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CONGREGATION FOR THE DOCTRINE OF THE FAITH
Letter
SAMARITANUS BONUS
on the care of persons in the critical and terminal phases of life
Introduction
The Good Samaritan who goes out of his way to aid an injured man (cf. Lk 10:30-37) signifies Jesus Christ who encounters man in need of salvation and cares for his wounds and suffering with “the oil of consolation and the wine of hope”.[1] He is the physician of souls and bodies, “the faithful witness” (Rev 3:14) of the divine salvific presence in the world. How to make this message concrete today? How to translate it into a readiness to accompany a suffering person in the terminal stages of life in this world, and to offer this assistance in a way that respects and promotes the intrinsic human dignity of persons who are ill, their vocation to holiness, and thus the highest worth of their existence?
The remarkable progressive development of biomedical technologies has exponentially enlarged the clinical proficiency of diagnostic medicine in patient care and treatment. The Church regards scientific research and technology with hope, seeing in them promising opportunities to serve the integral good of life and the dignity of every human being.[2] Nonetheless, advances in medical technology, though precious, cannot in themselves define the proper meaning and value of human life. In fact, every technical advance in healthcare calls for growth in moral discernment[3] to avoid an unbalanced and dehumanizing use of the technologies especially in the critical or terminal stages of human life.
Moreover, the organizational management and sophistication, as well as the complexity of contemporary healthcare delivery, can reduce to a purely technical and impersonal relationship the bond of trust between physician and patient. This danger arises particularly where governments have enacted legislation to legalize forms of assisted suicide and voluntary euthanasia among the most vulnerable of the sick and infirm. The ethical and legal boundaries that protect the self-determination of the sick person are transgressed by such legislation, and, to a worrying degree, the value of human life during times of illness, the meaning of suffering, and the significance of the interval preceding death are eclipsed. Pain and death do not constitute the ultimate measures of the human dignity that is proper to every person by the very fact that they are “human beings”.
In the face of challenges that affect the very way we think about medicine, the significance of the care of the sick, and our social responsibility toward the most vulnerable, the present letter seeks to enlighten pastors and the faithful regarding their questions and uncertainties about medical care, and their spiritual and pastoral obligations to the sick in the critical and terminal stages of life. All are called to give witness at the side of the sick person and to become a “healing community” in order to actualize concretely the desire of Jesus that, beginning with the most weak and vulnerable, all may be one flesh.[4] It is widely recognized that a moral and practical clarification regarding care of these persons is needed. In this sensitive area comprising the most delicate and decisive stages of a person’s life, a “unity of teaching and practice is certainly necessary.”[5]
Various Episcopal Conferences around the world have published pastoral letters and statements to address the challenges posed to healthcare professionals and patients especially in Catholic institutions by the legalization of assisted suicide and voluntary euthanasia in some countries. Regarding the celebration of the Sacraments for those who intend to bring an end to their own life, the provision of spiritual assistance in particular situations raises questions that today require a more clear and precise intervention on the part of the Church in order to:
‒ reaffirm the message of the Gospel and its expression in the basic doctrinal statements of the Magisterium, and thus to recall the mission of all who come into contact with the sick at critical and terminal stages (relatives or legal guardians, hospital chaplains, extraordinary ministers of the Eucharist and pastoral workers, hospital volunteers and healthcare personnel), as well as the sick themselves; and,
‒ provide precise and concrete pastoral guidelines to deal with these complex situations at the local level and to handle them in a way that fosters the patient’s personal encounter with the merciful love of God.
I. Care For One’s Neighbor
Despite our best efforts, it is hard to recognize the profound value of human life when we see it in its weakness and fragility. Far from being outside the existential horizon of the person, suffering always raises limitless questions about the meaning of life.[6] These pressing questions cannot be answered solely by human reflection, because in suffering there is concealed the immensity of a specific mystery that can only be disclosed by the Revelation of God.[7] In particular, the mission of faithful care of human life until its natural conclusion[8] is entrusted to every healthcare worker and is realized through programs of care that can restore, even in illness and suffering, a deep awareness of their existence to every patient. For this reason we begin with a careful consideration of the significance of the specific mission entrusted by God to every person, healthcare professional and pastoral worker, as well as to patients and their families.
Continued below.
RORATE CÆLI: Letter "Samaritanus Bonus", of the Congregation for the Doctrine of the Faith -- On the Care of Persons in Critical or Terminal Phases of Life
Letter
SAMARITANUS BONUS
on the care of persons in the critical and terminal phases of life
Introduction
The Good Samaritan who goes out of his way to aid an injured man (cf. Lk 10:30-37) signifies Jesus Christ who encounters man in need of salvation and cares for his wounds and suffering with “the oil of consolation and the wine of hope”.[1] He is the physician of souls and bodies, “the faithful witness” (Rev 3:14) of the divine salvific presence in the world. How to make this message concrete today? How to translate it into a readiness to accompany a suffering person in the terminal stages of life in this world, and to offer this assistance in a way that respects and promotes the intrinsic human dignity of persons who are ill, their vocation to holiness, and thus the highest worth of their existence?
The remarkable progressive development of biomedical technologies has exponentially enlarged the clinical proficiency of diagnostic medicine in patient care and treatment. The Church regards scientific research and technology with hope, seeing in them promising opportunities to serve the integral good of life and the dignity of every human being.[2] Nonetheless, advances in medical technology, though precious, cannot in themselves define the proper meaning and value of human life. In fact, every technical advance in healthcare calls for growth in moral discernment[3] to avoid an unbalanced and dehumanizing use of the technologies especially in the critical or terminal stages of human life.
Moreover, the organizational management and sophistication, as well as the complexity of contemporary healthcare delivery, can reduce to a purely technical and impersonal relationship the bond of trust between physician and patient. This danger arises particularly where governments have enacted legislation to legalize forms of assisted suicide and voluntary euthanasia among the most vulnerable of the sick and infirm. The ethical and legal boundaries that protect the self-determination of the sick person are transgressed by such legislation, and, to a worrying degree, the value of human life during times of illness, the meaning of suffering, and the significance of the interval preceding death are eclipsed. Pain and death do not constitute the ultimate measures of the human dignity that is proper to every person by the very fact that they are “human beings”.
In the face of challenges that affect the very way we think about medicine, the significance of the care of the sick, and our social responsibility toward the most vulnerable, the present letter seeks to enlighten pastors and the faithful regarding their questions and uncertainties about medical care, and their spiritual and pastoral obligations to the sick in the critical and terminal stages of life. All are called to give witness at the side of the sick person and to become a “healing community” in order to actualize concretely the desire of Jesus that, beginning with the most weak and vulnerable, all may be one flesh.[4] It is widely recognized that a moral and practical clarification regarding care of these persons is needed. In this sensitive area comprising the most delicate and decisive stages of a person’s life, a “unity of teaching and practice is certainly necessary.”[5]
Various Episcopal Conferences around the world have published pastoral letters and statements to address the challenges posed to healthcare professionals and patients especially in Catholic institutions by the legalization of assisted suicide and voluntary euthanasia in some countries. Regarding the celebration of the Sacraments for those who intend to bring an end to their own life, the provision of spiritual assistance in particular situations raises questions that today require a more clear and precise intervention on the part of the Church in order to:
‒ reaffirm the message of the Gospel and its expression in the basic doctrinal statements of the Magisterium, and thus to recall the mission of all who come into contact with the sick at critical and terminal stages (relatives or legal guardians, hospital chaplains, extraordinary ministers of the Eucharist and pastoral workers, hospital volunteers and healthcare personnel), as well as the sick themselves; and,
‒ provide precise and concrete pastoral guidelines to deal with these complex situations at the local level and to handle them in a way that fosters the patient’s personal encounter with the merciful love of God.
I. Care For One’s Neighbor
Despite our best efforts, it is hard to recognize the profound value of human life when we see it in its weakness and fragility. Far from being outside the existential horizon of the person, suffering always raises limitless questions about the meaning of life.[6] These pressing questions cannot be answered solely by human reflection, because in suffering there is concealed the immensity of a specific mystery that can only be disclosed by the Revelation of God.[7] In particular, the mission of faithful care of human life until its natural conclusion[8] is entrusted to every healthcare worker and is realized through programs of care that can restore, even in illness and suffering, a deep awareness of their existence to every patient. For this reason we begin with a careful consideration of the significance of the specific mission entrusted by God to every person, healthcare professional and pastoral worker, as well as to patients and their families.
Continued below.
RORATE CÆLI: Letter "Samaritanus Bonus", of the Congregation for the Doctrine of the Faith -- On the Care of Persons in Critical or Terminal Phases of Life
