Nuala P, Kenny, OC, MD, FRCP(C) Department of Bioethics, Dalhousie Catholic Values and Health Care

Canadian Health Care  Health policy-an expression of values Solidarity, equity, efficiency (single public funder)  Medical advances exploding “medically necessary”  System reform needed  Accountability & sustainability at stake  Post-Chaouilli market/profit enthusiasm

The Social/Political Context  Individualism  Decline of religion; rejection of religion  Liberalism’s limit on the ends of society  Globalization and dominance of the market  Failure of ‘democratic deliberation’  The technological imperative!

Opportunities & Challenges to Catholic Values  Health care as a healing ministry  The Gospel of Life A Resurrection people  The social justice tradition  Formation of conscience & critical thinking  Natural moral law in an un-natural world

Health Care as a Healing Ministry  Healing is more than curing  Health care is service to persons  The health professions are a calling  Not health care as a commodity or a business

The Gospel of Life  Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good.  Catechism #2288  If morality requires respect for the life of the body, it does not make it an absolute value.  Catechism #2289

The Gospel of Life  A Resurrection People  A good death  Prudent care of our biologic life  Commitment to “ consistent ethic of life” (Bernardin)  Technology has changed profoundly our ability to affect biologic life and death

Catholic Social Teaching  Dignity of each person  Social nature of persons and solidarity with the whole of creation  Subsidiarity  Preferential option for the poor  The common good

Medicine and the Individual “ Profound changes are affecting the traditional structures of a society that is increasingly globalized and has difficulty in relating to the individual, while medicine is involved in developing diagnostic and therapeutic methods which are ever more complex and effective, but often available only to limited groups of people.” John Paul II, November 2000

The Common Good “…the sum total of social condition which allow people, either as groups or as individuals, to reach their fulfillment more fully and more easily.” Gaudium et Spes (Para 74)

 Each human community possesses a common good which permits it to be recognized as such; it is in the political community that its most complete realization is found  Catechism # 1910

Solidarity … is not a feeling of vague compassion or shallow distress at the misfortunes of so many people (but)…a firm and persevering determination to commit oneself to the common good; that is to say to the good of all and to each individual, because we are all really responsible for all Pope John Paul II Sollicitudo Rei Socialis December, 1987, # 38

Health Care & Justice  The health and healing concerns of the Christian community are not limited to, and much less exhausted by its focus on the health of individuals as such; it extends also to the physical and social environment in which the community lives and works…. Working to promote health and well- being is not only about curing symptoms, it also means confronting the social and political causes of suffering and injustice. Pastoral Letter –CCCB Permanent Council2005

Formation of Conscience  “ Conscience is the most secret core and sanctuary ( of a person). There he (or she) is alone with God, whose voice echoes in his (or her) depths.”  Gaudium et Spes, 1988

Conscience  Deeply personal but never individual Scripture, Jesus, the Church, the community of faith, moral experts  Judgments of conscience are binding but not always free from error  Formation of conscience is a lifelong process

Natural Moral Law in an Un-Natural World  “… an atrophy of understanding what is natural and what is not”  N. Giertych (Papal Theologian), Feb, 2007

Is Anything “Natural” Any More?  Air, water  Reproduction  Drugs Prozac-I am “more myself”  Devices Pacemakers, hips, knees, neuroscience advances  Genetics, genomics

Crucial Catholic Contributions  Dignity is inherent; respect for persons  Prudent care of our health and biologic life  Reject technological fix for moral issues  Justice and responsible stewardship  Conscience formation  Health care an element in the common good  Preferential option for the poor

Challenges for the Church We must modelling what it teaches Internal dissent Inconsistent ethic of life Failure of adult conscience formation Inability of Catholics to speak compellingly in the public space A radical shift in understanding the natural and the normal