Dienstbaar aan de waardigheid van de mens en geroepen tot het leven
Serving the dignity of man, and called to life
Address of His Excellency, the Most Reverend Vincenzo Paglia, president of the Pontifical Academy for Life
Moscow – February 12, 2019
Your Eminences, Most Reverend Prelates, Dear Professors,
I am pleased and honored to have this opportunity to speak on such an important occasion whose purpose is to bring about deeper understanding and fuller cooperation between the Catholic Church and the Patriarchate of Moscow and of the entire Russian Orthodox Church. During their meeting in Cuba three years ago, Pope Francis and Patriarch Kirill emphasized the importance of the Gospel and of the Christian faith in the construction of a more just and peaceful society, one that promotes “respect for the dignity of man, called to life.” It is important that we recognize this responsibility and take it on as a shared commitment.
I interpret as a providential sign the fact that I just returned from a stay in Cuba, where I attended the fourth International Conference for World Balance in Havana. It dealt with the question of a more human and more fair coexistence in our now globalized planet. I spoke to the participants about the meeting in Cuba between Pope Francis and Patriarch Kirill, as well as about this conference, which takes its inspiration from the Joint Declaration that the Pope and the Patriarch signed.
We find ourselves now at a moment in history that requires greater unity among Christians because globalization without Christian inspiration is lacking in love and is prey to conflict. And unfortunately, that is what we often see today. The moment in history that we are passing through is characterized by people retreating into their own closed circles. We see everywhere an increased danger of an individualism that weakens both society and religions themselves. It is urgent for ChristiansCin a globalized worldCto offer everyone that vision of the unity of humanity that permeates the Gospel.
The collapse of “us”
In fact, at the beginning of the 21st century, society is characterized by some of the negative results produced by modern Western culture and imposed by it on the rest of the world. These results are now centered on a contradiction that undermines the hopes for Christian humanism. While on the one hand, recent centuries have seen increased attention to the person, and the person’s irreplaceable and priceless uniqueness and desire for a well-lived life, on the other hand we see an explosion of individualism that leads to loneliness, self-referentiality, and embitterment against society. Some philosophers such as, for example, Gilles Lipovetsky, speak of a “second individualist revolution” marked by the worship of hedonism and of psychology, by the privatization of life and by the triumph of autonomy over collective institutions. Zygmunt Bauman, one of the most careful students of social phenomena, spoke recently of a “fluid society,” a society with no fixed values.
Contemporary man, obsessively concerned with his personal destiny, is at risk of such an overwhelming narcissism that he is insensitive to those around him and no longer has the inner strength to commit himself to building a shared human community. The passion for humanity’s condition and “common destiny,” which nourishes an aspiration for “universal brotherhood,” has weakened and became uncertain. We could speak of what I call “the collapse of ‘us,’” that is, the loss of a common dream, of common vision.
The men and women of today are more connected, but not for that are they more brothers and sisters. If on the one hand technology and the economy have more or less bureaucratically unified societies, they have on the other hand disrupted them emotionally: pressure for functional efficiency kills relationships. We are looking at plan for the cultural and social “creation” of the individual as an end in himself, disconnected from any individual uniqueness and any possible separate “empowerment.” In the search for autonomy, the contemporary individual removes, day after day, the memory of the roots and bonds that generated and constructed him as a human person. Some speak of a new religion, “egolatry,” the cult of the ego, on whose altar the most sacred affections are sacrificed. The deterioration of social bonds, in all their aspects – family, work, culture, politics – is one of the most critical effects of the global diffusion of this individualism that has no others and no history.
Pope Francis, on the recent celebration of the 25th Anniversary of the creation of the Pontifical Academy for Life, wrote us a letter entitled Humana Communitas. We have translated it into Russian and want to give it to Patriarch Kirill and to all of you. In the letter, the Holy Father asks questions about the life of man and points out the (theological) roots that can serve as reference points when addressing the questions and difficulties that confront life itself. He explicitly and clearly points to the human community as the most complete and genuine locus for the free and conscious development of every man and woman. This is what the Pope writes: The human community is God’s dream even from before the creation of the world (cf. Eph 1:3-14). In it, the eternal Son begotten of God the Father has taken flesh and blood, heart and emotions. Through the mystery of giving life, the great family of humanity is enabled to discover its true meaning. (HC1). This dream …is what Jesus has entrusted to the Church and has placed in the heart of every person: the whole human family has a common origin and a common destiny. In a globalized world, the unity of the human family is the horizon that must involve all peoples. It is crucial to rediscover brotherhood, which unfortunately has not yet been achieved. Life is not an abstract universal; life is each person from his conception until the moment of death. Life is the whole human family all over the world. This is life, an historical reality.
And further on the Pope says: Indeed, the many extraordinary resources made available to human beings by scientific and technological research could overshadow the joy of fraternal sharing and the beauty of common undertakings, unless they find their meaning in advancing that joy and beauty. We should keep in mind that fraternity remains the unkept promise of modernity. The universal spirit of fraternity that grows by mutual trust B within modern civil society and between peoples and nations B appears much weakened. (HC13)
In the web of relationships that are part of the life of contemporary individuals, the fundamental questions that fill their hearts, their minds, even their bodies, and that are otherwise incapable of being answered exhaustively, must be included. Even the pressing question of rights, in order that it not become simply a declaration of intent, needs to be raised, justified, communicated and implemented, not with reference to an unconnected “I” but rather with broader reference to a human “us.” Without a harmonious correlation, without shared rights and duties, the proper protection of the person and his inherent dignity is not guaranteed, and the life of the community is not more human. One example: too often we witness the reduction of the great theme of humanity’s aspiration to happiness to the search for psycho-physical gratification, which becomes the sole criterion for and measure of everyday “quality of life.” In fact, to think about it, true well-being is what wells up from mutual love, from being well-loved, that is, loved and able to love, welcomed and welcoming, mercied” (as Pope Francis likes to say) and merciful.
The challenge that the lives of the more than seven billion people alive today offers us is that of the “us”: that is, rethinking ourselves within a web of relationships that certainly marks, limits, and imposes itself, but precisely for this reason does not abandon the other, that continues to reproduce, remains in solidarity, and hopes for a salvation that can reconcile us, all together, in shared and hopeful life.
There are two initiatives that I believe are fundamental in this area. The first deals with relocating the questions that must be asked about human life into the broader global perspective that is obligatory today. It is objectively illogical and unproductive to deal with the analysis of individual questions without first placing them into a framework within which, as far as possible, the complexity of the current situation can be taken into account. Today, in respect for, in defense of, and in the promotion of human life, everything is under consideration: local symptoms cannot be treated if global causes are not taken into account. Global bioethics is the current vehicle for examining the human quality of the choices intended to protect and reaffirm the ultimate destiny of life: resistance to addressing the radical understanding of this activity would be a serious misunderstanding of the responsibility that faith has today.
The second initiative is instead an extension of that theme. In recent decades, quite rightly, attention has been given to conditions on our planet and to the consequences of human activity on the environment. Today, it is time to widen this attention, to turn from a consideration of our common home to concern for its inhabitants. Precisely because the habitability of the planet is put into crisis by the reckless and selfish actions of its inhabitants, the time has come to concern ourselves seriously with this behavior. We are called to rediscover the connection between the relationships among us on the one hand and our relationships with the places in which we live on the other.
Accompany in the passage of death
In the context of our discussions, a unifying social understanding of death is particularly important. What troubles me deeply about the demand for approval of the various modalities of euthanasia is not simply the fact that there is a desire to pervert the practice of medicine, which should be entirely dedicated to the patient’s life and not to his death, but rather the fact that a person who, at a particularly serious and difficult time in life, asks to die.
The task of accompanying those who approach the sensitive passage from earthly life to a definitive encounter with Heavenly Father has an importance that is not limited to those immediately involved, but rather has much broader implications. It is the expression of a caring that finds the proper balance between the use of available medical resources and the search for the integral good of the person, in his familial and social context. In fact, the progress of science in the biomedical field risks making healing almost the main, if not the exclusive, purpose of contemporary clinical practice. This evolution brings with it the risk of focusing on the fight against disease and neglecting (or eliminating) the patient. At that point, we forget that the deepest meaning of therapeutic efforts (curing) is found in a relationship centered on taking care of the patient (caring). The tendency, especially in strongly technological contexts, is to look at the elimination of disease as the only objective to be pursued.
This attitude, in its turn, has two consequences. First, there is the risk of being unreasonable in the use of medical treatments, in order to obtain a healing that “must” be achieved at all costs, because in any failure to heal is seen as a defeat for medicine. Doing this, however, opens the way to the stubbornly unreasonable adoption of excessive measures. We can end up inflicting suffering on the patient by using means that are invasive and losing sight of the integral good of the person. Doing everything possible (if this is understood as always using all available means) can mean doing too much (that is, an excess that damages the patient).
The second risk is abandonment of the patient when a cure is no longer possible. Once that happens, the relationship between the doctor and the patient ends, and medicine (society) no longer has anything to do for him. This is an unacceptable course of action. If we cannot heal, we can still relieve pain and suffering and continue to take care of that person. The incurable patient is never to be left uncared for. This total commitment to care springs from a conviction that every person is endowed with absolute dignity at every stage of his life. We cannot speak seriously about the humanization of medicine unless we have an effective understanding of the dignity of every unique human person, even when seriously ill or near death. The risk that the incurable patient runs today is the risk of abandonment due to the idea that “Oh well, there is nothing left to do” or that “It’s not worth the effort.” Another risk that is the other side of the coin is euthanasia, based on the idea that if there is nothing that can be done, we might as well “get it over with.”
The firm refusal to adopt such courses of action finds a strong ally in palliative care. Recently, the international scientific community has approved (and the Academy for Life has been among the supporters of this development) a new definition of palliative care. It begins by stating that: “Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illnesses, and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers.”
Two aspects of this definition seem particularly significant: the first is the holistic approach that palliative care offers, which is the exact opposite of a medical reduction in care. We don’t have patients, we have people, with all their physical, psychological, cultural and spiritual baggage. It is only within a framework that takes into account the whole of the human person, that technology, which is particularly efficient today, finds its true effectiveness, expresses its true strength.
The second aspect presented by the new definition of palliative care is that it recognizes, not only the person being treated but also family members and healthcare professionals, with the interesting proviso that they are not simply agents in the treatment of the person who is ill, they themselves are recipients of specific and caring attention. This formulation is crucial precisely because it keeps the suffering person, even one who is approaching death, within the circle of his fundamental family and social relationships. It is unthinkable to die alone! Experience has shown that the request for euthanasia or assisted suicide is in almost all cases the result of the patient being abandoned by society or the medical profession. To the contrary, once a true multi- disciplinary treatment protocol has been put in place and a network of affective and professional relationships created, it is very rare to encounter a death request.
Medicine must recognize the value of its fundamental vocation to “take care” and breathe new life into that vocation. We need to overcome the misunderstanding that equates “palliative” with “useless” or ineffective. This confusion explains some of the resistance that hinders the practice and acceptance of palliative care, even when its importance is recognized in principle.
Among the different levels and participants involved in a “taking care” that is reintroduced in a specific case, thanks in some way to palliative care, special attention is to be given to spiritual and religious questions and the persons (chaplains, spiritual counselors) who deal with them. For the believer, death always takes the form of a radical surrender to the mystery of God who does not abandon His children to the grave; moreover, the last days of the earthly life of every human person are a precious and irreplaceable opportunity to take stock of their existence and speak words of reconciliation and forgiveness. To assist and accompany a dying person (and that person’s family!) in this twofold transition is a precious gesture that gives added value to even the final moments of a person’s life.
Dear friends, following the Lord Jesus, healer of bodies and souls, confers on us the responsibility for the lives of men and women of today, especially the youngest and poorest, and of future generations. This is a great challenge because the world we live in is complex and its horizons are vast. This responsibility cannot be reduced to a simple technological process, but I can assure you that Christianity can really, in our time and within a humanistic and spiritual framework that is essential and inescapable, help the whole of humanity to answer the challenges of life. And this is one or the reasons we are here today. Together.