Message of the Prefect of the Dicastery for Promoting Integral Human Development for the 68th World Leprosy Day (31 January 2021)

To the Presidents of Episcopal Conferences, to the Bishops responsible for Health Pastoral Care, to Men and Women Religious, to social, healthcare and pastoral workers, to volunteers and all persons of good will,

“Beat Leprosy”

World Leprosy Day 2021 is observed this January 31 with the overall goal: “Beat Leprosy.” This noble aim begins with the medical reality that leprosy is a curable disease; but beating leprosy involves more than a mere medical struggle. It also seeks to eliminate the social stigma that accompanies this difficult illness and ultimately envisions the restoration of the human person in an integral way.

There is a compelling account of the healing of leprosy in the Gospel of St. Luke: Jesus is making his way to Jerusalem when he is suddenly met by ten persons suffering from that neglected tropical disease of the skin. They call out to him from a distance, seeking help and consolation in their affliction. He responds by curing them of their physical ailment. One of them, recognizing that he was healed and that his social condition had been restored, returns to Jesus and, drawing near, gives thanks. At the conclusion of that encounter Jesus responds, “Stand up and go, your faith has saved you” (LK 17:19).

The Latin word for salvation is salus, and it is the same word used for healing. When Christ brings healing to the man with leprosy in the Gospel, he applies the salve of human dignity in addition to the physical remedy. It becomes an event that touches the entire person and the effects are far reaching. When the Church speaks of God’s generous offer of salvation, that gift is described as both universal and integral.[1: Compendium of the Social Doctrine of the Church, 38.] God desires to heal all people and the whole person. Integral health likewise encompasses the personal and social dimension; it includes the spiritual nature of the person as well as the physical.

Health care services have advanced remarkably in addressing leprosy or Hansen’s disease in recent decades. Multi-drug therapy has proven successful and effective in curing leprosy and has afforded much hope. Health care, in addition to treating the physical ailments of the person, must also consider the social and psychological dimensions. Integral health involves, “prevention, diagnosis, treatment and rehabilitation for the better physical, psychological, social and spiritual balance and well-being of the person.”[2: Pontifical Council for Pastoral Assistance for Health Care Workers, “New Charter for Health Care Workers,” 3.]

The World Health Organization notes that stigma remains a challenge for early detection and successful completion of treatment for leprosy. “Many patients continue to experience social exclusion, depression and loss of income,” they explain.[3: World Health Organization, “Global Leprosy Strategy 2016-2020,” 5.] Promoting the inclusion of all persons in society and assuring integration in the community remain priorities. Additionally, financial support and opportunities to actively engage in the workplace and economic life are essential for people with leprosy and their families. “Every human being,” insists Pope Francis, “has the right to live with dignity and to develop integrally; this fundamental right cannot be denied by any country. People have this right even if they are unproductive, or were born with or developed limitations.”[4: Pope Francis, Fratelli Tutti, 107.]

Integral health is also an imperative for persons with leprosy with regard to their mental well-being, “since leprosy can be demonstrated to have a significant impact on social participation and mental health in addition to causing physical impairments.”[5: PMW Somas, MW Waltz, WH van Brakel (2020), “The impact of leprosy on the mental wellbeing of leprosy-affected persons and their family members-a systematic review,” Global Mental Health 7, e15, 1.] In a sense the person with leprosy suffers from the illness itself, and from the way he or she is received in the community. Lack of social adhesion can have a profoundly negative impact on self-esteem and a person’s outlook on life, ultimately leaving the person vulnerable to mental illness. Pope Francis indicates that the human person is, by nature, open to relationships. “Implanted deep within us,” he insists, “is the call to transcend ourselves through an encounter with others.”[6: Pope Francis, Fratelli Tutti, 111.] The health care community in particular, and society as a whole, offer a tremendous service to the common good when they help facilitate this process of personal integration for those who suffer from leprosy and their families. Not everyone will have the skills or expertise to cure Hansen’s disease physically, but everyone is capable of promoting that culture of encounter which brings about healing and the mental well-being of those affected by this distressing illness.

In conclusion, I offer my sincere respect and gratitude to all who dedicate themselves to “beat leprosy” and offer healing and hope to those who suffer from Hansen’s disease. They show us, in very practical ways, that leprosy is curable, that human encounter can eliminate stigma, and that mental well-being is an essential part of integral health.

May the powerful intercession of Mary, health of the sick, lead us all more completely towards the healing touch of Jesus Christ.

Katholiek Nieuwsblad, 22 januari 2021

door dr. Anton ten Klooster, moraaltheoloog aan Tilburg University en priester van het aartsbisdom Utrecht

Binnen en buiten de Kerk heerst wantrouwen ten opzichte van de nieuwe coronavaccins. Kritische vragen stellen is terecht, maar er zijn goede (katholieke) redenen om je toch te laten vaccineren.

Het toedienen van de eerste vaccins markeert het begin van een nieuwe fase van de corona-pandemie. Velen hopen en verwachten dat het het begin van het einde van de beperkende maatregelen is. Daarvoor is een bepaalde vaccinatiegraad nodig; een dusdanig groot deel van de bevolking is gevaccineerd dat het virus zich moeilijker of zelfs helemaal niet kan verspreiden. Voor die vaccinaticgraad moeten mensen vertrouwen hebben in de werking van het vaccin en bereid zijn het te ontvangen. Deze zaken staan echter onder druk door zowel onduidelijkheid als desinformatie.

Voorop staat dat de vraag van wel of niet vaccineren iedereen persoonlijk raakt. Het is een handeling die ingrijpt in het eigen lichaam, om dit tegen ziekte te beschermen. Wie voor vaccinatie kiest, zal dus terecht willen weten of het veilig is. De werkzaamheid en veiligheid van de vaccins die nu in West-Europa toegediend worden, zijn onderzocht volgens de geldende wetenschappelijke standaarden. Toch blijven er vergezochte theorieën rondgaan over mogelijke genetische manipulatie door een vaccin en onbewezen bijwerkingen.

Wantrouwen

De bron van dit probleem is een wantrouwen naar officiële instanties, dat gevoed wordt door de onzekere omstandigheden en de snelheid waarmee het vaccin ontwikkeld is. Maar juist die snelheid is ook een hoopvol teken van wat de mensheid kan bereiken als ze zich voluit en gezamenlijk inzet voor het oplossen van problemen. Uiteindelijk rest dan de vraag: wie vertrouw je? Zelf kies ik ervoor mijn vertrouwen te stellen in ethici met medische kennis, zoals bijvoorbeeld verenigd in de Katholieke Stichting Medische Ethiek (medische-ethiek.nl). Zij betogen met kennis van zaken dat vaccinatie verantwoord, veilig en aanbevelenswaardig is. Terecht stellen we kritische vragen over zoiets belangrijks als het ontwikkelen en toedienen van een vaccin. Maar wc mogen ook kritisch zijn bij de weging van de betrouwbaarheid van beschikbare informatie.

Terecht krijgt het gebruik van cellijnen van geaborteerde menselijke foetussen in de ontwikkeling van vaccins veel aandacht. Het leergezag wijst dit gebruik af. Tegelijk heeft het consequent betoogd dat het gebruik van deze vaccins in ernstige omstandigheden te rechtvaardigen is. De Congregatie voor de Geloofsleer bevestigde kort voor Kerstmis dat we ons in zulke omstandigheden bevinden. Toch blijft een aantal katholieken, met name in de VS, betogen dat het ontvangen van zo’n vaccin moreel onaanvaardbaar is. Zij verwerpen daarmee impliciet (en soms ook expliciet) de stelling-name van het leergezag. Ook hier komt de kwestie van vertrouwen terug: paus Franciscus en bisschoppen wereldwijd – een enkele uitzondering daargelaten – houden eensgezind voor dat vaccinatie aanvaardbaar en aanbevelenswaardig is. Zo helpen zij ons bij het vormen van ons geweten. De Kerk heeft door de eeuwen heen de eensgezindheid over een leer ook gezien als een teken van de leiding van de Heilige Geest, ook hierop mogen we vertrouwen.

Het katholieke leergezag houdt eensgezind voor dat vaccinatie aanvaardbaar en aanbevelenswaardig is

Vaccinatie afwijzen lijkt een manier om jezelf te vrijwaren van vermeende risico’s, moreel of medisch. Dit gaat echter voorbij aan het sociale aspect een vaccinatieprogramma beoogt niet alleen de bescherming van het individu, maar daardoor ook het beschermen van de samenleving als geheel, in het bijzonder diegenen die het kwetsbaarst zijn voor het coronavirus. Een afgewogen gewetensbeslissing dient ook dit mee te wegen.

Het spreekt voor zich dat daarbij de belangen van de ene groep niet opgeofferd mogen worden voor die van een andere. Dat is ook niet aan de orde: vaccinatie beschermt het individu en de gemeenschap. Wie denkt zelf weinig te vrezen te hebben van een eventuele corona-infectic, doet er goed aan om uit solidariteit voor vaccinatie te kiezen. Juist vanwege de grote belangen moet de overheid zorgvuldig communiceren over de werking van vaccins, mogelijke bijwerkingen, en ingaan op de zorgen van burgers. Waar zij dit nalaat, moet zij kritisch bevraagd worden, in het bijzonder door experts. Tegelijk mogen we als gelovige mensen en betrokken burgers laten zien dat we geen individualisten zijn, maar deel willen uitmaken van een solidaire en gezonde samenleving.

Overgenomen met toestemming van Katholiek Nieuwsblad.

A Fair and Just Vaccines Approach as Step Towards Healing the World

Vatican COVID-19 Commission and Pontifical Academy for Life, december 29th, 2020

Vatican COVID-19 Commission and Pontifical Academy for Life Calls for Fair and Just Vaccines Approach as Step Towards Healing the World

Vatican lays out principles and values for vaccine adoption, providing a clear moral roadmap for world leaders and everyday citizens

The Vatican COVID-19 Commission and Pontifical Academy for Life issue 20-point joint paper confirming moral responsibility of taking COVID-19 vaccines, building off guidance from the Congregation for the Doctrine of the Faith issued 21 December.

The paper states there is a moral responsibility to accept the vaccine, not just for individual personal health but to protect the health of all. The Vatican Commission and Pontifical Academy of Life reminds world leaders that vaccines were developed as a public good and must be provided to all fairly and equitably, prioritizing those most in need.

It calls on world leaders to resist the temptation to participate in “vaccine nationalism”, urging nation states and companies to cooperate – not compete – with each other.

Cardinal Turkson, head of the Dicastery for Promoting Integral Human Development (DPIHD), who leads the Commission said, “we are grateful to the scientific community for developing the vaccine in record time; it is now up to us to ensure it becomes available for all, especially the most vulnerable. It is a matter of Justice. We need to show once and for all that we are one human family.”

“The interconnectedness that binds humanity has been revealed by the COVID-19 pandemic,” said Archbishop Vincenzo Paglia, President of the Pontifical Academy of Life. “Together with the Commission, we are working with many partners to reveal lessons the human family can learn and to develop an ethics of risk and solidarity to protect the most vulnerable of society.”

“We are at a turning point in the COVID-19 pandemic and have an opportunity to start to define the world we want to see post-pandemic,” says Mons. Bruno-Marie Duffe, Secretary of the DPIHD. “The way in which vaccines are deployed – where, to whom, and for how much – is the first step for global leaders to take in committing to fairness and justice as the principles for building a better post- COVID world,” stresses Father Augusto Zampini, Adjunct Secretary of DPIHD.

About the Vatican Commission on COVID-19

● The Vatican’s COVID-19 Commission was established by Pope Francis in March 2020 to respond to the global devastation caused by the pandemic. As we respond and move through recovery, we must ensure the cures for the immediate crises are stepping-stones to a more just, inclusive and integrated set of systems, responding to global crises as a global family.
● Housed within the Dicastery for Promoting Integral Human Development (DPIHD) and led by Cardinal Peter Turkson, the Commission is a new model of working for the Vatican that places high priority on inter-dicasterial collaboration and deep engagement with external partners and local Church to inform global policy and practice toward a new model of global development that better serves the most vulnerable among people and planet.
● The work of the Commission is coordinated by a Directorate reporting directly to the Holy Father and includes the DPIHD’s Prefect, Cardinal Peter Turkson, Secretary, Msgr. Bruno-Marie Duffé, and Adjunct Secretary, Fr. Augusto Zampini.

Note on the morality of using some anti-Covid-19 vaccines
Congregation for the Doctrine of the Faith, 21 december 2020

The question of the use of vaccines, in general, is often at the center of controversy in the forum of public opinion. In recent months, this Congregation has received several requests for guidance regarding the use of vaccines against the SARS-CoV-2 virus that causes Covid-19, which, in the course of research and production, employed cell lines drawn from tissue obtained from two abortions that occurred in the last century. At the same time, diverse and sometimes conflicting pronouncements in the mass media by bishops, Catholic associations, and experts have raised questions about the morality of the use of these vaccines.

There is already an important pronouncement of the Pontifical Academy for Life on this issue, entitled “Moral reflections on vaccines prepared from cells derived from aborted human fetuses” (5 June 2005). Further, this Congregation expressed itself on the matter with the Instruction Dignitas Personae (September 8, 2008, cf. nn. 34 and 35). In 2017, the Pontifical Academy for Life returned to the topic with a Note. These documents already offer some general directive criteria.

Since the first vaccines against Covid-19 are already available for distribution and administration in various countries, this Congregation desires to offer some indications for clarification of this matter. We do not intend to judge the safety and efficacy of these vaccines, although ethically relevant and necessary, as this evaluation is the responsibility of biomedical researchers and drug agencies. Here, our objective is only to consider the moral aspects of the use of the vaccines against Covid-19 that have been developed from cell lines derived from tissues obtained from two fetuses that were not spontaneously aborted.

1. As the Instruction Dignitas Personae states, in cases where cells from aborted fetuses are employed to create cell lines for use in scientific research, “there exist differing degrees of responsibility”  of cooperation in evil. For example,“in organizations where cell lines of illicit origin are being utilized, the responsibility of those who make the decision to use them is not the same as that of those who have no voice in such a decision”.

2. In this sense, when ethically irreproachable Covid-19 vaccines are not available (e.g. in countries where vaccines without ethical problems are not made available to physicians and patients, or where their distribution is more difficult due to special storage and transport conditions, or when various types of vaccines are distributed in the same country but health authorities do not allow citizens to choose the vaccine with which to be inoculated) it is morally acceptable to receive Covid-19 vaccines that have used cell lines from aborted fetuses in their research and production process.

3. The fundamental reason for considering the use of these vaccines morally licit is that the kind of cooperation in evil (passive material cooperation) in the procured abortion from which these cell lines originate is, on the part of those making use of the resulting vaccines, remote. The moral duty to avoid such passive material cooperation is not obligatory if there is a grave danger, such as the otherwise uncontainable spread of a serious pathological agent –in this case, the pandemic spread of the SARS-CoV-2 virus that causes Covid-19. It must therefore be considered that, in such a case, all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive. It should be emphasized, however, that the morally licit use of these types of vaccines, in the particular conditions that make it so, does not in itself constitute a legitimation, even indirect, of the practice of abortion, and necessarily assumes the opposition to this practice by those who make use of these vaccines.

4. In fact, the licit use of such vaccines does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted fetuses.  Both pharmaceutical companies and governmental health agencies are therefore encouraged to produce, approve, distribute and offer ethically acceptable vaccines that do not create problems of conscience for either health care providers or the people to be vaccinated.

5. At the same time, practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary. In any case, from the ethical point of view, the morality of vaccination depends not only on the duty to protect one’s own health, but also on the duty to pursue the common good. In the absence of other means to stop or even prevent the epidemic, the common good may recommend vaccination, especially to protect the weakest and most exposed. Those who, however, for reasons of conscience, refuse vaccines produced with cell lines from aborted fetuses, must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent. In particular, they must avoid any risk to the health of those who cannot be vaccinated for medical or other reasons, and who are the most vulnerable.

6. Finally, there is also a moral imperative for the pharmaceutical industry, governments and international organizations to ensure that vaccines, which are effective and safe from a medical point of view, as well as ethically acceptable, are also accessible to the poorest countries in a manner that is not costly for them. The lack of access to vaccines, otherwise, would become another sign of discrimination and injustice that condemns poor countries to continue living in health, economic and social poverty.

The Sovereign Pontiff Francis, at the Audience granted to the undersigned Prefect of the Congregation for the Doctrine of the Faith, on 17 December 2020, examined the present Note and ordered its publication.

Rome, from the Offices of the Congregation for the Doctrine of the Faith, on 21 December 2020, Liturgical Memorial of Saint Peter Canisius.

Luis F. Card. Ladaria, S.I.  
Prefect  

+ S.E. Mons. Giacomo Morandi
Titular Archbishop of Cerveteri
Secretary

Vatican News, 15 december 2020

De bisschoppen van de Verenigde Staten verduidelijken in een verklaring hoe er vanuit Rooms-katholiek perspectief tegen COVID-19 vaccinatie aangekeken moet worden. Ze concluderen dat vaccinatie tegen COVID-19 in de huidige omstandigheden met de beschikbare vaccins moreel aanvaardbaar is. Het blijft een opdracht voor alle katholieken onder de aandacht te brengen en er dus voor te pleiten dat ontwikkeling en productie van vaccins plaatsvindt zonder hiervoor materiaal te gebruiken dat in verband kan worden gebracht met abortus.

De Congregatie voor de Geloofsleer heeft een document gepubliceerd over de zorg voor ernstig en terminaal zieken: Samaritanus bonus.

The human person in the centrality of his integrity

The address of Undersecretary Gambino at the presentation of the Letter on the care of persons in critical and terminal phases of life.

First of all, “the vulnerability of every human being, body and spirit, mysterious marked by the desire for infinite love for which he has been destined from all eternity”; secondly, “the principle that caring for others who are in a state of need is not only a question of the ethics of social solidarity or of beneficence,” but is even more “the recognition of the inestimable value of one’s life as an insurmountable limit in the face of any claim of autonomy”; and last but not least, “the foundation of any juridical order: the worth of every person at any stage of life or condition of existence.”

These are the three cornerstones which the Undersecretary of our Dicastery, Gabriella Gambino, explored in depth this morning in the Sala Stampa, commenting on the Letter “Samaritanus Bonus,” on the care of persons in critical or terminal phases of life, which was edited by the Congregation for the Doctrine of the Faith and presented today at a press conference.

“Care,” explained the Undersecretary, “cannot be reduced to simply attending to the sick from a medical or psychological perspective, but must branch out into a virtuous attitude of devotion and concern for the other, which finds its substance in caring for the whole person, for those who are in a state of need.” It is this caring which, she continued, “supports the encounter between ‘I’ and ‘You,’ thereby calling man out of the state of insignificance and anxiety into which his illness has thrown him, and helping him to rediscover the unity of body and spirit. This aspect,” she clarified, “is full of pastoral and bioethical implications, which should lead us to modify the way the critically and terminally ill are cared for in many contexts.”

Faced with the “complexity of the medical management of sickness and death,” before a “secularized culture and legislation that confounds us on the value of suffering and of our life,” Gambino concluded that with the Letter Samaritanus Bonus “the Church desires to restore the centrality of man in his integrity, a unified totality of body and spirit; and to remind us that we are children of a Father who has loved us to the end, who is the only one who can make sweet the burden of our suffering.”

It is entitled “Humana Communitas in the Age of Pandemic: untimely meditations on Life’s Rebirth” and it is the second document – the first one is from 30 March 2020 – that the Pontifical Academy for Life dedicates to the consequences of the world health crisis and its interpretation.

«In the suffering and death of so many, we have learned the lesson of fragility», stresses the text.

The document underlines the importance of a change of pace: global efforts and a determined international cooperation are needed to face the challenge of a fairer and more just future, whose keywords are better health care for all and vaccination.

«We have not payed sufficient attention, especially at the global level, to human interdependence and common vulnerability. While the virus does not recognize borders, countries have sealed their frontiers. In contrast to other disasters, the pandemic does not impact all countries at the same time. Although this might offer the opportunity to learn from experiences and policies of other countries, learning processes at the global level were minimal. In fact, some countries have sometimes engaged in a cynical game of reciprocal blame».

Moreover, «The phenomenon of Covid-19 is not just the result of natural occurrences. What happens in nature is already the result of a complex intermediation with the human world of economical choices and models of development, themselves “infected” with a different “virus” of our own creation: it is the result, more than the cause, of financial greed, the self-indulgence of life styles defined by consumption indulgence and excess. We have built for ourselves an ethos of prevarication and disregard for what is given to us, in the elemental promise of creation. This is why we are called to reconsider our relation to the natural habitat. To recognize that we dwell on this earth as stewards, not as masters and lords». Then « When compared to the predicament of poor countries, especially in the so called Global South, the plight of the “developed” world looks more like a luxury: only in rich countries people can afford the requirements of safety. In those not so fortunate, on the other hand, “physical distancing” is just an impossibility due to necessity and the weight of dire circumstances: crowded settings and the lack of affordable distancing confront entire populations as an insurmountable fact. The contrast between the two situations throws into relief a strident paradox, recounting, once more, the tale of disproportion in wealth between poor and rich countries».

The crisis has shown the possibilities and limitations of those models focused on hospital care: «For sure, in all countries the common good of public health needs to be balanced against economic interests» and the nursing homes and the elderly have been hit hard. To this must then be added that «Ethical discussions of resource allocation were primarily based on utilitarian considerations, without paying attention to people experiencing higher risk and greater vulnerabilities. In most countries, the role of general practitioners was ignored, while for many people they are the first contact in the care system. The result has been an increase in deaths and disabilities from causes other than Covid-19».

The response that must be given to the Covid-19 pandemic cannot be reduced to an organizational-operational level. Re-interpreting the crisis we went through, the text highlights how much we can learn on a deeper level. The fragility, finitude and vulnerability in which all human beings have found themselves united urge us to a conversion that includes and elaborates existentially and socially the experience of loss, as a constitutive part of human condition. Only starting from this awareness will it be possible to involve our conscience in a conversion that will allow us to feel responsibly supportive in a global fraternity (cf. Francis, Humana communitas, 6 January 2019).

On the level of ethics and public health globally, this entails: 1. An equal risktaking and the distribution of those risks that cannot be eliminated in the conduct of human life, including as regards access to healthcare resources, among which vaccination has a strategic role; 2. A responsible attitude towards scientific research, which protects its autonomy and independence, overcoming forms of subordination to particular economic or political interests, which distort its achievements and its communication; 3. Coordination and cooperation at international and global level to put into effect the universal right to the highest levels of health care, as an expression of protection of the inalienable dignity of the human person.

«We are called to an attitude of hope, beyond the paralyzing effect of two opposite temptations: on the one hand, the resignation that passively undergoes events; on the other, the nostalgia for a return to the past, only longing for what was there before. Instead, it is time to imagine and implement a project of human coexistence that allows a better future for each and every one. The dream recently envisaged for the Amazon region might become a universal dream, a dream for the whole planet to “integrate and promote all its inhabitants, enabling them to enjoy ‘good living’” (Querida Amazonia, 8)».

Inter alia, prof. Henk ten Have, Academician of the Pontifical Academy for Life and one of the leading experts in Global Bioethics (Professor emeritus at the Center for Healthcare Ethics at Duquesne University in Pittsburgh, USA) and prof. Roberto Dell’Oro, professor at Loyola Marymount University (California, USA) contributed to the drafting of the text. Professor ten Have points out that «The Covid-19 pandemic as a global phenomenon demonstrates that we are nowadays intrinsically interconnected. What affects human beings across the world is a concern for everyone. We all share the same vulnerability because we inhabit the same common home. This experience makes us aware that our individual well-being is dependent on the human community. As articulated in Nota 2 of the Pontifical Academy for Life, a global ethical perspective should therefore be applied which articulates the moral importance of solidarity, cooperation, social responsibility, the common good, and ecological integrity».

For his part, prof. Dell’Oro underlines how «this Nota 2, building on the premises on the first document on COVID, offers a meditation on the human family in the time of the pandemic. The tone is meditative, rather than normative. The intention of the document is not to give cheap recipes, but to recognize that together, as a human family (humana communitas), we have to go back to the lessons we have learned. It is life itself who teaches us, but we have to be mindful and attentive, in addition to foster action. In that sense, we need to change together, to dispose ourselves to a different attitude toward life as a whole. The church calls us to interrogate our most profound experiences, without being preachy, but with realism: our finitude, the limits of our freedom, the shared vulnerability that opens our eyes to those who suffers greatly, especially in the Global South. The document also calls for global efforts and international cooperation and for an ethics of solidarity. I personally hope for people of good will, believers and non-believers, to see this document as a call to conversion, which is first of all, a change in our own way of looking at reality, and to build our efforts on a renewed mindfulness».

Pontifical Academy for Life
Vatican City, July 22th 2020

COMECE, 17 juli 2020

In its contribution to the ‘Consultation on the White Paper on Artificial Intelligence – A European Approach’, COMECE calls the EU institutions to adopt a human-centric approach to Artificial Intelligence (AI) in order to promote the common good and serve the lives of all human beings both in their personal and community dimensions.

The COMECE contribution, published on 14 June 2020, welcomes the White Paper’s general intention to establish a solid European approach to Artificial Intelligence (AI) deeply grounded on human dignity and protection of privacy. It highlights that “data” and “algorithms” are the main drivers of Artificial Intelligence, while humans determine and overview the goals which an AI system should attain.

As already highlighted in the April 2017 COMECE contribution to the EP consultation on robotics, COMECE expresses perplexity on the possible creation of a new dedicated EU Agency as “the current key structures of the EU ensure sufficient support for addressing AI and robotics challenges”.

Should the EU opt for the establishment of some sort of EU coordination body devoted to AI, COMECE agrees with the statement made in the White Paper that the “…governance structure should guarantee maximum stakeholders participation”, including Churches, which have a specific status as partners of the EU institutions under Article 17 TFEU and should be explicitly mentioned in this context.

In its contribution, COMECE underlines the necessity of establishing a sustained social ethics discourse accompanying the political discussion on regulating AI. The EU should build tools and mechanisms for such a broad interdisciplinary discourse into the existing EU structures and programmes – as effective and concrete as possible, e.g. through the new research programme Horizon Europe or the revised Coordinated Plan on AI.

The COMECE document also includes detailed proposals in relation to areas such as fundamental rights (liability, safety, algorithms, children, protection of personal data), AI and sustainabiltiy, the fight against money-laundering and AI and cybersecurity.

In February 2019 COMECE published the reflection paper “Robotisation of Life: Ethics in view of new challenges”. In February 2020 COMECE participated in the international workshop “The ‘good’ algorithm? Artificial Intelligence, Ethics, Law, Health”, held at the Vatican on the occasion of the 26th General Assembly of the Pontifical Academy for Life. On that occasion, H.E. Mgr. Vincenzo Paglia, President of the Pontifical Academy for Life, signed the document “Rome Call for an AI Ethics”, supporting an ethical approach to Artificial Intelligence and the promotion of a sense of responsibility among organisations, governments and institutions in order to assure that digital innovation and technological progress serve human genius and creativity.

Letter to the superior general of the Congregation of the “Brothers of Charity”, regarding the accompaniment of patients in psychiatric hospitals of the congregation’s Belgian branch

Congregation for the Doctrine of the Faith, 30 March 2020

Most Reverend Br René, Superior General,

In March 2017, on the website of the Belgian branch of the Congregation of the “Brothers of Charity”, a document was published which permits — under certain conditions — the practice of euthanasia in a Catholic hospital. This practice, supported by the Association Provincialat des Frères de la Charité asbl, is fundamentally based on three criteria: the inviolability of life, the autonomy of the patient and the relationship of care. Such a document, however, makes no reference either to God, or to Sacred Scripture, or to the Christian vision of humanity.

The Congregation for the Doctrine of the Faith wrote to the Superior General, who had already disapproved of this document, asking for clarifications, and the then-prefect of the Dicastery informed the Holy Father about the gravity of the case in an audience on 20 May 2017.

From 27 June 2017 until now, contacts and meetings have taken place between the Congregation for the Doctrine of the Faith, the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life, the Secretariat of State, Representatives of the Frères and of the Association Provincialat des Frères, as well as representatives of the Episcopal Conference of Belgium, in order to offer opportunities and spaces for dialogue on an extremely delicate subject and thus to find, in a spirit of sincere ecclesiality, a convergence on Catholic doctrine on the subject.

The numerous interdicasterial meetings of 31 August and 7 November 2017, of 1 February, 15 March, 20 June and 12 October 2018, and of 20 July 2019, this Dicastery’s letter to the Superior General of the Frères dated 30 June 2017, the document Principles to be observed on the accompaniment of patients in psychiatric hospitals, and the meeting which took place in Rome on 21 March 2018 should all be recalled.

In this context, the Secretary of State and the Prefects of the Congregation for the Doctrine of the Faith and of the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life asked the Representatives of the Frères and of the Association Provincialat des Frères to unequivocally affirm in writing their adherence to the principles of the sacredness of human life and the unacceptability of euthanasia, and, as a result, their absolute refusal to carry it out in the institutions dependent on them. Unfortunately, the replies received gave no assurances on these points.

Euthanasia remains an inadmissible act, even in extreme cases, inasmuch as it “is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person. This doctrine is based upon the natural law and upon the written word of God, is transmitted by the Church’s Tradition and taught by the ordinary and universal Magisterium” (John Paul II, Evangelium Vitae, n. 65).

For his part, Pope Francis has affirmed that “the current socio-cultural context is progressively eroding the awareness of what makes human life precious. Indeed, it is increasingly valued in terms of its efficiency and utility, to the point of considering lives that do not correspond to this criterion as ‘rejected’ or ‘unworthy’. In this situation of the loss of authentic values, the inalienable duties of human and Christian solidarity and fraternity also fail. In reality, a society deserves to be recognized as ‘civil’ if it develops antibodies against the throwaway culture; if it recognizes the intangible value of human life; if solidarity is actively practiced and safeguarded as the foundation of coexistence” (Pope Francis, Address to participants in the Plenary Assembly of the Congregation for the Doctrine of the Faith, 30 January 2020).

Furthermore, he reiterated that “the relational — and not merely clinical — approach to the patient, considered in the uniqueness and integrality of his person, imposes the duty never to abandon anyone in the presence of incurable diseases. Human life, because of its eternal aim, preserves all its value and all its dignity in any condition, even of precariousness and fragility, and as such is always worthy of the highest consideration” (ibid.).

In these latter words, Pope Francis touches on the theme of “compassion”, which is increasingly invoked by public opinion as a justification for euthanasia.

John Paul II had already made it unequivocally clear that euthanasia is “a false mercy, and indeed a disturbing ‘perversion’ of mercy. True ‘compassion’ leads to sharing another’s pain; it does not kill the person whose suffering we cannot bear. Moreover, the act of euthanasia appears all the more perverse if it is carried out by those, like relatives, who are supposed to treat a family member with patience and love, or by those, such as doctors, who by virtue of their specific profession are supposed to care for the sick person even in their most painful terminal stages” (Evangelium Vitae, n. 66).

In short, therefore, Catholic teaching affirms the sacred value of human life; the importance of caring for and accompanying the sick and disabled; the Christian value of suffering; the moral unacceptability of euthanasia; the impossibility of introducing this practice into Catholic hospitals, even in extreme cases, and of collaborating in this regard with civil institutions.

It seems clear that the position of the Brothers of Charity group in Belgium does not conform to such principles. Indeed: 1.) it rejects the absolute nature of respect for life, or rather, it calls into doubt that the life of an innocent human being must be respected “always”, leaving open the possibility of exceptions; 2.) with regard to the importance of the care and accompaniment of psychiatric patients, it refers to the Belgian law on euthanasia, clearly opening the possibility for non-terminal psychiatric patients; 3.) it leaves the responsibility and the right to accept or reject the request for euthanasia (“medical act”) to the doctor, thereby excluding the hospital’s choice; 4.) it maintains the possibility of euthanasia within the Institute with the justification of enabling family members to avoid the effort of having to find another solution.

The report of the Apostolic Visitator, H.E. Bishop Jan Hendriks, also demonstrated no progress, since it shows the profound difficulty in maintaining the link between the works and the Congregation of the Brothers of Charity, since those responsible do not accept the commitment to finding a viable solution that avoids any form of responsibility for euthanasia on the part of the institution.

Therefore, at the end of this long and painful journey, and noting the lack of willingness to accept the Catholic Doctrine on euthanasia, it is announced, albeit with deep sadness, that the psychiatric hospitals run by the Association Provincialat des Frères de la Charité asbl in Belgium, henceforth, can no longer be considered Catholic institutions.

I gladly take this opportunity to confirm my feelings of religious respect.

Cardinal Luis F. Ladaria,
sj Prefect

✠ Giacomo Morandi Titular
Archbishop of Cerveteri
Secretary

Pontifical Academy for Life

All humanity is being put to the test. The Covid-19 pandemic puts us in a situation of unprecedented, dramatic and global difficulty whose power to destabilize the plans we have for our lives is growing day by day. The pervasiveness of this threat calls into question aspects of our way of life that we have been taking for granted. We are living painfully a paradox that we would have never imagined: to survive the disease we must isolate ourselves from each other, but if we were ever to learn to live isolated from one another, we would quickly realize how essential for our lives is life with others.

In the very middle of our technological and managerial euphoria, we have found ourselves socially and technically unprepared for the spread of this contagion: it has been difficult for us to recognize and admit its impact. And now, we are rushing to limit its spread. But if we consider the existential destabilization that it is causing, we see similar unpreparedness—not to say a certain resistance—with respect to the recognition of our physical, cultural and political vulnerability in the face of the phenomenon. This destabilization is beyond the reach of science and of the technology of therapeutic devices. It would be unfair—and a mistake—to attribute the responsibility for this situation to scientists and technicians. At the same time, it is certainly true that greater depth of vision and the input that comes from more responsible reflection about the meaning and values of humanism has the same urgency as research on pharmaceuticals and vaccines. And not only that. Realizing this profundity and responsibility creates a context of cohesion and unity, of alliance and brotherhood, by reason of our shared humanity which, far from suppressing the contributions of men and women of science and government, greatly supports them and reaffirms their roles. Their dedication—to which is already owing the deserved and heartfelt gratitude of all—will certainly come through this time strengthened and appreciated.

In this context, the Pontifical Academy for Life, which by its institutional mandate promotes and supports the alliance between science and ethics in a search for the best possible humanism, wishes to contribute its own reflections. Its intent is to locate certain elements of this situation within a renewed spirit that must nourish social relations and care for the person. The exceptional situation that today challenges the brotherhood of the humana communitas must finally transform itself into an occasion for this spirit of humanism to influence institutional culture at a regular pace: within individual peoples, and in the harmonious bonds between peoples.

Solidarity in vulnerability and in limitations.

First, the pandemic highlights with unexpected harshness the precariousness that radically characterizes our human condition. In some regions of the world, this precariousness in individual and community existence is a daily experience due to poverty that does not allow everyone access to care, even if it is available, or to food in sufficient quantities, even if not lacking worldwide. In other parts of the world, the number of areas of uncertainty has been progressively reduced through advances in science and technology, to the point where we deceive ourselves by thinking that we are invulnerable or that we can find a technical solution for everything. Yet, however much effort we make, it has not been possible to control the pandemic that is underway, even in the most economically and technologically developed societies, where it has overwhelmed the capabilities of laboratories and health care facilities. Our optimistic projections about our scientific and technological capabilities have perhaps allowed us to imagine that we would be able to prevent the spread of a global epidemic of this magnitude, so much so that its possibility seemed increasingly remote. We have to recognize that this is not the case. And today we are even encouraged to think that, together with the extraordinary resources of protection and care that our progress produces, there are also side effects that show the weakness of our systems and we have not been vigilant enough with respect to them.

In any case, it is painfully obvious that we are not masters of our own fate. And science as well is showing its limitations. We already knew this: the conclusions of science are always partial, whether because it focuses—for convenience or for substantive reasons—on certain aspects of reality and leaves out others, or by reason of the nature of scientific theories, which are temporary in any case and subject to revision. But in the uncertainty that we have experienced in dealing with the Covid-19 virus, we have perceived with new clarity the gradualness and complexity that are part of scientific knowledge, which has its special requirements with respect to methodology and validation. Precariousness and the limits of our understanding also appear as global, real and shared; there are no real arguments that allow some civilizations or entities to consider themselves sovereign, better than others and able to isolate themselves when convenient. Now, we are close enough to “touch” our interconnectedness. Indeed, we are more interconnected by our exposure to vulnerability than by the efficiency of our tools. Contagion spreads very quickly from one country to another; what happens to one person becomes decisive for everyone. This situation makes more immediately evident what we knew but did not adequately internalize: for better or worse, the consequences of our actions always fall on others as well as on ourselves. There are no individual acts without social consequences. This applies to each individual, and to each community, society and population center. Reckless or foolish behavior, which seemingly affects only ourselves, becomes a threat to all who are exposed to the risk of contagion, perhaps without even affecting the actor. In this way we learn how everyone’s safety depends on everyone else’s.

The outbreak of epidemics is certainly a constant in human history. But we cannot hide the characteristics of today’s threat, which shows that it can adapt its pervasiveness to our current way of life very well and can circumvent protective measures. With our efficient and wide-ranging transportation and delivery network, we must be aware of the effects of our development models, which exploit hitherto inviolate forest areas where microorganisms unknown to the human immune system are found. We will probably find a solution to what is attacking us now. We will have to do so, however, with the knowledge that this type of threat is gathering long-term systemic potential.

Secondly, it will be better to address the problem with the best scientific and organizational resources that we have, avoiding ideological emphasis on the model of a society that equates salvation with health. Rather than being considered a defeat for science and technology—which must surely always excite us because of its progress, but at the same time it must make us humbly live with its limits—disease and death are a deep wound to our dearest and deepest affections, but it cannot however impose on us the abandonment of the rightness of those affections and the breakdown of affective bonds. Not even when we have to accept our inability to fulfill the love those affections and bonds contain within themselves. Even though our life is always mortal, we have the hope that such is not the case with the mystery of love in which life resides.

From de facto interconnection to chosen solidarity

Never have we been called on to become aware of the reciprocity that is at the basis of our life as much as we have during this terrible emergency. Realizing that every life is a life in common, together we make up life, and life comes from “the other.” The resources of a community that refuses to consider human life as only a biological fact are a precious commodity which also accompanies, responsibly, all the other activities necessary for care. Perhaps we have thoughtlessly wasted this patrimony, whose value makes a difference in times like these, and have seriously undervalued the relational goods that it is able to share and distribute when emotional bonds and community spirit are sorely tried, precisely by our need for the very necessities that protect biological life.

Two rather crude ways of thinking that nevertheless have apparently become commonplace and reference points when we speak of freedom and rights tend to be brought up in discussions today. The first is, “My freedom ends where the other’s begins.” This formula, already dangerously ambiguous, is inadequate to the real understanding of experience, and not by accident is it affirmed by those who are in fact in a position of strength: our freedoms are always intertwined and overlapped, for better or for worse. Rather, we must learn to render our freedoms collaborative for the common good, to overcome the tendencies, which an epidemic can nourish, to see in the other an “infectious” threat from which to distance ourselves, an enemy from which to protect oneself. The second is, “My life depends solely on me.”—No, it doesn’t. We are part of humanity and humanity is part of us. We must accept this dependency and appreciate the responsibility that makes us participants and protagonists in it. There is no right that does not have a resultant corresponding duty: the coexistence of those who are free and equal is an exquisitely ethical question, not a technical one.

We are therefore called to recognize, with new and deep emotion, that we are entrusted to each other. Never as much as today has the caring relationship presented itself as the fundamental paradigm for human coexistence. The change from de facto interdependence to chosen solidarity is not an automatic transformation. But already we have various signs of a shift toward responsible actions and fraternal behavior. We see this with particular clarity in the commitment of health care personnel who generously devote all their energy, sometimes even at the risk of their own life or health, to alleviating the suffering of the sick. Their professionalism extends well beyond the confines of contractual obligations, thus testifying that work is above all an area of expression, of meaning and of values, not just “transactions” or “merchandise” to be exchanged for a price. But the same goes for researchers and scientists who put their skills at the service of others. Commitment to the sharing of forces and information has made possible the rapid establishment of cooperation among research center networks on experimental protocols to establish the safety and efficacy of pharmaceuticals.

As well, we must not forget all those other women and men who every day choose positively and courageously to guard and nourish brotherhood. It is the mothers and fathers of families, the elderly and the youth; it is the persons who, even in objectively difficult situations, continue to do their work honestly and conscientiously; it is the thousands of volunteers who have not stopped serving; it is the leaders of religious communities who continue to serve those entrusted to their care, even at the cost of their lives, as has been revealed by the stories of so many priests who have died of Covid-19.

Politically, the current situation urges us to take a broad view. In international relations (and in the relations among the Members of the European Union) it is a short-sighted and illusory logic that seeks to give answers in terms of “national interests.” Without effective cooperation and effective coordination, which addresses the inevitable political, commercial, ideological and relational resistances firmly, viruses do not stop. Of course, these are very serious and burdensome decisions: we need an open vision and choices that do not always satisfy the immediate desires of individual populations. But given the markedly global current dynamic, our responses, to be effective, cannot be limited to what happens within one’s own borders.

Science, medicine and politics: the social link is put to the test

Political decisions will certainly have to take scientific data into account, but they cannot not be limited to those factors. Allowing human phenomena to be interpreted solely on the basis of the categories of empirical sciences would mean producing answers on only a technical level. That would end in a logic that considers biological processes as the determinants of political choices, according to that dangerous path that bio-politics has taught us about. Nor is it respectful of the differences among cultures to understand them in a single technical-scientific way: the different connotations ascribed to health, disease, death and health care systems can constitute richness for all.

Instead, we need an alliance between science and humanism, which must be integrated and not separated from, or worse, set against each other. An emergency like that of Covid-19 is overcome with, above all, the antibodies of solidarity. Technical and clinical means of containment must be integrated into a broad and deep search for the common good, which will have to resist a tendency to direct benefits toward privileged persons and a neglect of vulnerable persons according to citizenship, income, politics or age.

This applies as well to all the choices made pursuant to a “care policy,” including those more closely connected with clinical practice. The emergency conditions in which many countries are finding themselves can lead to forcing doctors into dramatic and painful decisions, with respect to rationing limited resources not available to everyone at the same time. In such cases, after having done at an organization level everything possible to avoid rationing, it should always be borne in mind that decisions cannot be based on differences in the value of a human life and the dignity of every person, which are always equal and priceless. The decision concerns rather the use of treatments in the best possible way on the basis of the needs of the patient, that is, the severity of his or her disease and need for care, and the evaluation of the clinical benefits that treatment can produce, based on his or her prognosis. Age cannot be considered the only, and automatic, criterion governing choice. Doing so could lead to a discriminatory attitude toward the elderly and the very weak. In any case, it is necessary to formulate criteria, agreed upon as much as possible and based on solid arguments, to avoid arbitrariness or improvisation in emergency situations, as disaster medicine has taught us. Of course, it bears repeating: rationing must be the last option. The search for treatments that are equivalent to the extent possible, the sharing of resources, and the transfer of patients, are alternatives that must be carefully considered, within a framework of justice. Under adverse conditions, creativity has also furnished solutions to specific needs, such as the use of the same ventilator for multiple patients. In any case, we must never abandon the sick person, even when there are no more treatments available: palliative care, pain management and personal accompaniment are never to be omitted.

Even in terms of public health, the experience we are going through presents us with a serious test, even if it is one that can only be carried out in the future, in less troubled times. In question is the balance between a preventive approach and a therapeutic approach, between treatment of an individual and the collective dimension (given the close correlation between health and personal rights, and public health). These are questions based on a deeper concern about the goals that medicine can set for itself, considering overall the role of health in social life with all its dimensions, such as education and care for the environment. One can glimpse the fruitfulness of a global bioethical perspective, which takes into account the multiplicity of interests at stake and the global scope of problems that is greater than an individualistic and reductive view of the issues of human life, health and care.

The risk of a global epidemic requires, in the context of responsibility, the introduction of global coordination in health care systems. Be aware that the strength of the process is determined by its weakest link, in terms of speed of diagnosis, rapidity of reaction and proportionate containment measures, adequate structures, systems for record keeping and ability to share information and data. It is necessary that the authorities who can deal with emergencies comprehensively, make decisions, and orchestrate communications, can also be relied upon as reference points to avoid the communication storms that have broken out (“infodemia”), with their inexact data and the fragmentary reports.

The obligation to protect the weak: Gospel faith put to the test

In this scenario, particular attention should be paid to those who are most fragile, and we are thinking especially of the elderly and people with special needs. All other things being equal, the lethality of an epidemic varies in relation to the situation of the affected countries—and within each country—in terms of available resources, the quality and organization of the health care system, living conditions of the population, the ability to know and understand the characteristics of the phenomenon and to interpret information. There will be more deaths where already in everyday life people are not guaranteed simple basic health care.

This last consideration, too, on the greater negativity faced by the most fragile, urges us to pay a great deal of attention to how we talk about God’s action in this historical crisis. We cannot interpret the sufferings that humanity is going through according to the crude scheme that establishes a correspondence between “lèse-majesté” against the divine and a “sacred reprisal” undertaken by God. The mere fact that in such a scenario the weakest would suffer, precisely those whom He cares for the most and with whom He identifies (Mt 25:40-45) forestalls this possibility. Listening to Scripture and the fulfillment of the promise that Jesus accomplishes shows that being on the side of life, just as God commands us, is made real through gestures of humanity for “the other.” Gestures that, as we have seen, are not lacking in these days.

Every form of solicitude, every expression of benevolence is a victory of the Resurrected Jesus. Witness to this is the responsibility of Christians. Always and for everyone. At this juncture, for example, we cannot forget the other calamities that affect the most fragile, such as refugees and immigrants, or those peoples who continue to be plagued by conflict, war and hunger.

Intercessory prayer

Where evangelical closeness meets a physical limit or hostile opposition, intercession— founded in the Crucifix—retains its unstoppable and decisive power, even should people seem not to live up to God’s blessing (Es 32: 9-13). This cry of intercession from the people of believers is the place where we can come to terms with the tragic mystery of death, fear of which is part of all our stories today. In the cross of Christ, it becomes possible to think of human existence as a great passage: the shell of our existence is like a chrysalis waiting for the liberation of the butterfly. The whole of creation, says St. Paul, is living “the pains of childbirth.”

It is in this light that we must understand the meaning of prayer. As an intercession for everyone and for all those who are in suffering—and Jesus has brought them as well into solidarity with us—and as a moment in which to learn from Him the way to live suffering as an expression of trust in the Father. It is this dialogue with God that becomes a font that enables us to trust men as well. From here we gain the inner strength to exercise all our responsibility and make ourselves open to conversion, according to what reality makes us understand about how a more human coexistence is possible in our world. We remember the words of the Bishop of Bergamo, one of the most affected cities in Italy, Bishop Francesco Beschi: “Our prayers are not magic formulas. Faith in God does not magically solve our problems, rather it gives us an inner strength to exercise that commitment that one and all, in different ways, are called to live, especially those who are called to contain and overcome this evil.”

Even someone who does not share the profession of this faith can in any case draw from the witness of this universal brotherhood insights that point toward the best part of the human condition. Humanity that, for the sake of life as an unwaveringly common good, does not abandon the field in which human beings love and toil together earns the gratitude of all and the respect of God.