be 'rigorously applied' to ascertain 'the complete & irreversible cessation of all brain activity'.... </li></ul><ul><li>&quot;For vital organs to be suitable... they must be living organs removed from living human beings....persons condemned to death as 'brain dead' are not 'certainly dead' but, to the contrary, are certainly alive.... </li></ul><ul><li>&quot;adherence to the restrictions stipulated by the Pope & the prohibitions imposed by God Himself in the Natural Moral Law precludes the transplantation of unpaired vital organs, an act which causes the death of the 'donor' & violates the fifth commandment of the divine Decalogue, 'Thou shalt not kill' (Deut. 5:17).&quot; </li></ul>
    143. 143. Non-Heart Beating Donation (NHBD) (As per George Isajiw, MD’s & Nancy Guilfoy Valko, RN’s March 2004 address at the Vatican: 'Non-heart beating organ donation' & the 'vegetative state' < >) <ul><li>&quot;a new procedure called ‘non-heart-beating organ donation’ has been quietly added to brain death organ donation in more and more hospitals….the potential NHBD patient does not meet the brain death criteria but is termed ‘hopeless’ or ‘vegetative’ soon after suffering a devastating condition such as a severe stroke or trauma, and while still needing a ventilator to breathe…. </li></ul><ul><li>“ In NHBD, the ventilator is usually stopped in an operating room while a doctor watches for up to one hour until the heartbeat and breathing stops. After an interval of usually just 2 to 5 minutes, the patient is declared dead and the transplant team takes over to remove the organs. A determination of brain death is considered unnecessary even though one of the inventors of the NHBD protocol, Dr. Michael DeVita has admitted, ‘the possibility of [brain