"To Reveal Christ the Healer"
ROME, 21 JULY 2007 (ZENIT)Here is the text of an message written by
Cardinal Javier Lozano Barragán, the president of the Pontifical
Council for Health Care Ministry on the profile of the Catholic teacher
of medicine.
* * *
PROFILE OF THE CATHOLIC TEACHER OF MEDICINE
Introduction
It is a very drawn out task to establish the profile of the Catholic
teacher of Medicine. It involves understanding what a teacher is, what a
teacher of medicine is, and knowing what it means to describe them as
Catholic.
In the following reflection I will especially look at the term
"Catholic." The question has to be asked whether a non-Catholic teacher
of medicine will really be different from a Catholic teacher of
medicine. And, if so, of what will this difference consist?
I will try to begin by following this sequence in order to answer these
questions: the teacher as the one who teaches, the teacher as professor,
and the teacher as a Catholic.
To talk about a teacher is to talk about culture. Culture has been
defined in very many ways; here I understand it as the humanization of
nature. I understand nature to be everything outside individuals that
they need to live. Education, seeing culture like this, will be the
assimilation of culture. It is necessary to understand the process of
culture to understand the process of education. This involves four basic
stages: introspection, tradition, assimilation and progress. In
introspection, individuals realize their own needs. In tradition, they
see what they are offered to meet these needs. In assimilation, they
meet them. And in progress, they detect new needs and proceed to create
new satisfiers which they have not found in tradition.
I. The Catholic professor of medicine
1. The teacher of medicine as a "teacher"
Teachers of medicine are teachers; they teach. The word "teach" comes
from a word meaning a sign. The teacher gives the students the signs
that they need and must appropriate. This means that first of all the
teacher has to know what the students need in order to guide them in
their own introspection and to realize what their needs are.
Once the teacher has taught the students to know their own needs, they
show them how they can meet these needs in tradition. This is what tends
to be called a "cultural asset."
Having detected the "cultural asset" they also signal the way to be able
to appropriate this asset and assimilate it.
They also need to signal new horizons, both in relation to needs and in
relation to possible new horizons. They teach the research which leads
to the "creation" of new cultural assets as something necessary.
Consequently, medical culture consists of the humanization of medicine,
and medical education consists of the assimilation of the humanization
of medicine. The task of the teacher of medicine is to signal to the
medical student how to assimilate the humanization of medicine.
Following the steps of all culture, in the introspection stage, the
teacher of medicine needs to signal to the students the path so that it
is the students themselves who find the needs that they have, which lead
them to seek the medical tradition as a satisfier of these needs. Here
we can see firstly whether or not the students have the aptitude to
learn medical culture. If their needs, which are related to their
abilities, are not those which are fulfilled with medical culture, the
teacher should indicate to the possible student that they should not be
educated in a culture that they do not need, or for which they are not
capable.
Having passed the introspection step in medical culture, the teacher of
medicine should signal the medical tradition. This is the whole set of
medical "cultural assets" that exist. Here we find the complex field of
medical science, technology and art. The teacher of medicine should have
a command of this field, or, given the complexity of current medical
know-how, at least the specialty that they are teaching.
In addition to scientific and technical competence, the teacher of
medicine, like any other teacher, should be an expert in educational
science, especially in Didactics, as when "teaching," they should do so
with such clarity that the students can find the medical cultural asset
that they are being shown. The teacher of medicine thus tackles the
third step of culture, assimilation. It is not sufficient to teach
medical culture; rather it is necessary to indicate to the students the
practical path which has to be taken to have a command of it.
Once the teacher of medicine has completed this third step, they should
open up subsequent paths for the students to recognize subsequent
medical needs and, based on that already existing, to succeed in
"creating" new medical cultural assets in the future. In particular,
they should indicate the paths of medical progress, and how their
students should move along these previously unexplored paths.
2. The teacher of medicine as a professor
In addition to a teacher, the teacher of medicine should be a professor,
and here we expand our thoughts to enter the field of the Catholic
teacher of medicine. As teachers, to a certain extent, they share their
personality with any other teacher of medicine, of whatever mentality or
ideology. As a professor, it is different.
Indeed, the word professor contains a religious connotation, as it comes
from the verb to profess, which means adherence to a faith and its
profession. If the teacher just remains at the level of teacher, they
will be frustrated and so will their students. They signal health and
life sciences and technology but, being realistic, they indicate that
the whole of medical science and technology finally lose the battle,
because death arrives and, in the face of death, all medical science and
technology are shown to be impotent and fail. Being sincere with
themselves and with their students, at the levels of introspection and
assimilation of medicine to overcome disease, they should signal the
ultimate failure of all medical science, technology and art, as death
can be found at the end of all their efforts.
Only if they are capable of signaling, together with the same medicine
and in a way from it, the overcoming of death, does their teaching have
a lasting value and is not lost in just delaying the end as much as
possible.
For this they must go beyond the mere level of the teacher and truly
become a professor. To profess a faith which opens up health and life to
transcendence.
3. The teacher of medicine as a Catholic professor
If the professor of medicine is a Catholic, then this transcendence and
this victory over death are not merely beautiful desires which, for
many, in our secularized culture, do not go beyond good intentions and
palliatives for the failure of death, but rather they are based on the
same reality of an irrefutable historical event, the resurrection of our
Lord Jesus Christ.
On professing this faith, the teacher of medicine becomes a triumphant
professor. He and his students advance toward medical culture with the
certainty and the joy of knowing that the progress in health science is
a foretaste of the full health that they will find for themselves and
for their patients in the resurrected Christ.
It is obvious that this is incomprehensible for those who do not profess
this faith. For a physician who does not have faith in Christ and in his
Church, nothing here means anything, and rather it is something absurd
which would appear to be for ignorant and mad people as it goes against
the biological experimental knowledge which they believe to be the only
one valid in medicine: "evidence-based medicine." However, here is
another type of evidence, even stronger than laboratory evidence, the
evidence of a faith based on an irrefutable fact which is reached for
the same reason, but which arises from a free and firm decision of the
will of each person. St Paul already said that the announcement of a
crucified Messiah was offensive for the Jews and madness for the
Gentiles, but it is much wiser than all human wisdom, and what may seem
to be weakness in God, is stronger than all human strength (1
Corinthians 1:23-25).
In accordance with this profession of faith, what then should a Catholic
professor of medicine be like? The answer is to teach how a physician
should be who is not frustrated but rather who opens up health science
and technology, the art of curing, toward the full victory over death in
the resurrection of Jesus Christ our Lord. A Catholic professor of
medicine is one who teaches, signals, to their students, how to be a
Catholic physician.
Below I propose a few lines which set out the figure of the Catholic
physician and which can be used as a basis for a Catholic professor of
medicine to signal to their students how to be a Catholic physician.
II. The Catholic physician
I take as the basis the Charter for Health Care Workers published by the
Pontifical Council for the Health Pastoral Care, which in turn refers to
the thought of God's Servant John Paul II in this respect and from the
identity expressed by the Pope, and in it I try to put together a few
ideas to interpret and discuss it.
CHARTER FOR HEALTH CARE WORKERS
The Catholic physician is described as follows in the Charter for Health
Care Workers:
The Catholic physician's profession requires them to be a custodian and
server of human life. They should do this through a watchful and
solicitous presence with the sick. The medical and healthcare activity
is based on an interpersonal relationship. It is an encounter between
trust and conscience. The trust of a man marked by suffering and disease
who trusts in another man who can take care of his need and who is going
to go to him to assist him, care for him and heal him.
The patient is not just a clinical case, but rather a sick man toward
whom the physician should adopt an attitude of sincere sympathy,
suffering together with him, through personal participation in the
specific situations of the individual patient. Sickness and suffering
are phenomena which, when dealt with in depth, go beyond medicine and
deal with the essence of the human condition in this world.
The physician who cares for them must be aware that the whole of
humanity is involved, and that complete dedication is required. This is
their mission, and is the fruit of a call or vocation that the physician
hears, personified in the suffering and invoking face of the patient who
trusts in their care. Here the physician's mission to give life is
linked to the life of Christ, who came to give life and to give it in
abundance (Jn 10,10). This life transcends the physical life, to reach
the height of the Holy Trinity. It is the new and eternal life that
consists of communion with the Father to whom every man is called freely
in the Son, through the work of the Holy Spirit.
The physician is like the Good Samaritan who stops by the side of the
sick man to become his neighbor, because of his understanding and
sympathy, in short because of his charity. The physician thus shares the
love of God as an instrument of diffusion and at the same time becomes
infected with the love of God for man.
This is the therapeutic charity of Christ who went around doing good and
healing all (Acts 10:38). At the same time, it is the charity toward
Christ represented in each patient. It is he who is cured in each man or
woman, "I was sick, and you looked after me," as the Lord will say in
the Last Judgment (Matthew 25:31-40).
It thus results that the physicians' identity is the identity received
from their therapeutic ministry, their ministry of life. They
collaborate with God in the recovery of health in the sick person's
body. The Church accepts the work of the physician as part of its
ministry, as it considers the service to sick people to be an integral
part of its mission. It knows that physical harm imprisons the spirit,
and the evil of the spirit overpowers the body. Through their
therapeutic ministry, physicians thus share in the pastoral and
evangelizing action of the Church. The paths that they should take are
those marked by the dignity of the human being and therefore by Moral
law, especially when it is a question of practising their activity in
the field of Biogenetics and Biotechnology. Bioethics will provide a
channel for them, outlining their principles of action.[1]
THE IDENTITY OF THE PHYSICIAN
A short summary of the Christian identity of the physician can be found
in this position of the Pontifical Council for the Health Pastoral Care.
As already mentioned, I will strive to reflect on this identity, paying
particular attention to the fact that it is an identity received from a
vocation and a mission which founds a very special ministry, the
therapeutic ministry, the ministry of life, the ministry of health.
The Vocation and the Church
We can begin by referring to the meaning of a vocation in the Church.
Etymologies often help to take us back to the original meaning of the
words that we use frequently and which appear to be weakened through
use. One of them is the word Church. There are two etymologies, the
Greek and the Latin. Its Greek etymology takes us to the verb "ekkalein,"
to call. The Church, "ekklesia," would be the plural participle of the
verb "ekkalein," and would mean those who have been called.
Looking from the Latin etymological perspective, the Church is the
effect of the "Vocation." The "Vocation," etymologically speaking, is
the nominalized Latin acceptance of the Latin verb "vocare," to call,
(the same as "ekkalein") and would this mean the same calling which
brings together those who have been called, that is which congregates
them in the Church. The vocation thus makes the Church.
The only "Vocation" or fundamental calling is the one made by God with
the Word with which he calls into existence everything that exists, and
this calling, this primitive "vocation," is Christ, who is the Word of
God through which everything that exists and each of us is called into
existence (cf. Ephesians 1:3-10; Colossians 1:15-20). It is especially
interesting to see that God's maximum way to call everything that
exists, the maximum presence of Christ in the world, is through the
Eucharist, as it is the memorial, the presence of Christ in the present
of history (cf. Luke 22:19).
In this calling from God, we discover three essential moments which make
it up and which we can summarize in three words: "BEING," "WITH," "FOR."
We are thus called to be (to exist), with God, for others.
We can verify this in Christ's call to his apostles (Mark 3:14-15), and
most especially his call to the Virgin Mary to be the Mother of God, the
Messiah (Luke 1:26-38). But it is a paradigm that spreads throughout the
history of Salvation.
We are going to use these three words of the Vocation as a guideline to
reflect on the pontifical doctrine on the identity of the Catholic
physician which we set out in the Charter of the Pontifical Council.
1. "BEING"
When we talk about "Being" in the vocation, we are talking about total
existence. God speaks and everything begins to exist. Genesis says: "God
said, Let there be light. And there was light ... (1:3). When God
pronounces his Word, it is practical: he does what he says, and
everything has its consistency, its beginning and its end, its totality,
in it.
When we talk about true Catholic physicians, they are so because of a
true vocation received from the same God from which they receive their
whole existence, obviously without excluding the same physician's
collaboration with the calling. How does God call the physician to the
medical vocation, and of what does this vocation consist? Below we offer
some characteristics of the " being" of this calling.
1.1. The profession
Firstly, we will say that God calls the physician for a profession which
is not the same as for a trade. Historically, three professions are
recognized, that of the priest, that of the physician and that of the
ruler or judge. It should be noted that, as we said earlier, the
profession is somewhat linked to the profession of the faith, is
something religious. The profession is not strictly speaking something
legal, as what is legal may or may not be carried out, or changed
depending on the will of those who take on an obligation. On the
contrary, the profession is an obligation and a responsibility which is
contracted with God himself. It is a responsibility and responsibility
originally meant the capacity to respond, and respond comes from the
Greek "Spenden" which originally meant to offer a sacrifice of libation
to God. Medical professional responsibility means a commitment
(Commitment is "syngrafein" in Greek, which means to write together),
which is written jointly by man and God.
This sacred nature of the medical profession led to the Hippocratic
oath, which is the oath not to harm the patient, to always do good to
them and to look after all stages of life, an oath which is not a
promise made to the patient, but rather directly to God. In this context
the physician's vocation is a vocation which is born from the love of
God, and it is God that the physician follows in this profession, as
extremely benevolent Good.[2]
1.2. The love of God in the physician
However, despite the sublime nature of this Hippocratic position, it is
limited and defective. We were talking about the love of God, but this
love, in accordance with the classical Greek mentality, the mentality of
Socrates and Plato, which Hippocrates shared, is defective because it
presupposes need and is never plenitude. Indeed, for classical Greek
philosophy, God does not love. He is extremely benevolent, but he does
not love, as love would mean a lack and God cannot lack anything. Love
is only characteristic of the needy man interested in sating himself,
not of God the All-perfect. In Greek mythology, love arises from Poros
and Penia in Aphrodite's wedding. Poros represents expediency, need, and
Penia, poverty; on bringing together need and poverty, love is born as
self-interested desire.
This mentality is completely corrected by the divine Revelation: God
himself is Love. This is the deepest definition of God. His love does
not consist of him lacking something, but rather of the greatest
circulation of his kindness, which is presented is such a way that God
the Father loves the world that he created so much that, out of his love
for it, he gives his one and only Son in death (John 3:16).
The Christian medical profession is therefore centered on love, but not
on self-interested and poor, Hippocratic, love, but rather it imitates
the perfect love of God and has its paradigm in the Good Samaritan, thus
suffering together with the sick, pitying them and providing them with
everything they need to cure them. The Good Samaritan is thus the
example to be imitated by the Christian physician. The Good Samaritan is
the figure of Christ who takes pity on the whole of sick and fallen
humanity, and raises it up to deification. He is infinite love and is in
both those who love and those who are loved. He is in both as plenitude.
The Good Samaritan is thus the figure which identifies the physician who
takes pity to such an extent on their patient that they do everything
they can to return them to health, out of love of plenitude.[3]
Talking about the love that physicians must have for God and thus for
their patients, Pope Pius XII talks to us about the commandments of the
law of God in the sphere of medicine. He talks to us about the first
commandment which is to love God above all else and about the second
which is to love your neighbor like yourself, and the identity of
physicians consists of this love when their relations with the patient
are surrounded by humanity and understanding, gentleness and devotion.
The same Pope Pius XII complements the characteristics of the physician
on referring to two other commandments in particular, the fifth, "you
shall not murder" and the eighth, "you shall not give false
testimony."[4]
1.3. Respect for and Defense of Life
The fifth commandment reminds us how the identity of the Christian
physician means that, because of the love they are obliged to have for
God and for their patient, they are totally obliged to defend life at
any of its stages, but especially at the stages at which it feels the
weakest, which are the initial and the terminal stages. Their
personality is formed from a clear and absolute no to abortion and no to
euthanasia. The whole meaning of human life is contained in the fifth
commandment, as a gift given by God to be merely administered by man and
by woman, and which should only have its origin in marriage.
1.4. Medical training
The eighth commandment, "you shall not give false testimony," tells us
about the physician's clear commitment to the truth, both to the truth
of disease and of health, and to the truth of medical science.[5]
The physician's identity comes from the training that they receive.
However, if we look at what is occurring in many Faculties of Medicine,
we can see that this training has many defects. Indeed, the curriculum
of the medical degree has two essential parts. The first is the basic
knowledge and the second is the knowledge that is obtained from the
clinical science divided into disciplines or from a consideration of the
different organs of the human body. It is obvious that these subjects
should be taught, but at the same time it is noted that there is a
bio-technical reductionism. On presenting the subjects, their
anthropocentric value and the ethical, affective and existential values
have been lost. The physician is seen from the requirements of the
patient and the demands of an economicist health system with complete
indifference for the violations of human rights, especially human life.
We often find as a paradigm of the current clinical applications a
fragmentation and reduction of the patient to organs and biological or
technological functions and to medicines. The intention is to obtain a
command of fragmented specialized knowledge without the perspective of
the whole, through knowledge and relational competence with other human
fields outside medicine. The idea of health is proposed as a passive
adaptation to pathogenic stimuli and to those of a bio-physical nature.
The adaptation of the clinic is carried out with often exclusive
reference to the requirements, even of an economic nature, of the
national health system. A loss of the ethical values in medicine and the
anonymity of the patients are observed. It is even seen that little
value is given to the existential aspects of the medical profession, to
the person of the patient, of the physician and of the nurse.
In the face of these problems of the medical "being" from the beginning
of the training that is received, a series of methods has been conceived
to make the teaching active, especially from the so-called PBL
(Problem-Based Learning) and the teaching method oriented toward the
community which sees the physician as a necessarily competent person on
a relational and scientific level, inserted in a community reality,
capable of collaborating with other health figures and of administering
the resources available with continuing learning, always an advocate of
the patient's health, capable of combining knowledge with medical
practice, and therefore with continuing training.
This kind of medical training would offer a new understanding of health
and of disease. It would deal with prevention and the handling of the
disease in the context of the individuality of the patient complemented
by their own family and society as a whole. It would thus develop a
learning based more on curiosity and continuous investigation than on
passive acquisitions. It would reduce the information load. It would
encourage direct contact with the patients through a personalized
analysis of their problems and of the whole of their curriculum.
A program should therefore be prepared which is based on the following
principles: 1. Existence of a comprehensive and ultimate meaning of
medical knowledge. 2. Definition of its epistemological orientation. 3.
Definition of the values, the motivations, the psychological maturity,
the quality of the objective knowledge and the methodological,
relational and technical capacities, applied to the exercising of the
profession. 4. Definition of the values, the motivations, the capacities
and the quality of the training of the teachers. 5. Definition of the
general and partial objectives of the training. 6. Definition of the
teaching methods. These principles contain the epistemological knowledge
of present-day medicine which considers health as a psycho-biological
construction determined by the possibility and the quality of the
person's resources and whose aim is to give a single response to the
fundamental questions of human existence.[6]
1.5. Lifelong learning
The physician's identity is not shaped once and for all in their initial
training, but rather is prolonged in their lifelong learning. It demands
a very careful preparation of students of medicine, but at the same time
requires the continuing and progressive preparation of the lecturers who
teach any medical subject, a preparation that should never be lacking.
The lecturers in particular have the responsibility to promote new
physicians, and they will never achieve this if they are not sure of
each student's capacity to carry out such a delicate mission.
The same eighth commandment obliges all physicians to keep professional
secrecy and, as we have already mentioned, to have a sound medical
culture which should be improved constantly through lifelong
learning.[7]
2. "WITH"
We said that the second characteristic of the Christian vocation is
expressed with the preposition "with," with God. That is to say that any
vocation is to be with God our Lord, who prepares man to carry out a
mission which, without his strength, it would be pointless to carry out.
In the book of Exodus we can read what Moses says to God on mount Horeb:
"Who am I that I should go to Pharaoh and bring the Israelites out of
Egypt, and God said: I will be with you ..." (Exodus 3:12).
2.1. Revelation of Christ the physician
In this section we set out the deepest values that should shape the
identity of the Catholic physician. The personality of the Christian
physician is identified with the revelation of Christ the physician.
Christ sent his apostles to cure all ailment and disease and said to
them, I will be with you to the end of the age (Mark 16:17; Matthew
28:20). The physician performs the therapeutic ministry in this way,
beside the apostles, as a continuation of the mission of Christ and with
his revelation.
The whole breadth of this revelation should be understood. The physician
should reveal the whole life of Christ, which is the presence of Christ
in the physician. Because Christ cures all ailments and disease with all
his action taken as a whole. The miracle cures that he performed,
including the resurrection of the dead, were not definitive in his
struggle against the evil that exists in humanity, against its ailments
and death, but rather just a sign of the profound reality that entails
his own death and resurrection.
2.2. Pain
He took all suffering, all ailments, all disease, without exception, and
summarized them in his own death as the death of God who had become man,
so that no pain would remain outside, and from his death he exploited
death itself, he conquered it in the plenitude of his resurrection. One
of the physician's main doubts is always the problem of pain. This
question only has its answer here, when pain does not appear as
something negative, but rather as a positivity which, it is true, ends
in death, but in a death full of resurrection.
The physician should thus cure, revealing the death and the resurrection
of Christ. An identification of the physician as such, as a healer, with
Christ the healer, is necessary for this revelation. This identification
is now carried out especially through the Eucharist and through the
other sacraments. The sacraments are the historic presence of Christ in
the present, at the specific moment that we are crossing in life.
2.3. Health
Consequently, the physician should realize that health is complexive and
bodily health should not be talked about as something radically
different from the complete health that we call eternal health or
salvation. The physician's ministry is therefore an ecclesiastic
ministry which is directed toward the salvation of man from his body,
but which involves other aspects.
We thus describe health as a dynamic tension toward physical, mental,
social and spiritual harmony and not just the absence of disease, which
prepares men to carry out the mission with which God has entrusted them,
in accordance with the stage of life at which they are.
The physician's mission is therefore to ensure that this dynamic tension
toward complete harmony exists, as required at each stage of the life of
this specific man who is their patient, so that they can carry out the
mission with which God has entrusted them. Thus, the contradiction of
reducing the medical function to the single physical and chemical aspect
of the disease. This function is complete and moreover cannot be static,
but rather should be inserted within the dynamism of the patients who
tend toward their own harmony.
In this context, death is not a frustration for the physician, but
rather a triumph, as they have accompanied their patient in such a way
that they have been able to use their talents to the full at each stage
of their life. When it has reached its end, the medical function ends,
not with a cry of impotence, but rather with the satisfaction of a
mission fulfilled, both by the patient and by the physician.
Thus, the physician truly is with Christ and their profession is
identified in this communion with Christ, and then the physician joins
together with our Father God like a son with his father, and their
professional love becomes the action of the Love of God in himself,
which is the Holy Spirit. A Christian physician is therefore one who is
always guided by the Holy Spirit. From the Holy Spirit and with the Holy
Spirit is all the sympathy that must exist between the physician and the
patient, all the due humanization of medicine and all the demand for
updating and lifelong learning, as the Love of the Holy Spirit makes the
physician an essentially open person for the rest, as they are obliged
to do so before God because of their profession of Faith represented by
their medical profession. We thus succeed in outlining the third trait
of the medical identity, being for others, is the "FOR" of their
vocation and of their professional identity.
3. "FOR"
When God chose Moses, it is very clear that he did so to remove his
people from the power of the Egyptians. God says, "I have come down to
rescue them from the hand of the Egyptians" (Exodus 3:8).
Physicians cannot withdraw into themselves. They cannot simply think
that they already have enough money, that they do not need to work any
more, and that therefore they will now leave their profession. A true
physician is a physician for life. If they have truly received this
vocation, they will have it for ever and they must practice it for
humanity as a mission specifically received for the good of all, and for
which they must account to God when He says to them, "I was sick, and
you looked after me" (Matthew 25:36,43).
3.1. Openness to the patient
We said that love of the medical profession imitates the love of God
which is disseminated. Physicians cannot hide their knowledge in pure
theories and laboratories, but rather should expand them in favor of the
community. They have received the gift of taking care of life and making
it grow. Their vocation is for life, never for death, which would be to
blind the mission with which God has entrusted each human being.
According to Pope John Paul II, nowadays the religious ministry is
connected to the therapeutic ministry of physicians in the affirmation
of human life and of all those specific contingencies in which life
itself can be endangered by deliberate human will. Their deepest
identity involves being ministers of life and never instruments of
death. This is the most intimate nature of their noble profession. They
are called to humanize medicine and the places where they practice it,
and to use the most advanced technologies for life and not for death,
always having Christ, the physician of bodies and of souls, as their
supreme model.[8]
According to Pope Pius XII, Catholic physicians should place their
knowledge, their strengths, their heart and their devotion at the
disposal of the sick. They should understand that they and their
patients are subject to the will of God. Medicine is a reflection of the
goodness of God. They should help the sick to accept their illness, and
they should make sure they are not dazzled by technology and use the
gifts that God has given them and not give in to the pressure to
assaults on life. They should remain firm in the face of the temptations
of materialism.[9]
The good physician must therefore have dianoetic virtues and skills and
convert them into virtuosity, that is to say into a habit, so that both
the virtues of theoretical science and those of practice come together
in them as if they were second nature.[10]
3.2. Fundamental qualities of the physician
The fundamental qualities of the physician have thus been classified
under 5 sections: Awareness of responsibility, humbleness, respect, love
and truthfulness. Awareness of responsibility leads them to work with
the patient and be aware that it is the physician who gives the
direction. Humbleness tells them that physicians look after their
patients and not the opposite. Humbleness makes them see themselves as
indebted to the patient. Physicians cannot talk about "their" patients,
but rather the patients will talk about "their" physician. Physicians
should receive their patients as written on the lintel of an old German
hospital: "recipere quasi Christum"; they should receive their patients
as if they were Christ himself.
Respect and love for the patient, about which we have already spoken,
are the basis for their humbleness. They know that they have received a
mission for which they do not have the necessary strength, but rather
they receive it from the person who sends it for this reason.
Truthfulness entails being aware of the great trust that the patient
places in them on revealing their personal matters. Truthfulness is
required in the diagnosis and in the therapy, not just on the bodily but
also on the complete, mental, social, psychic, spiritual level. They
should never experiment on the patient if this involves a danger
disproportionate to the good that they intend to do. This must be
absolutely necessary and the patient must agree to it. They should
notify the patient of the development of their illness, tell them the
truth about their condition in the most appropriate way and at the most
appropriate time possible. They should complement their action with the
action of the priest as both missions, that of the priest and that of
the physician, are closely connected.[11]
3.3. Portrait of the physician
The "Portrait of the perfect physician," described by Enrique Jorge
Enriquez in 16th century Spain in the flowery language of the time, is
still current: "The physician should be fearful of the Lord and very
humble, and not haughty and arrogant, and be charitable to the poor,
meek, kind, affable and not vengeful. They should maintain secrecy,
should not be talkative or gossipy, flattering or envious. They should
be prudent, restrained, not be too audacious … should be distinguished
and given to honesty and reserved. They should work on their skill and
flee from idleness. They should be a well-read physician and should know
how to give information about everything."[12]
Nowadays, we would talk about medical excellence. This would be what
Aristotle called the "Teleios iatrós" (perfect physician), or Galen
called "Aristós iatrós" (best physician).
3.4. Morality and Law
Initially we said that the medical profession is something that goes
beyond the Law and is positioned in the framework of Morality, and this
is true, but this does not mean that we can do without medical Law.
Medical Law without adequate morality would be arbitrariness based on
shameful interests. Morality without medical Law would just be general
principles without direct application. The rules of medical Law must be
sufficiently clear and brief to aid the physician's action. The leading
principle is always the same: the physician's purpose is to help and to
heal, not to do harm or to kill.
It is worth mentioning in particular the field of Ethics, the field of
Morality, in which the physician must be competent, but in which so
often they are not specialists. Bioethical committees are therefore
required in each health centre, and should also be created in the
teaching centers, in open dialogue with the specialists in the different
subjects taught.
Physicians are thus trained to bear witness to God in all the medical,
trade union and political environments, etc. They can even be valid
bearers of ecumenical dialogue and dialogue with other religions, as
sickness does not know religious barriers. The physician will thus
actively belong to the Church as an individual person and as a
group.[13]
3.5. Teamwork
In order to carry out such a demanding mission, physicians cannot stay
enclosed in their own individuality, but rather should first open up to
other physicians and be sufficiently humble to work in collaboration and
as a team, both on strictly physiological matters, and especially on
those relational matters connected to fields of which they do not
necessarily have a command and which to a certain extent are outside
their competence, namely sociological, anthropological and political
aspects, and those from technical fields beyond their profession, namely
everything connected to the strictly computing field.
In a certain way, within this opening-up, in the Spanish field of
medicine what two authors call the decalogue of the new physician is
designed. They express it like this: 1. Multidisciplinary teamwork with
a single person ultimately responsible. 2. The more scientific the
professional, the better. 3. The human aspects will be strengthened in
professional practice. 4. Action will be adapted to agreed scientific
diagnostic and therapeutic protocols. 5. They will be aware of the
expense. In addition to the protocols, they will use guides to good
practice. 6. They shall aid coexistence and solidarity with work
colleagues and with the patients. 7. They shall think that all
healthcare acts can involve a preventive action, and even a promotion of
health. 8. They shall bear in mind at all times the need to care for the
satisfaction of the user of the service. 9. The Patient Service Units
will be strengthened, circulating the complaints and suggestions which
arise among the people affected. Frequent opinion surveys will be held.
10. It will be essential to apply ethical principles to the professional
activities.[14]
CONCLUSION
Being a Catholic physician is a ministry which arises from a vocation in
the Church. It is a therapeutic ministry. It is closely linked to God
our Father, revealed in Christ the physician, full of the Love which is
the Holy Spirit. Being a physician is a path to achieve the plenitude of
the human being, to initiate the resurrection already. It involves
proximity and a special intimacy with God, and at the same time
represents an opening-up and a complete gift to others. This is the
Catholic identity of the physician, to reveal Christ the healer.
Being a Catholic professor of medicine is to have far-reaching sight to
be able to see the resurrection in death. It is not just this, though.
It is the ability to sense a harmonious tension in health which leads to
plenitude, in accordance with the different stages of the life of
people. And it is to feel in medical science, technology and skills the
all-powerful force of God who resurrects his Son Jesus Christ and who
already gives us a foretaste of the resurrection in medical progress.
Being a Catholic professor of medicine is to teach the Love with which
the Holy Spirit delivers Jesus Christ on the cross to the Father, who
with his loving strength brings him back to life. Being a Catholic
professor of medicine is to teach the physician to be the loving caress
of God who looks after his children in sickness and in death, making
their condition more bearable for them and opening up for them a
complete expectation of health which will not now be tension toward
harmony, but rather the total harmony of love. Being a Catholic
professor of medicine is to teach the physician to be the revelation of
Christ the healer.
Vatican City, 15 April, 2007.
Javier Card. Lozano Barragán
President, Pontifical Council for Health Care Ministry
[1] Cf. Pontifical Council for the Health Pastoral Care, Charter for
Health Care Workers, Vatican City, May 1995, 1-7.
[2] Cf. Gracia Diego, "El Juramento de Hipócrates en el desarrollo de la
medicina," Dolentium Hominum, 31, 1996, 12-14.
[3] Cf. Capelletti Vincenzo, "Donde hay amor por el arte médico hay amor
por el hombre," Dolentium Hominum, 31, 1996, 22-28.
[4] Cf. Pius XII, "Discorsi ai medici," Orizonti Medici , Rome (1959),
46-54.
[5] Cf. Pius XII, "Discorsi ai medici," Orizonti Medici , Rome (1959),
46-54.
[6] Brera Giuseppe Rodolfo, "La formazione dei medici del terzo
Millennio. La scuola medica come scuola di uomini e di umanità."
Conferenza inaugurale dell'anno accademico 1998-1999. Università
Ambrosiana di Milano, inaugurazione della scuola di Medicina.
[7] Cf. Pius XII, "Discorso ai medici...," op. cit .
[8] Cf. John Paul II, in the XV Congresso dei Medici Cattolici, AMCI, "Cinquent'anni
di vita per la vita," Orizonti Medici (1994), 105-114.
[9] Cf. Pius XII, Radio Messaggio al VII Congresso Internazionale dei
Medici Cattolici (11.09.1956), "Discorso ai medici," 503.
[10] Cf. Gracia Diego, "El Juramento de Hipócrates...," 12-14.
[11] Cf. Martini P., "Arzt und Seelsorge," in LTK (1).
[12] Cited by Gracia Diego, "El Juramento de Hipócrates...," op. cit.,
26.
[13] Cf. Leone Salvino, Orizonte Medico, 6, Nov-Dec.1996 , 10-11.
[14] Asenjo Miguel Angel-Trilla A., "Necesidad de nuevos profesionales
para las nuevas situaciones sanitarias," Todo Hospital, 149, Sept.1988,
497-499.
[Text adapted]
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