By Professor Jim McManus
Catholics have a long history of working in health and social care. From the examples of the saints who have founded orders to the history of hospitals, to the work done today, the evidence is all around us.
Indeed, the Catholic Church worldwide today remains one of the biggest providers of health and social care globally, and is the single biggest provider of HIV and Aids care.
So why are we so interested in health and social care? Simply and solely because we see it as a commitment to human dignity and wholeness, and that in itself stems from the mission of Christ.
The fact is the Catholic Church’s position is and has been consistent for some time. Human beings are precious because they are precious to God. So we should cherish life, however weakened and disabled. It is precious. We should support people to achieve best health. But the Church has always balanced that by saying we should embrace natural death when it comes.
That means participation in this mission of health and healing is important to the Church because of what it sees as its participation in the mission of Christ. And workers who participate in this mission of health and healing – indeed, have a vocation to this – are important because they are doing something – paid or unpaid – that the Church sees as valuable and in many ways is central to its mission.
The Church has produced a range of consistent teaching for many years on this. What it hasn’t done terribly well is codify this or always make it readily accessible for us. St John Paul II created a Pontifical Council for Health Care Workers, and in his Apostolic Constitution Dolentium Hominum taught us much about suffering and our understanding of it.
Many would say he taught us even more by his bearing of it personally. In creating the Pontifical Council for Health Care Workers, he gave us a range of resources including a Charter for Health Care Workers which, sadly, have not received the coverage they should have. The council was recently, after 30 years, subsumed into the new papal organisation for Integral Human Development. Some see this as a retrograde step.
I disagree. Health and health care have to be about integral human development across the whole life course. And this gives us some new opportunities to articulate what being healthy means across our whole life.
Within the last month, a document which I believe needs a much wider audience was produced by the Vatican. Entitled A New Charter for Health Care Workers, this document – as yet, only available in Italian – represents nothing less than a major opportunity for us. I’ve already received invitations to lecture and teach on this. I hope an official English version will be made available soon. For the present, I am on my fourth reading of this document and it is nothing less than inspirational.
So why is this document important? I would like to advance a few reasons. First, it is a document which does joined up thinking. Health is hugely important to us as a human good, and it was important to Christ. That means that the ministry of healing, and the work of health and social care, is an important part of the Church’s ministry. This document rings that message out loud and clear. If you are a carer – paid or unpaid – you live the Church’s mission by encountering people in pain and need.
The document begins with a rather beautiful ‘ministry of health’ introduction and a preface re-iterating the teaching of St John Paul II. It frames the whole discussion of health and healthcare as part of the Church’s mission.
…the health care worker is ‘the minister of that God who in scripture is presented as “a lover of life”’ (Wisdom 11:26). To serve life is to serve God in the person: it is to become ‘a collaborator with God in restoring health to the sick body’ and to give praise and glory to God in the loving acceptance of life, especially if it is weak and ill.
The therapeutic ministry of health care workers is a sharing in the pastoral and evangelising work of the Church. Service to life becomes a ministry of salvation that is a message that implements the redeeming love of Christ. Doctors, nurses, other health care workers and voluntary assistants are called to be the living image of Christ and of his Church in loving the sick and the suffering: witnesses to “the gospel of life”.
Second, the document sets the whole journey of human life, and the issues of health and suffering, within the context of integral human development.
Third, the document links Catholic Social Teaching to issues of health quite explicitly. There is a framing of rights people have to health and healthcare within the duty of justice. The document frames healthcare quality within the context of justice too, and this theme of justice continues throughout. People have a right to the means to health (education, employment, food etc) and to good quality healthcare.
Fourth, the document takes a whole life course approach. The text is divided into sections on procreation, living and dying so there is a bioethical theme running through it (which sometimes dominates) but if you read closely the social justice for all theme is strongly there.
Fifth, and here I think very profoundly, the document attempts to join up an understanding of health, health care and the mystery of suffering. Health is a ‘good’ to enjoy. Suffering in some senses is something to avoid and so healing when we can cure is a participation in Christ’s healing ministry. But suffering is not valueless. It has a redemptive quality. We can offer it to God and unite ourselves with Christ in his suffering. We can learn through our pain – and I say that personally here.
Finally, I personally feel it says something profound about the nature of health. If people who suffer, or are disabled, are precious to God, health cannot be the perfect state of everything being wonderful that the aspirational 1948 World Health Organisation definition suggests. Health needs to be seen as an orientation to be the best we can be, for God, for self and for others, given our physical and psychological limitations. We need not be physically perfect. We must be realistic. But through it all we remain precious to God and the Church’s position on valuing all human life seen in this light is entirely consistent. Those we cannot cure we can support, sustain and learn from.
There is a wonderful section on death and dying which you would think was almost written as a development of some of the recent work on end-of-life care policy nationally. It says: ‘In the last days of life the dignity of the person should be understood as the right to die with greatest possible serenity, and with that human and Christian dignity which is their due.’ There’s a call to mission for Catholics if ever there was one.
It goes on to remind us of the importance of spiritual care at end of life. ‘The spiritual crisis which comes as death approaches, compels the Church to bear the light of hope to the dying person and their loved ones, a light which only faith can shed on the mystery of dying.’
Seen in this light, the Art of Dying Well website www.artofdyingwell.org is a clear attempt to communicate these riches of the Church’s understanding to a society which really needs them.
This document gives us some major opportunities. And it comes at the right time as in all of the four health systems of the UK, we see some significant changes being wrought.
The diocese of Westminster has already spurred a season – Called to Serve the Sick – which is intended to be a practical continuation of the Year of Mercy. This new charter lands right in the middle of that season.
A series of roadshows, championed by Bishop Paul McAleenan, will discuss a Catholic understanding of health and social care, why Catholics should feel a particular vocation to health and social care, and what parishes can do about it. “It is fitting that this season comes as a continuation of the Year of Mercy, giving us the opportunity to practise that most important act of Christian love, care for our neighbour,” says Bishop Paul. “Good health, poor health, disability and ultimately our death, are integral aspects of what it means to be humans precious to God, and so they are of huge importance to us as Catholics.”
To register and for more information and resources go to www.rcdow.org.uk/called-to-serve-the-sick
He added: “The Church has a special place of value for those who are sick, those with disabilities and those who work with and for them. Cardinal Vincent and I very much want priests, deacons, religious and lay faithful to understand that working with the sick is part of their core ministry and mission”.
At the same time, new resources are being published by CTS. A Priest’s Guide to Hospital Ministry and a Catholic Patient’s Guide to Being in Hospital are available from www.ctsbooks.org
Professor Jim McManus is director of public health for Hertfordshire, and a consultant to the Art of Dying Well.
For more, see www.artofdyingwell.org