FROM BIOLOGICAL TO BIOGRAPHICAL HEALING CARING FOR THE SICK IN o Cognitive

A WHOLISTIC WAY o Commitment/Follow-Up “he then hoisted him on his own beast
and brought him to an inn...”
HOSPITAL MESSAGE DR. MUSSI (1841 – 1932)  Planning
• Come to be healed o Support networks
• If not healed at least cared for o Institutional
• If not cared at least consoled o Community
Three words: healing, caring, comforting o Volunteers
o Delegation/Team work “look after him and if there is any
HEALING THE SICK IN A WHOLISTIC WAY further expense, I will repay you on my way back...”
Perspectives on health and sickness:  Team work
• World Health Organization has defined health as “a state of complete o Interdisciplinary team work
well-being: physical, psychic and social” (1961) o Ecumenical or interfaith cooperation
o Groups of mutual support
EUROPEAN COUNCIL OF HEALTH CARE MINISTERS (1988) o Support to families
• “A quality of life that includes the social, mental, moral and affective
dimensions, besides the physical one. It is an unstable good that CULTURAL MAP
needs to be acquired, defended and constantly strengthened in the • Cultures are ways of being, thinking and behaving (traditions,
course of one’s life”. norms, rituals, attitudes, expectations.)
• No culture is sacred. Every culture is a mixture of positive and
ADVANTAGES negative elements. Importance of wise assessment and
• Wholistic view discernment.
• Acceptance of fragility • We are children of our culture, not slaves. The greatest law is love.
• Treasure and defend health • We are also agents for the transformation of culture.

THREE BASIC PRINCIPLES IN LIFE BEFORE A CULTURE IT IS IMPORTANT

1. We cannot live without suffering • To welcome
2. We cannot suffer without hoping • To try to understand
3. We cannot hope without opening up • To appreciate
• To discern
HEALTH CARE • To transform
• Humanization
• Dehumanization PERSONAL MAP
The Wounded Healer “From his wounds we have been healed” (Is. 53,5)
PASTORAL CARE OF THE SICK • In order to understand others we need to be in touch with our
Four Maps For The Journey: wounded healer. Learning to heal ourselves enables us to facilitate
• Biblical healing processes in others.
• Cultural • Each one of us is a wounded healer, that is in everyone there are
• Personal small or big wounds (physical, mental, psychological, relational,
• Pastoral spiritual) as well as healing resources.
• My “wounded side” keeps me aware of my weaknesses, limitations,
BIBLICAL MAP impotence.
• Nedes (physical, relational, spiritual) • My wounds keep me human and humble.
• Values • Everyone has healing powers (physical, mental, psychological,
• Attitudes or behaviors social, spiritual) that give confidence and inner strength.
• Choices (before and after the incident) • The challenge is to: transform hurt into healing, disgrace into grace
• The Good Samaritan (Lk 10, 30-37)
o Awareness “saw him..” PROCESS OF HEALING
 Formation • Listen to the hurting part of the person
o Human • Bring to light his healing resources
o Emotional
o Spiritual PASTORAL MAP
o Ethical • Litourgia (prayer - sacraments)
o Compassion “was moved to pity...” • Kerygma-Martyria (witnessing the good news - evangelization)
 The Wounded Healer • Diakonia (service - charity - humanizing)
o Listening • Koinonia (community - communion)
o Self-Acceptance
o Empathy THE CARING OF THE SICK AND THE WITNESS OF THE CHURCH
o Closeness “he approached him...” Corporal Works of Mercy
 Warmth • Feed the starved
o Solidarity • Give drink to the
o Non-verbal communication • Clothe the naked
o Silence • Shelter the homeless
o Gestures • Visit the imprisoned
o Involvement “dressed his wound pouring oil and wine...” • Visit the sick
 Resources • Bury the dead
o Physical or material
o Psychological
o Spiritual
Spiritual Works of Mercy • Conversation
The spiritual acts of mercy provide for the needs of the spirit o Superficial
• Admonish the sinner. o Personal (health, family, work, faith, future, death)
• Instruct the ignorant. • Attitudes
• Counsel the doubtful. o Openness
• Comfort the sorrowful. o Trust
• Bear wrong patiently. o Listening
• Forgive all injuries. • Closure
• Pray for the living and the dead. o Leave too soon
o Stay too long
All the pastoral care interventions are summarized under four verbs: o Appropriate departure
• What can I do for the sick?  Promise to come back
• What can I communicate to the sick?  Prayer
• What can I be for the sick?  Synthesis of main concerns, fears, and hopes of the sick
• What can I learn from the sick?
THE ART OF RELATING EFFECTIVELY OF THE SICK
Ideal sequence: Communication skills
• Being Learn:
• Communicating • To observe
• Learning • To listen
• Doing • To respond

Ministry directed to: Filters that interfere with listening

• The sick • One’s past memories or experiences
• The family • One’s value system
• The health care workers • One’s feelings
• The community • One’s expectations
• Caring for the sick • One’s prejudices
• One’s needs
The Different Faces of Suffering • One’s attitudes
Different Fragilities
• Physical Suffering Learn To Respond 6 Types of Responses:
• Mental Suffering • Evaluative
• Social Suffering • Interpretative
• Emotional Suffering • Supportive
• Spiritual Suffering • Investigative
• Solution
The Different Faces of Hope • Empathetic
• Administrators o Apathy (Detachment or Distance)
• Physicians o Sympathy (Identification with wounds)
• Nurses o Empathy (understanding or Objectivity)
• Auxiliaries
• Social Workers EMPATHY
• Psychologists It requires:
• Chaplains (Pastoral care) • Understanding of the feelings
• Volunteers • Understanding of the situation which originates the
• Members of Associations • Communicating acceptance
• Technicians
HEALING THE WHOLE PERSON
PASTORIAL ROLES LOVE (Lk. 10, 27)
Positive Pastoral Roles To love:
• Symbolic • God
• Comforter • Your neighbor
• Spiritual Guide • Yourself
• Facilitator How:
• Animator • With all your heart (emotional path)
• Evangelizer • With all your mind (cognitive path)
• Educator • With all your strength (physical path)
• Profetic • With all your soul (spiritual path)
• Ecumenical-Interfaith Dialogue
• Sacramental DIMENSIONS OF THE PERSON
• Physical
THE PASTORAL VISIT • Mental
• Introduction • Social
• Observation of: • Emotional
o Environment • Spiritual
o Expressions of the person
o Self-observation
LIFE’S BIOGRAPHIES DEHUMANIZING HEALTH CARE
• Physical Biography • To treat the patients as numbers, sick organs rather than people
• Cognitive Biography • To absolutize physical healing
• Affective Biography • To value functional more than personal relationships
• Social Biography • To give priority to technology and productivity
• Spiritual Biography • To focus on technical rather than relational competence
• To privilege competition rather than collaboration
FACTORS IN RESPONSE TO AN ILLNESS • To ignore the role of spiritual resources in the healing processes
• Circumstances • To transform illness into an opportunity for business (corruption,
• Interpretations of the sickness* the use of power and priorities in the health care systems)
• External support
• Inner resources* FROM BIOLOGICAL TO BIOGRAPHICAL HEALING
TWO PARADIGMS
* Interpretations of the sickness • In every sick person there is a physician
• A punishment (for one’s sins) • In every physician there is a sick person
• A trial (to witness one’s faith)
• A means of expiation or purification We are all simultaneously
• An expression of human imperfection and condition • Helpers and helpee
• An opportunity for one sanctification • Teachers and learners
• A school of life • Healers and wounded
• An enigma or an absurdity
• A mystery to accept Process of Healing the Sick
• A consequence of one’s behaviour or lack of responsibility • Give space and listen to their hurts
• An event due to predestination or fatalism • Identify and bring to life their resources
• A problem caused by outside forces (superstition, satanic forces...)
• A call to conversion RELIGIOUS TRADITION/SPIRITUALITY
* Inner resources People
• Cultural • Some are spiritual and religious
• Psychological • Some spiritual but not religious
• Interpersonal (Social) • Some religious but not spiritual
• Spiritual • Some neither religious nor spiritual

THE ART OF RELATING EFFECTIVELY OF THE SICK

HUMANIZING HEALTH CARE
• To humanize culture
o We humanize culture by accepting the presence of aging,
suffering and death in life (Risks: denial, avoidance, removal)
o We need to be aware that cultures are not sacred and need
to be purified and transformed
o We are children of our cultures, but not slaves. We are also
agents for the transformation of cultures.
• To humanize structures
o To promote attitudes of welcome and respect towards those
who are admitted to an institution
o To provide information for the sick, families and friends
o To create a climate of warmth and caring in the hospital
environment, to give dignity to the people
• To humanize professionals
o Professionals show respect to the sick
o Physicians offer information according to the appropriate
contexts, needs and situations
o Physicians and nurses grow in the art of communication and
learn to be empathetic in relating to patients and families

FOUR KEY VERBS IN CARING

• What can I do for the sick
• What can I communicate to the sick
• What can I be for the sick
• What can I learn from the sick

DEVELOPING COMPETENCIES:
• Professional
• Human
• Ethical
• Emotional
• Relational
o Learn to: Obseve
o Listen
o Respond
 ANTHROPOLOGY
Introduction
• One of the most important issues of the foundation of
bioethics is the study of the anthropological models of
reference: they are explicit or simply implicated, constitute the
horizon of sense in which bioethical reason works and
substantiate its regulatory content.
• The average anthropology is between empirical data and
standardization
The specifics of Catholic bioethics
• Different bioethical proposals differ in the metabioethic, in the
system of values and in the anthropologies assumed.
• The model of man that Catholic bioethics assumes corresponds
to the revealed anthropology elaborated and systematized by
theology.
• The specificity of Catholic bioethics lies in the horizon of
meaning in which the ethical reason is created, created by the
Christian understanding of existence, which ultimately refers to
the Christological foundation of morality.
• First - and without that, everything else loses interest - we
should expect a clear statement of what difference there is, in
the general moral field, to be a Jew or a Christian or a Muslim
and to be a secular thinker.
• Second, and consequently, we need to feel a theological
criticism of secular morality and secular culture.
• Thirdly, we want to tell to what extent on what has been
argued in the first two points for the specific problems that
arise from modern medicine.
I. THE SECULAR ANTHROPOLOGICAL MODEL
• With the secular model we want to point to more than an in-
depth anthropological model in its characters, a widespread
mentality, an anthropological attitude characterizing the last
glimpse of modernity or post-modernity in which we are living.
• We highlight some aspects:
o Individualism
o Reductionism
o Efficientism
A. Individualism
• Primacy of the subject that is conceived as completely
autonomous and self-referential.
• Extreme emphasis on human freedom as absolute freedom,
free from any meaningful relationship with the other, without
any responsibility or reference to a system of transcendental
values as a criterion of moral truth.
• Ethics without Truth: It does not recognize and enforce values
but puts them into an unsustainable ethical relativism.
• "Wild application" of the principle of autonomy.
• The ultimate good criterion is self- realization of the individual,
as satisfaction of desires and needs.
• "Supporters of legalization [of euthanasia] have a major
subject. I will call it "the subject of freedom". According to this
argument, each dying patient should be free to choose
euthanasia or reject it as a matter of personal liberty. No one,
including the government, has the right to impose on a person
the choice to do. If a dying patient wants euthanasia, it's a
private deal; After all, life belongs to the individual, and so the
individual should be the only one to decide. This topic is
centered on the principle that people should be free to live their
lives as best they believe. “
B. Reductionism
• Reduction brings a complex phenomenon to simpler realities.
• Very useful in scientific research.
• It can lead to hyper simulation.
• In the secularized and scientist mentality man is reduced to his
biological moment and also culture is resolved in nature.
• "Nothing but" - "Nothing but"
• Modernity has been marked by three great revolutions that
have removed man's illusions of supremacy
o Copernican Revolution
o Darwinian Evolutionism
o Freudian psychoanalysis
• Copernicus (1475-1543)
o He proposed a revolutionary cosmological model
o He dropped man from the center of the universe
o He obscured man’s privileged and dominant role
• Darwin (1809-1882)
o The origins of man and animal origin came together
o “Man began to lay an abyss between sub-human
beings and their being. They disagreed with them
and attributed an immortal soul, appealing to a high
divine origin that would allow him to break his ties
with the animal world. We know that the researches
of Charles Darwin and his collaborators and
predecessors have put an end to this man's
presumption, just over half a century ago. Man no
more is, and nothing less, than the animal.”
• Freud (1856-1939)
o He showed that the soul is based on the darkness of
the Subconscious and that the motor of the psyche
is the libido.
o In the late modernity, the certainty of the
ontological overtaking of man with respect to its
animal dimension diminishes, and consequently the
perception of the axiological excellence of human
life disappears.
Reducing and Neuroscience
• In the bio-functionalist perspective, the subjective ego is
annulled as a radical ontological nucleus.
• The spiritual is brought back to the psychic, the neurological
psychic, the chemical-electrical neurologist.
• The person is fragmented into a series of acts disenchanted by
a substantial ego.
• Current neuroethics is the result of this reductionist reading
C. Efficientism
• Undisputed primacy to having, to conquering and dominating
(economic- productive values) on being, contemplating, and
absorbing (spiritual values).
• Modernity has exalted science and technology as instruments
of human progress, an unstoppable and ever-positive flow
(Illuminism, Positivism, Practice Philosophy).
• From technocracy to technopoly
• The simple instrument technique has become the cornerstone
of human life and justification of culture.
• POSTMAN speaks of "deification of technology".
• "The first, if not the only goal of human work and thought is
efficiency;
• Technical calculation is always superior to human judgment;
• Subjectivity is an obstacle to the clarity of thought; All that can
not be measured does not exist or has no value; ...
 • Society is much better served if humans are at the disposal of
their techniques and technologies.
• Men, that is, are worth less than cars.”
Accepted by Anthropological Modernity
• The person is defined by his actions ...
• ... from what one does and not from what one is.
• H.T. Engelhardt Jr.
o Not all humans are persons. Not all humans are self-
conscious, rational, and able to conceive of the
possibility of blaming and praising.
o Fetuses, infants, the profoundly mentally retarded
and the hopelessly comatose provide examples of
human nonpersons.
o Such entities are members of the human species.
They do not in and of themselves have standing in
the moral community.
o They cannot blame or praise or be worthy of blame
or praise. They are not prime participants in the
moral endeavor. Only persons have that status.
THE ETHICS OF QUALITY OF LIFE
• The value of life depends on its qualities.
• There are lives that do not achieve adequate performance
standards and are not considered deserving of the protection
or the same protection they enjoy in good quality lives.
• Down Syndrome newborn
• Claims on the right to biological survival are entirely dependent
on the ability that the individual in question has to build, with
the help of others, a human life. This means that in situations
where there is no possibility of approaching a truly human life,
the right to biological or physical subsistence loses its raison
d'être and thus that pitiful termination of life In the biophysical
sense it is acceptable or perhaps mandatory.
• The ethics of quality of life introduces discrimination among
humans.
• The quality of life category, if used as a criterion of value for
life, denies the natural and cultural foundation of equality
• And leads to an ethic of inequality.
Feasibility
• For an efficient mind, what is practically feasible becomes
morally acceptable.
• Indeed, what is practically feasible becomes ethically
necessary.
II. THE CHRISTIAN ANTHROPOLOGICAL MODEL
• It is difficult to delineate a uniquely revealed anthropological
model.
• There are some basic elements or attitudes of revealed
anthropology that form the basis of the Christian concept of
man.
• They constitute the fundamental coordinates of the
anthropological horizon within which it is possible to elaborate
a Catholic bioethics
o Man exists in relationship
o Man is a unified whole
o Man is the image of God
o Man exists in Christ
A. Man exists in relationship
• Man is a creature and therefore it is only conceivable in
relation to God.
• Man's relationship with God is absolutely unique and unique,
constitutive and exclusive.
• It is a personal relationship because it makes the person
person.
Value of Human Life
• There is an ontological and axiological difference between
human and non-human life.
• Singular value of human life.
• Traditionally it is said that human life is sacred.
• “A sacred person” – Seneca
False or Partial Interpretations of Sacredness
• Organic vitality refers to a pre-scientific sacred
• Intangibles for divine command: "Do not kill".
• Sacred demilitarized and secular.
• A sacred in a parenetic and evocative sense.
“Human life is sacred because, since its inception, involves the creative
action of God and remains forever in a special report with its Creator, its
only end” – Donum vitae, Introd. 5
The root of the value and inviolability of every human life is lately in God.
You are the one who formed my kidneys
And you wove me in the womb of my mother ...
You did not hide my bones
When I was formed in secret,
Embroidered in the depths of the earth.
I still saw your eyes
They were all written in your book
The days that were fixed
When there was no one yet
–Psalm 13
Every human existence is worthy of being accepted, protected and
promoted in its entirety because it has value in itself, self-accredited as
human.
• Bioethics of quality of life presupposes that life is ethically
defined through its qualities and admits a possible inequality of
value between the various human existences.
• The bioethics of sacred life presupposes that the value of
human life does not depend on an appreciation and evaluation
of the qualities that it accidentally presents, but from the very
fact of being a person's life.
B. Man is a unified whole
• Man is one and the whole multidimensional.
• Man is not reducible to his physicality or to his spirituality.
• "Man is body and soul unus” (GS 14).
• The man is one and two together, it is multiplex unitas.
• Man is body, he is incarnate spirit.
• One in the body and in the soul, man for his own bodily
condition gathers in himself the elements of material world.
• In fact, man does not deceive himself when he recognizes
himself superior to bodily reality ...
• In fact, with its interiority, it overcomes all things.Gaudium et
spes, n. 14
Meaning of the Human Body
• The human body is not a simple body object (Körper), but a
body of a person, it is lived body (Leib) as the very condition of
personal existence.
• Body reality represents the mode of existence of the person in
the world.
• It is a fundamental structure of knowing, loving, loving, feeling.
First Consequence: Body and Person
• The human body, for the sole fact that it is human, is
bearer of a meaning that refers to the totality of the
person.
• Every intervention on the body does not stop at the
physicality of the soma, but reaches the whole person.
 • If I hurt, mutilate, outraged, manipulate, destroy a human
body, I bring a "vulnus" to the person.
Second Consequence: Ethical Value of Corporeality
• Personal ethics takes distances from two extreme positions.
o The human body is a gross, meaningless one
that liberty can shape at will.
o Physiological laws have in themselves moral value
(biologism or naturalism).
• The integrity of the human body and its psychophysical
dynamism are not indifferent from the ethical point of
view. But they have ethical value only in reference to the
totality of the person.
• Natural dynamism gains moral significance only because
they refer to the human person and to its realization,
which on the other hand can only occur in human nature.
GIOVANNI PAOLO II, enc. Veritatis Splendor , 6-8-1993, n.
50 .
• “The natural law spoken of by Catholic theology is not
called natural in reference to the biological nature that
man communion with other living, but in reference to the
nature of the human person, "that is, the person in the
soul and body unity , In the unity of its inclinations of
order both spiritual and biological and of all the other
specific characteristics necessary for the pursuit of its
purpose.” ( VS 50).
C. Man is the image of God
• "God Created Man in His Image" (Gen 1,27).
• The image of God is based on the personal nature of
man: opening to the relationship, free will, and intellectual
knowledge.
• It is the root and justification for those human rights that
call upon the bioethic discourse: right to autonomy, truth,
assistance.
• It does not just refer to the spiritual qualities of man
because "the whole man is desired by God" (CCC 362). •
• "The human body participates in the dignity of God's
image: it is a human body animated by the spiritual soul,
and it is the whole person to be destined to become, in
the Body of Christ, the temple of the Spirit" (CCC 363)
“Image of God” and Lordship over Life
• God blessed them and said to them: "Be fruitful And multiply,
Fill the earth; Subjugate and dominate On the fish of the sea
And the birds of the sky And on every living thing, Which strips
on the ground. Gen. 1, 28
• Defending and promoting, venerating and loving life is a task
that God entrusts to every man, calling him, as his throbbing
image, to participate in the Lordship that He has on the world.
Lordship on Non-Human Life
• The biblical text reveals the amplitude and depth of the
Lordship that God gives to man. This is, first of all,
domination on earth and on every living being, as the
Book of Wisdom remembers: "God of fathers and Lord of
mercy ... with your wisdom you have formed the man,
because you dominate the creatures that you have Done,
and govern the world with holiness and righteousness
(Sap. 9, 1. 2-3).
• It is a partisan or ministerial lordship, so that man can not
assume a despotic attitude toward creation, nor can it
upset the intrinsic dynamics of the creature, because all
beings have the right to exist in their own ways.
• The root of the ecological crisis lies in a disastrous human
error: forgetting that the world is not for him to possess,
but gift, man "thinks he can arbitrarily dispose of the
earth, subjecting it unconditionally to his will, as if he did
not Its own form and a prefaced date of God's destiny,
which man can certainly develop, but not betray.”
Lordship on Human Life
• The most significant expression of partisanship is the
lordship over human life.
• “Man is made somehow part of the Lordship of God. And
this manifests itself in the specific responsibility that is
entrusted to him with respect to humanly proper life.
• It is the responsibility that touches on its summit in the
donation of life by man and woman in marriage.
• But apart from the specific mission of the parents, the
task of welcoming and serving life concerns everyone and
must manifest itself above all to life in the conditions of
weakness.”
Natural or Artificial
• An integral part of human vocation is the desire to
intervene on the body dimensions of his person, having a
true lordship on his own life.
• But he must do this by imitating the action of the divine
model, with wisdom and love, responding with freedom
and awareness to the value of life.
• The ultimate ethical criterion of interventions lies in the
person itself and is given by the protection of the
authentic human good and by the safeguarding of essential
human values, including bodily values
D. Man exists in Christ
• Primacy of Christ in the work of creation and redemption:
our existence as human creatures, as incarnate spirits, is
for and in Christ.
• The flesh is salutis cardo, the hint of salvation, because,
by becoming flesh, the Son of God has united our flesh
forever to his. [See. TERTULLIANO, Carnis Resurrection, 8
(PL 2, 809)].
• The glorified body of the Risen Lord is the new Temple in
which the fullness of the divinity dwells, and we, together
with Him, become the temple and abode of the Spirit.
• There is nothing farther from the Christian faith than
contempt or fear of the body. Our corporeality is instead
the human mode of living and of enjoying, being, and
realizing itself. Man is called to respond to the gospel call
with himself, including his bodily dimension.
Christian Dignity of Corporeality
• [13] The body is not for impudence, but for the Lord, and
the Lord is for the body.
• [15] Do not you know that your bodies are members of
Christ? Will I then take the limbs of Christ and make him
a prostitute's limb? Never be!
• [19] Or do you not know that your body is the temple of
the Holy Ghost that is in you and which you have from
God, and that you are not your own? [20] You have been
bought for a price. So glorify God in your body! 1 Cor 6
III. THE PERSONALISTIC PROPOSAL
• Personality makes the person the center of reference for
the real, the being and the value.
• Personality emphasizes the singularity of the human being:
o Free
o Self-conscious
o Open to self-transcending to otherness and
furtherity.
• It safeguards the integrity of man, underlining its
ontological pluridimensionality, intangible dignity, and
radical opening to a network of relationships.
 • In the field of Catholic bioethics, the personal model is
one of the most followed
• Main personality declinations:
o Ontological (Center of Bioethics of Gemini of
Rome)
o Relational (A. Autiero);
o Hermeneutic (K. Demmer)
• In personality of neo-classical inspiration, the person
occupies an essential point in the articulated metaphysical
status of being and hence in the finalist dynamic of
values. In this ontological personality the being person
receives a substantial determination before actualization.
• This is reflected in the respect given to human existences
(such as those of the embryo) whose full personality is
not functionally verifiable through the verification of the
person's sign, but is rationally arguable within a conception
of being and its degrees of perfection.

Conclusion
• Bioethics, taking on the burden of the profound cultural
labor of our time, decides on the part of man and his
reasons, but it does not even seem to be able to
determine exactly which man to speak, since the very
words of life, As a person, nature, dignity, freedom, born
in the Christian and religious sphere, have undergone a
process of secularization throughout modernity, pushed to
the semantics of exhaustion.
• Bioethics is the systematic study of human behavior in life
sciences and health care when such conduct is examined in the
light of moral values and principles.