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DUC IN ALTUM!
Medical Doctors and the new evangelization.
Considerations one year after John Paul II's Apostolic Letter:
"Novo Millennio Ineunte"
Dr Gian Luigi GIGLI, president of FIAMC
1. The responsibility of the new evangelization
2. The content of the Christian proclamation
3. The conditions to proclaim the Good News
4. The features that make the work of evangelization credible
5. Communion
6. Ecclesial joint responsibility
7. Charity
8. The style of the Good Samaritan
9. Creativity in charity: new works for new needs
10. Bio-medical science
11. The inculturation of the Christian proclamation
12. Sociopolitical responsibility
DUC IN ALTUM ! Let us cast again the nets!1. The responsibility of the new evangelization
The year 2000, just gone by, was the year of the Great Jubilee. The Church commemorated the 2000 years of Christ's Incarnation, the great event which divided history and which the Church keeps actualizing in time. The Jubilee was a chance to give thanks, to praise, to convert. In the course of it, we experienced God's mercy.We, Catholic doctors, also experienced the grace of the Jubilee, both on the individual level, in the secret of our hearts, and on a diocesan and national level, during the moments proposed by our Associations. We experieced it as an even greater gift in the catholicity of the Church, when on February 11th we took part in Rome in the Jubilee of the Sick Persons and of Health Workers and when, on the occasion of our 20th World Congress held in Rome from July 3rd to July 7th, we lived together with the Pope the Jubilee of Medical Doctors.
Now that the Jubilee is over and we have returned to our daily professional life and pastoral commitment, we ask ourselves: what is left of the Great Jubilee? Was it only a moment of celebration? Or have the grace and the mercy that poured upon us abundantly given new strength and revitalized our lives as Christians?
These same questions were object of profound considerations on the part of the Holy Father John Paul II who, at the close of the Great Jubilee, deemed it useful to propose them to all Christians in the Apostolic Letter Novo Millennio Ineunte (NMI), published on January 6th, 2001. 1
In the Letter, the Pope invites us to go forward, to look at the third millennium of the Church, to put out into the deep with Peter's boat in order to bring to all men the announcement of Christian grace and joy. Duc in altum! It is the exhortation with which the Pope, recalling the words of our Lord Jesus Christ, invites us to bring the joyful announcement of the Gospel to all mankind: the new millennium, as a fruit of the Great Jubilee, has to be the millennium of the new evangelization.
In this article I would like to apply the Apostolic Letter NMI to the specificity of our professional lives and of the lives of our Associations of Catholic Doctors, for I am convinced that, following the way the Pope has pointed to, we can be factors of change of individuals, of medical culture and of society as a whole.
The exhortation to evangelization can be found throughout the NMI Letter, and at its very beginning, when the Pope writes:
At the beginning of the new millennium, and at the close of the Great Jubilee during which we celebrated the two thousandth anniversary of the birth of Jesus and a new stage of the Church's journey begins, our hearts ring out with the words of Jesus when one day, after speaking to the crowds from Simon's boat, he invited the Apostle to "put out into the deep" for a catch: "Duc in altum" (Lk 5:4). Peter and his first companions trusted Christ's words, and cast the nets. "When they had done this, they caught a great number of fish" (Lk 5:6) (NMI, 1).Later the Pope states that, at the dawn of the new millennium:
the work of evangelization is surely a priority for the Church… Even in countries evangelized many centuries ago, the reality of a "Christian society" which, amid all the frailties which have always marked human life, measured itself explicitly on Gospel values, is now gone. Today we must courageously face a situation which is becoming increasingly diversified and demanding, in the context of "globalization" and of the consequent new and uncertain mingling of peoples and cultures. Over the years, I have often repeated the summons to the new evangelization. I do so again now, especially in order to insist that we must rekindle in ourselves the impetus of the beginnings and allow ourselves to be filled with the ardour of the apostolic preaching which followed Pentecost. We must revive in ourselves the burning conviction of Paul, who cried out: "Woe to me if I do not preach the Gospel" (1 Cor 9:16) (NMI, 40).This passion will not fail to stir in the Church a new sense of mission, which cannot be left to a group of "specialists" but must involve the responsibility of all the members of the People of God. Those who have come into genuine contact with Christ cannot keep him for themselves, they must proclaim him. A new apostolic outreach is needed, which will be lived as the everyday commitment of Christian communities and groups (NMI, 40).
To evangelize means to bring the light of Christ to those who do not know it or do not see it.
Ours - writes the Pope - is the wonderful and demanding task of becoming its "reflection". This is the mysterium lunae, which was so much a part of the contemplation of the Fathers of the Church, who employed this image to show the Church's dependence on Christ, the Sun whose light she reflects. It was a way of expressing what Christ himself said when he called himself the "light of the world" (Jn 8:12) and asked his disciples to be "the light of the world" (Mt 5:14) (NMI, 54).Today, however, evangelization is regarded with suspicion by modern societies and it is out of fashion in the Church itself. In the name of interreligious dialogue and in order to respect the germs of truth that are to be found in other religions, many give up the idea of presenting Christ, light of the world, and reach in fact a sort of religious indifferentism. The underlying axiom is that we must not impose anything to anyone. However, this kind of approach is misleading. We must not impose, but we have the mission to present our faith. It is surprising, for example, that in European societies, where Islam is the second confession, and sometimes the first in terms of practice, no effort is made to present the Christian Good News. We seem to be indifferent to the faith of our brothers. Again, it is not a matter of imposition, but of being convinced of the beauty of the Christian life that is being proposed, for us in the medical field, for others in other temporal realities.2
This is also the belief of the Pope who invites all Christians to develop dialogue without giving up the idea of bearing clear witness to the hope that is within us:
Dialogue, however, cannot be based on religious indifferentism, and we Christians are in duty bound, while engaging in dialogue, to bear clear witness to the hope that is within us (cf. 1 Pt 3:15). We should not fear that it will be considered an offence to the identity of others what is rather the joyful proclamation of a gift meant for all, and to be offered to all with the greatest respect for the freedom of each one: the gift of the revelation of the God who is Love, the God who "so loved the world that he gave his only Son" (Jn 3:16). As the recent Declaration Dominus Iesus stressed, this cannot be the subject of a dialogue understood as negotiation, as if we considered it a matter of mere opinion: rather, it is a grace which fills us with joy, a message which we have a duty to proclaim (NMI, 56).If Christians are asked to approach the dialogue with an inner disposition towards understanding, however, the Pope states, the Church cannot forgo her missionary activity among the peoples of the world. It is the primary task of the missio ad gentes to announce that it is in Christ, "the Way, and the Truth, and the Life" (Jn 14:6), that people find salvation. Interreligious dialogue "cannot simply replace proclamation, but remains oriented towards proclamation" (NMI, 56).
2. The content of the Christian proclamation
We have seen up to this point the urgency of evangelization, responsibility and commitment of Christian communities and groups.That which we proclaim is not a thing, it is not a program, it is not a philosophy nor an ethical vision, albeit very noble. It is not an ideology nor a power, be it even that of the Church. When we evangelize the world, we proclaim a person, Jesus Christ himself. We proclaim the absolute novelty of a God who became man, took up human flesh and, for mankind, suffered, died, and resurrected. This is the event which shook history, which inspires our hearts and renders our actions meaningful. This is also what the world awaits. The world, however, expects us to show Christ, rather than to hear us speak about Christ; it wishes to be able to see Jesus, by looking at us.
"We wish to see Jesus" (Jn 12:21). This request, addressed to the Apostle Philip by some Greeks who had made a pilgrimage to Jerusalem for the Passover, echoes spiritually in our ears too during this Jubilee Year. Like those pilgrims of two thousand years ago, the men and women of our own day &emdash; often perhaps unconsciously &emdash; ask believers not only to "speak" of Christ, but in a certain sense to "show" him to them. And is it not the Church's task to reflect the light of Christ in every historical period, to make his face shine also before the generations of the new millennium? (NMI, 16)
Our witness, however, would be hopelessly inadequate if we ourselves had not first contemplated his face (NMI, 16).
The Pope proposes the contemplation of the face of Christ to the devotion of all Christians as foundation of the new evangelization. Naturally, it is a matter of contemplating the face of Christ in order to be able to reflect its light. There is, however, a face of Christ that appeals to us medical doctors. Being accustomed in our profession to be near those who suffer, we are particularly drawn to the suffering of God made Man, to the suffering face of the Man of Gethsemane and of the Way of the Cross, to the face covered by ecchymoses, wounds and blood during the Passion and delivered to us by the linen of the Holy Shroud.
As we contemplate, as medical doctors, this suffering face, we find strength and inspiration to contemplate the face of every suffering man, to look upon him with eyes that are new, as a face saved by the bleeding face of Christ, as a precious face, for it was redeemed at a very high price, as a face endowed with divine dignity even when disfigured and almost unrecognizable, insofar as it is the face assumed by God who became man.
As we contemplate the face of the Passion, we will practice our profession with new heart and eyes and we will make the world see Christ, and his radical novelty.
These concepts, that are apparently old, are in fact radically new as far as today's medicine is concerned. Medicine, in fact, is encountering some difficulties in recognizing the dignity of every human being and can therefore be available for manipulating the human being at embryonic stage; it can take part in the suppression of human beings at foetal stage through abortion; with euthanasia, it can take part in the elimination of human beings for whom a sufficient quality of life in not recognized, because terminally ill, or of those for whom the spark of the human mind was turned off because in a persistent vegetative state or because seriously retarded or affected by dementia.
Moreover, once we lose the concept according to which all men, in all phases of their lives, have the same dignity as persons, medicine can preferably turn its attention to those who have the means to get treatment. Or, it can contribute to divert public resources towards problems concerning small groups of patients, forgetting more serious social realities, though they may be of a lesser scientific-technological interest. Or it can approve a distribution of resources on a planetary scale that seems to passively accept the fact that there are groups of people who are doomed to malnutrition, epidemics, and infant mortality. For this medicine, the Christian announcement, Christianity, are concepts of an absolute novelty, the foundation of a practice of medicine that is completely different from the dominant practice.
3. The conditions to proclaim the Good News
The face of Christ is therefore the content of our evangelization, yet we ask ourselves, in which way should we proclaim it? What must we do to bring the Good News to everybody? The Pope invites us first of all not to fall into a misunderstanding.No, we shall not be saved by a formula but by a Person, and the assurance which he gives us: I am with you (NMI, 29)!
It is not therefore a matter of inventing a "new programme". The programme already exists: it is the plan found in the Gospel and in the living Tradition, it is the same as ever. Ultimately, it has its centre in Christ himself, who is to be known, loved and imitated, so that in him we may live the life of the Trinity, and with him transform history until its fulfilment in the heavenly Jerusalem. This is a programme which does not change with shifts of times and cultures, even though it takes account of time and culture for the sake of true dialogue and effective communication (NMI, 29).
This programme for all times is our programme for the Third Millennium. It is for this reason that the Pope confines himself to indicating to us the conditions for an effective pastoral work, that is able to proclaim the Good News.
I shall not examine here in detail the conditions the Pope proposed to us, but I will at least mention them.
First of all - the Pope writes - I have no hesitation in saying that all pastoral initiatives must be set in relation to holiness…(NMI, 30)
In fact, to place pastoral planning under the heading of holiness is a choice filled with consequences… For example, …it would be a contradiction to settle for a life of mediocrity, marked by a minimalist ethic and a shallow religiosity (NMI, 31).
The whole life of the Christian community and of Christian families must lead in this direction. It is also clear however that the paths to holiness are personal and call for a genuine "training in holiness", adapted to people's needs. This training must integrate the resources offered to everyone with both the traditional forms of individual and group assistance, as well as the more recent forms of support offered in associations and movements recognized by the Church (NMI, 31).
I wonder whether, in the context of our Associations of Catholic Doctors, such training in holiness, on account of the specific needs of doctors, should not propose more specifically models of men and women who sanctified their lives by practising the medical profession.
The calendar presents many figures of saint doctors. I believe that our profession is the most represented among the ranks of saints, naturally after bishops, priests and nuns. Actually, perhaps ours could have been the most numerous category, but, speaking from an epidemiological point of view, there is a selection bias: the whole process of selection is in fact in the hands of the clergy, and we are only called to evaluate the reliability of miracles.
In a recent collection, Dr. Richard Watson from New Jersey introduces at least thirty-three saint doctors; he also states that the list is not complete. Some of them are known to all, like our patron saint, Luke the Evangelist, or like the saint brothers Cosma and Damian, called "moneyless ones" for they did not charge their patients a fee (is it perhaps on account of this that it is now more difficult for us to become saints?).
Then there are saints doctors most people do not know of, such as Saint Pantaleon, Saint Diomedes, Saint Emilian, or very famous saints in medicine, like Nicholas Steno or Anthony Mary Zaccaria.
Finally, there are very modern saint doctors, such as Prof. Joseph Moscati and Dr. Gianna Beretta Molla. They were both lay doctors. The first, who was sanctified by popular claim, taught and practised medicine in Naples. The latter, who was a paediatrician in Milan, and a member of the local Association of Catholic Doctors, after a fruitful witness in the profession and in the family, sacrificed her life for the love of life, forgoing to get treatment in order to give birth to her youngest daughter.
Other medical doctors have not been beatified yet, but the proposal of the beatification proceedings would almost be a moral duty for our Associations. For example, I am thinking of Prof. Nagai, a Japanese convert who taught at the University of Nagasaki, and who died after having dedicated himself to evangelization in the course of long years full of suffering, the consequence of the atomic bomb that had fallen in the heart of the district inhabited by the flourishing Catholic community of Nagasaki, and that destroyed it. Nagai's wife, who had converted him to Christianity, had also died in the explosion (even then, there was somebody speaking about "smart bombs"!).
I am thinking of Jerôme Lejeune, who made of his life and of his scientific research a coherent witness that understood the beauty and the humanity of the Magisterium of the Church. With faith and hope, he offered the suffering he experienced toward the end of his life as sacrifice to God, in order to obtain from him the protection of human life just when this was attacked, all over the world, by medical doctors themselves. I thank the Lord for having granted me the privilege of meeting him more than once, and of discussing with him the possibility of a scientific research in favour of man, especially with regard to children with mental disabilities.
Finally, other saints waiting to be recognized, though they are not medical doctors, would deserve a honorary degree in medicine, like Dr. Marcello Candia, an entrepreneur who, like a novel Saint Francis, gave away all his riches in order to build health centres for lepers and to live among them in Brazil. I once had the good fortune to eat together with him in his Milan, where he, who had been wealthy, returned at regular intervals begging for his Brazilian lepers.
Luckily, therefore, we only have plenty to choose from in proposing models to be followed by our doctors, both historical and contemporary. But in order to be able to train and be trained in holiness, the Pope writes again, we need a Christianity distinguished above all in the art of prayer (NMI, 32).
It is a fact that, in today's world, despite the process of secularization, a widespread demand for spirituality is present. It expresses itself precisely in a renewed need for prayer (NMI, 33).
Is it not perhaps our responsibility, as individuals and as Associations, if often this need is perceived to be unfulfilled in the Church and turns to other religions and to sects? Is it not perhaps also the responsibility of us Catholic doctors if contemporary man turns to these sects, to these new and at times old forms of spirituality, for an answer to his need of physical and spiritual healing?
The Pope rightly invites us to recover the great mystical tradition of the Church, of both East and West. He invites us to make so that our Christian communities become
genuine "schools" of prayer, where the meeting with Christ is expressed not just in imploring help but also in thanksgiving, praise, adoration, contemplation, listening and ardent devotion, until the heart truly "falls in love". Intense prayer, yes, but it does not distract us from our commitment to history: by opening our heart to the love of God it also opens it to the love of our brothers and sisters, and makes us capable of shaping history according to God's plan (NMI, 33).
This is an invitation and a project that is also valid for our Associations of Catholic Doctors: to be genuine schools of prayer.The Pope then invites us to give our principal attention to the celebration of the Sunday Eucharist; to rediscover the Sacrament of Reconciliation, so as to appreciate God's mercy and to confront the crisis of the sense of sin that afflicts contemporary society; to listen with renewed attention to the Word of God, in order to revitalize the work of evangelization.
Holiness, prayer, listening to the Word, Sunday Eucharist, Sacrament of Reconciliation: this is the path the Pope points to in order to carry out our work of evangelization. Following this path, the work of evangelization may not be easier, but surely we will be able to face it without anxiety, free above all from the anxiety of acting out and of planning.
There is a temptation which perennially besets every spiritual journey and pastoral work: that of thinking that the results depend on our ability to act and to plan. God of course asks us really to cooperate with his grace, and therefore invites us to invest all our resources of intelligence and energy in serving the cause of the Kingdom. But it is fatal to forget that "without Christ we can do nothing" (cf. Jn 15:5) (NMI, 38).
It is prayer which roots us in this truth. It constantly reminds us of the primacy of Christ and, in union with him, the primacy of the interior life and of holiness. When this principle is not respected, is it any wonder that pastoral plans come to nothing and leave us with a disheartening sense of frustration? We then share the experience of the disciples in the Gospel story of the miraculous catch of fish: "We have toiled all night and caught nothing" (Lk 5:5) (NMI, 38).
4. The features that make the work of evangelization credible
We looked again, together with the Pope, at the conditions necessary to propose to others the encounter with Jesus. The Holy Father also points out those features that make the work of evangelization credible. They can be summed up in one fundamental feature, that of Love.
"By this all will know that you are my disciples, if you have love for one another" (Jn 13:35). If we have truly contemplated the face of Christ, dear Brothers and Sisters, our pastoral planning will necessarily be inspired by the "new commandment" which he gave us: "Love one another, as I have loved you" (Jn 13:34) (NMI, 42).
The fundamental feature of Love is expressed in turn in three signs of the credibility of the proclamation: ecclesial communion, ecclesial joint responsibility, charity.5. Communion
Communion, first of all. The Pope invites us to make the Church the home and the school of communion: that is the great challenge facing us in the millennium which is now beginning, if we wish to be faithful to God's plan and respond to the world's deepest yearnings (NMI, 43).
Naturally, this applies to our Associations as well, from which no one must feel left out, homes of communion and schools of holiness in which holiness is proposed as a path rather than being requested as a demand; for which the relationship with other associations and ecclesial movements is not one of competition, but rather of collaboration; for which the communion with the Bishop and the Holy See is a spiritual need, before being a duty.6. Ecclesial joint responsibility
Therefore the Church of the Third Millennium will need to encourage all the baptized and confirmed to be aware of their active responsibility in the Church's life (NMI, 46).To reflect upon our pastoral responsibility clearly does not mean to think first of all about our participation in the pastoral councils of hospitals or in the health pastoral committees of dioceses. It means, above all, that inside hospitals, the Catholic Doctor can remarkably contribute to the pastoral of the Church, in the situations where men and women are confronted with the most dramatic questions of their lives, those at the very basis of the religious experience: Who I am? Why are we born? What is the meaning of suffering? Why do I have to die and what is there beyond death? In some circumstances, the Catholic Doctor can be more important than the priest, at least when the priest is unavailable or is not accepted.
Not only, also in parishes and schools the Catholic Doctor can have an important pastoral role, in the courses of preparation to marriage, or sexual education of youth. The Catholic Doctor is an actor of the Pastoral of the Church, he shares the apostolic ministry. Christ sent out the Apostles to proclaim the Kingdom of God and to heal (Luke 9,2).
Yet the Pope adds:
In a special way it will be necessary to discover ever more fully the specific vocation of the laity, called "to seek the kingdom of God by engaging in temporal affairs and by ordering them according to the plan of God"; they "have their own role to play in the mission of the whole people of God in the Church and in the world ... by their work for the evangelization and the sanctification of people" (NMI, 46).
Along these same lines, another important aspect of communion is the promotion of forms of association, whether of the more traditional kind or the newer ecclesial movements, which continue to give the Church a vitality that is God's gift and a true "springtime of the Spirit". Obviously, associations and movements need to work in full harmony within both the universal Church and the particular Churches, and in obedience to the authoritative directives of the Pastors. But the Apostle's exacting and decisive warning applies to all: "Do not quench the Spirit, do not despise prophesying, but test everything and hold fast what is good" (1 Th 5:19-21) (NMI, 46).How not to see in this call of the Pope a pressing invitation to develop and strengthen the work of our Associations of Catholic Doctors, so that, beyond our personal witness, the face of the Church, that is the face of Christ himself in today's time, may be immediately visible?
7. Charity
Beginning with intra-ecclesial communion, charity of its nature opens out into a service that is universal; it inspires in us a commitment to practical and concrete love for every human being. This too is an aspect which must clearly mark the Christian life, the Church's whole activity and her pastoral planning. The century and the millennium now beginning will need to see, and hopefully with still greater clarity, to what length of dedication the Christian community can go in charity towards the poorest. If we have truly started out anew from the contemplation of Christ, we must learn to see him especially in the faces of those with whom he himself wished to be identified: "I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me" (Mt 25:35-37). This Gospel text is not a simple invitation to charity: it is a page of Christology which sheds a ray of light on the mystery of Christ. By these words, no less than by the orthodoxy of her doctrine, the Church measures her fidelity as the Bride of Christ (NMI, 49).8. The style of the Good Samaritan
Our work, when we carry it out well, when we recognize in the face of our patient the suffering face of Christ and his dignity, is already a work of charity, it is authentic and special participation in the ministry of salvation. As the Pope states, it
is a testimony to the nature of God's love, to his providence and mercy; and in some way history is still filled with the seeds of the Kingdom of God which Jesus himself sowed during his earthly life whenever he responded to those who came to him with their spiritual and material needs (NMI, 49).In fact, what is the Gospel but a proclamation of salvation, a proclamation of health and of healing? Jesus proclaimed the Kingdom of God and healed the sick. Salvation makes health possible as well ("Go, your faith has saved you", says Christ to the blind man). On the other hand, healings provide the first witness of the power of the Saviour, and make his preaching credible. The work of charity, and especially the work of us medical doctors, if when we carry it out we recognize the face of Christ in our patients and we use the style of the Good Samaritan, can give particular credibility to the proclamation of the Gospel.
The Pastoral of the Church in the world of Health needs the laity in order to accomplish Christ's mandate: to announce the Gospel and to heal the sick. Healing the sick is not something to be added as an afterthought, but it is almost an integral part of evangelization, it is that which makes it credible. Jesus himself defined his announcement as "healing the sick".
The merciful and healing love of Christ manifests itself especially when we accept to offer our skills to those who cannot give us anything back. We have the responsibility of showing the face of Christ to those who are poor or have no access to standard levels of quality in medicine because of their census or of their social and psychological conditions.
9. Creativity in charity: new works for new needs
However, our being, individually, good Samaritans is not sufficient in itself. The Pope proposes a much wider horizon, within which there is a great space for associate forms of witness, such as our Associations of Catholic Doctors.In our own time, there are so many needs which demand a compassionate response from Christians. Our world is entering the new millennium burdened by the contradictions of an economic, cultural and technological progress which offers immense possibilities to a fortunate few, while leaving millions of others not only on the margins of progress but in living conditions far below the minimum demanded by human dignity. How can it be that even today there are still people dying of hunger? Condemned to illiteracy? Lacking the most basic medical care? Without a roof over their heads (NMI, 50)?
The scenario of poverty can extend indefinitely, if in addition to its traditional forms we think of its newer patterns. These latter often affect financially affluent sectors and groups which are nevertheless threatened by despair at the lack of meaning in their lives, by drug addiction, by fear of abandonment in old age or sickness, by marginalization or social discrimination. In this context Christians must learn to make their act of faith in Christ by discerning his voice in the cry for help that rises from this world of poverty. This means carrying on the tradition of charity which has expressed itself in so many different ways in the past two millennia, but which today calls for even greater resourcefulness (NMI, 50).
This enormous effort is not aimed only at making up for the fact that governments did not show any concern for some forms of poverty and marginalization; the effort was and is a witness to the fact that attention directed to the human person is not true unless the whole of man is involved, even when he is frail, weak, and all men are involved, even when they have been abandoned, and their social weight and their importance in the society of productivity and commodities are no longer significant.
It is for this reason that we can say with pride that the effort of the Church in the world of health greatly contributed to the development of human civilization, favouring all over the world the growth of a culture of mercy and compassion, of rights and of the respect of man in all situations of life and in all phases of existence.3
Today, however, is the time for a new "creativity" in charity, not only by ensuring that help is effective but also by "getting close" to those who suffer, so that the hand that helps is seen not as a humiliating handout but as a sharing between brothers and sisters (NMI, 50).
We must therefore ensure that in every Christian community the poor feel at home. Would not this approach be the greatest and most effective presentation of the good news of the Kingdom? Without this form of evangelization through charity and without the witness of Christian poverty the proclamation of the Gospel, which is itself the prime form of charity, risks being misunderstood or submerged by the ocean of words which daily engulfs us in today's society of mass communications. The charity of works ensures an unmistakable efficacy to the charity of words (NMI, 50).
The presence of the Church in the world of health was and is dictated by the awareness that it is precisely when man expresses the need to be healthy that he is led to question himself on the fundamental questions of life, the meaning of birth, of suffering, of dying. The Church is aware that a correct answer to these questions can also condition the answer to other questions on which the religious consciousness of man is founded. Who am I? Where am I going? What meaning does my life have? The need to regain health (salus) can lead to asking for salvation.
It is for these reasons that, even in non-Catholic hospitals, the Church always favours the presence of chaplains, of sisters of nursing orders, of doctors and nurses with Catholic training and faith, of volunteers inspired by the model of the Good Samaritan.
If these are the reasons for a presence, how can we not detect a call to us doctors, a new proposal of the spirituality of the Good Samaritan, when the Pope speaks of malnutrition, of the lack of basic medical treatments, of despair, of drugs, of the neglect of old people and of the sick, of social marginalization? The Pope invites individual medical doctors to create new forms of service to the poor, to discover new forms of health service for the new forms of poverty that are present the cities of wealth as well; he encourages them to be present in the scenario of international health cooperation with the developing countries.
Countless are the emergencies to which every Christian heart must be sensitive (NMI, 51). And he mentions the ecological crisis, the problems of peace, the contempt for the fundamental human rights, especially children.
10. Bio-medical science
An important area for charity is that of bio-medical science. It is the most important charity, intellectual charity, so that medical science may not lose its scope of helping man and may not become instrument of destruction and selection of human life.Then he adds:
A special commitment is needed with regard to certain aspects of the Gospel's radical message which are often less well understood, even to the point of making the Church's presence unpopular, but which nevertheless must be a part of her mission of charity. I am speaking of the duty to be committed to respect for the life of every human being, from conception until natural death. Likewise, the service of humanity leads us to insist, in season and out of season, that those using the latest advances of science, especially in the field of biotechnology, must never disregard fundamental ethical requirements by invoking a questionable solidarity which eventually leads to discriminating between one life and another and ignoring the dignity which belongs to every human being (NMI, 51).For Christian witness to be effective, especially in these delicate and controversial areas, it is important that special efforts be made to explain properly the reasons for the Church's position, stressing that it is not a case of imposing on non-believers a vision based on faith, but of interpreting and defending the values rooted in the very nature of the human person (NMI, 51).
Clearly, all this must be done in a specifically Christian way: the laity especially must be present in these areas in fulfilment of their lay vocation, without ever yielding to the temptation to turn Christian communities into mere social agencies (NMI, 52).
11. The inculturation of the Christian proclamation
In our work of evangelization, the Pope invites us to be mindful of the different cultures where the Christian message is to be proposed, so that the specific values that animate them are not repudiated but rather purified and brought to their fullness. This applies particularly to medical culture, for a long time allied with the Church in the defence of human dignity.In the Third Millennium, Christianity will have to respond ever more effectively to this need for inculturation. Christianity, while remaining completely true to itself, with unswerving fidelity to the proclamation of the Gospel and the tradition of the Church, will also reflect the different faces of the cultures and peoples in which it is received and takes root (NMI, 40).
Charity will necessarily become service to culture… (NMI, 51).Up to a few decades ago in fact doctors' morality and Catholic morality were rarely in contrast and the Catholic doctor had no difficulties in making available to his patients all that medical science offered, without for this reason suffering from conflicts of conscience. It is true, there have always existed doctors and midwives who performed abortions, but they did so outside the common moral recognized by the profession and in a hidden manner because they would be blamed. When I studied medicine, the forensic medicine textbook distinguished only four types of abortion: spontaneous, therapeutic (only to save the mother's life), eugenetic and criminal. On the latter two types the professional blame was extremely clear.
Things have deeply changed in the past decades. The availability of methods of pharmacological contraception, the feminist movement, the introduction of abortion in a great number of legislations, the growing possibilities offered by genetics of discovering illnesses before birth, the development of techniques of in vitro fertilization, the consequent production of embryos with the objective of curing sterility, their availability to scientific research, the discovery of the potential of embryonic cells for the development of useful tissues for transplantation for the cure of degenerative illnesses, the hypothesis of total or partial cloning already realized in the animal kingdom, all this has radically changed the scenario.
Pregnancy and childbirth are no longer seen as acts which are, most of the times, physiological; they are instead often lived as a disgrace and an illness the doctor must take upon himself to cure. A son is no longer seen as a gift, but as an object of desire, to be made only if one wants, when one wants, and to be accepted only if the gift is well packed and is not damaged.
Medicine no longer has as its objective the defense of life, it is more worried about the quality of life.
International organizations gave up the fight to ensure the fundamental health rights to all populations and social strata; they only worry about reducing the request of such rights, favouring a fall in the birth rate all over the world.
The ambiguous term of "reproductive health" has been created behind which, together with the prevention and control of gynaecological illnesses, contraception, abortion, sterilization, fall in birth rate, are publicized, offered and imposed to governments and health workers, while we still worry too little about maternal mortality, still too high in some countries in the world and in some social strata even in developed countries.
The Catholic doctor, and the Catholic obstetrician gynaecologist in particular, naturally finds himself in the middle of these tensions and changes.
We have to manifest the courage of asking again the fundamental questions about life, suffering and death. The pagan vision that is behind the cult of health is afraid of suffering, ageing, death and even birth. Before this vision we have to witness the Christian perspective, looking at birth, disease, suffering, care, healing and death as opportunities for growth. The experience of our limits helps us discover the infinity and the reality of ourselves, and breaks the dream of omnipotence and invulnerability.
It is necessary for every medical doctor to feel personally engaged in limiting the medicine of desires, in contrasting the technological invasion of medicine, in reversing the social invasiveness of medicine. Instead, every effort should be made to develop an idea of medicine based on prevention, on health education, on correction of inappropriate lifestyles; in other words, an idea of medicine grounded on the responsibility of the person.
In a time of limited resources we have to save resources on the grounds of a culture of responsibility in medicine and to use them for creating valid health systems in developing countries.
This responsibility should be felt especially by those who have teaching appointments and who have a great responsibility in the education of the new generations of physicians.2
12. Sociopolitical responsibility
Charity will necessarily become service to culture, politics, the economy and the family, so that the fundamental principles upon which depend the destiny of human beings and the future of civilization will be everywhere respected (NMI, 51).The ethical and social aspect of the question is an essential element of Christian witness: we must reject the temptation to offer a privatized and individualistic spirituality which ill accords with the demands of charity, to say nothing of the implications of the Incarnation and, in the last analysis, of Christianity's eschatological tension. While that tension makes us aware of the relative character of history, it in no way implies that we withdraw from "building" history. Here the teaching of the Second Vatican Council is more timely than ever: "The Christian message does not inhibit men and women from building up the world, or make them disinterested in the welfare of their fellow human beings: on the contrary it obliges them more fully to do these very things" (NMI, 52).
We are called to make medicine and the places where it is practised more humane, and to ensure that technological progress is not used against human rights. We are called to serve public health, by promoting health policies that are respectful of human life, dignity and nature.
12.1. Professional boards
The medical profession is something that rises above the law and lives in the dimension of ethics, even if it cannot depart from deontology and from the laws dealing with medical practice. Laws dealing with medicine and human life, without a suitable ethics, would be mere arbitrariness, possibly based upon unmentionable interests. Ethics without translation into deontology and laws would be something confined to general principles, without any direct application.
The rules and regulations of medical law should be sufficiently clear and brief to facilitate the action of the medical doctor. The guiding principle is always the same: the medical doctor is called to help and to heal, never to do harm and never to kill.
It is for these reasons that the medical doctor will cooperate with the application of just laws, except for the duty of conscientious objection when the civil law does not respect human rights, especially the right to life. For these same reasons, the medical doctor, respectful of the dignity of his profession, will refuse to become an instrument of violent or oppressive applications of medicine.12.2. Ethical committees
The medical doctor should be competent in ethics, even without being a specialist. For the same reason, ethical committees are necessary in every health care centre and ethics should be taught to medical students, in an open dialogue with specialists who belong to the various relevant disciplines.12.3. Health policies
Pressed between a utilitarian idea of health, which recognizes only some health rights considered socially useful, and the health ideologies, which propose health practices as a form of cult for a sort of new religion, for which death seems almost to be avoidable and health and fitness are modern Gods, we cannot simply withdraw on the line of a mercantile ideal of medicine where profit (personal and institutional) is the meter of what is right.
Again, we have to place the subject at the very centre of our attention and to promote a net of human relationships based on solidarity.
Finally, we have an enormous sociopolitical task in promoting legislation in favour of life. And of human rights.12.4 Action in favour of life and for the promotion of human rights
It is not only a matter of resisting to the temptations of abortion, embryo wasting and euthanasia. We must feel ourselves engaged in promoting social conditions where life can be accepted and in fighting against those situations where the dignity of life is humiliated. As a matter of fact, the respect and promotion of life and of other human rights is the basis of every social aggregation, worthy of being considered human. In this regard, working in favour of life and human rights is probably the most important contribution to human civilization.
We chose to be Medical Doctors in order to heal, to alleviate pain, to have compassion, to comfort, to accompany. We cannot passively witness a slow, seemingly unavoidable transformation of medicine into a profession servant of current cultural trends or of the compromises of politics. We should instead find the courage to firmly oppose all this, convinced as we are that neither Governments, nor Parliaments have any rights to issue laws that go against the fundamental human rights and against doctors' deontological codes.
Human rights are grounded on the single root of the dignity of the person and the legitimacy of states and of governments is founded upon them.
This fundamental right is guaranteed by ethical duty, which confers sense and legitimacy to civil coexistence, laws, and institutions.The protection of the right of every individual of the human species, especially if weak and powerless, is what marks the difference between the state and any lobby, corporation or criminal association.4
DUC IN ALTUM ! Let us cast again the nets!
The Christ whom we have contemplated and loved bids us to set out once more on our journey: "Go therefore and make disciples of all nations, baptizing them in the name of the Father, and of the Son and of the Holy Spirit" (Mt 28:19). The missionary mandate accompanies us into the Third Millennium and urges us to share the enthusiasm of the very first Christians (NMI, 58).After the enthusiasm of the Jubilee, it is not to a dull everyday routine that we return…(NMI, 59).
The Risen Jesus accompanies us on our way and enables us to recognize him, as the disciples of Emmaus did, "in the breaking of the bread" (Lk 24:35). May he find us watchful, ready to recognize his face and run to our brothers and sisters with the good news: "We have seen the Lord!" (Jn 20:25) (NMI, 59).
Udine, 25 january 2002
