Joint Centre for Bioethics : Ethics in Practice : Fellowships in Clinical and Organizational Bioethics
Joint Centre for Bioethics : Ethics in Practice : Fellowships in Clinical and Organizational Bioethics.
February 11, 2021
You have but one teacher and you are all brothers (Mt 23:8)
A trust-based relationship to guide care for the sick
(See the Message of Pope Francis after this reflection.)
In 2021 with COVID-19 and its lingering effects ravaging and changing society, concerns about sickness, recovery and health preoccupy our attention. “Sickness has more than one face” writes Pope Francis. We have seen heartbreaking images of isolation, death, and sorrow. Inadequate preparedness, pandemic planning, and institutional mismanagement have contributed to avoidable illness and deaths. We gratefully thank all those who work in healthcare’s various capacities: “A silent multitude of men and women, they chose not to look the other way but to share the suffering of patients, whom they saw as neighbours and members of our one human family.”
Celebration is regarded as a happy occasion and we may question what is there to celebrate on this 29th Anniversary of the World Day of the Sick? We have endured a global pandemic for over a year with no immediate end in sight, and new COVID-19 variants threaten populations with rapid transmission. Yet Pope Francis says this celebration on the Feast of Our Lady of Lourdes is an opportunity, an opening, to renew commitment to the sick. He offers “A trust-based relationship to guide care for the sick” based on Jesus’s desire that we love our neighbour as ourselves and demonstrated by the actions of the Good Samaritan.
Pope Francis zeroes in on serious issues throughout his Message however his Message always returns to our Faith and our encounter with the healing Lord which we need to understand and experience as the basis for a relationship with the sick. Francis calls us to be alert, pay “special attention” to the sick, their caregivers, families, institutions, communities and particularly to the poor and marginalized. He wants our attention focused on people who may be ignored, on inequalities, inefficiencies in healthcare systems, on vulnerable populations. He wants good political decisions, improved resource management, commitment of those in positions of responsibility. “Investing resources in the care and assistance of the sick is a priority linked to the fundamental principle that health is a primary common good.” Throughout his Message Francis returns to addresses us personally: this opens the way for us to understand how our faith nourishes our call to serve our neighbour in authentic love through our teacher, Jesus.
In the passage from Matthew, Jesus criticizes hypocrisy telling the disciples that they have one Master and that they are “all brothers”; be honest, humble, serve; remember that “the Christ” is their teacher. To reinforce an example of such a person Pope Francis draws on the story of the Good Samaritan who through his actions breaks convention with his position in society. This is the type of encounter that Francis encourages us to think about: when Jesus meets a person who asks to be healed, it is personal. Jesus does not appear to assume He knows the person’s mind: he always wants the sick person to identify explicitly what he or she desires; the person places trust in Jesus; the healing comes but, as Jesus says, it is through the person’s faith. Why are these details meaningful? Francis says Jesus asks us to stop and listen to the person as he did; establish a conversation, a direction and personal relationship; to feel empathy and compassion; to let suffering become familiar, personal, our own, and always to be aware of our role to serve.
We may feel hardly up to the task. Francis guides us. To start, we must look into our hearts honestly and examine our life in faith. The reason is very important – we are meant to “flourish,” to thrive, to grow, to become our best selves. How may this be achieved? We are children of the Father, the Living God. We are never alone – Francis says we are called to a universal fraternity- a family of brothers and sisters. We must return again to the call to love and remember Jesus, the Good Samaritan.
Next, Francis leads us to consider our personal experience of illness – vulnerable, dependent on others, powerless, afraid, diminished. We are not ourselves and question the meaning of life. Francis wants us to bring all this in faith to God to find a new, deeper direction. Can illness bring change and transformation? We are the beaten person rescued by the Good Samaritan.
Francis notes that throughout the pandemic caregivers have gone beyond duty to relieve suffering. Through their example alone we know that the COVID patient is not an anonymous body, but a person, a neighbour, a citizen, has a name, a nationality, is loved, and has a place beyond the sickbed. The sick person belongs to a family and to our human family.
Francis expresses this relationship of patient with caregiver as a precious balm that “provides support and consolation” to the suffering. This experience is the love of Jesus, the Good Samaritan, with the heart of compassion. With this image of compassion in mind, Francis takes us another step further in the trust-based relationship as guide for the care of the sick. As before, we cannot move ahead alone, but in faith, “United to Christ by the working of the Holy Spirit, we are called to be merciful like the Father and to love in particular our frail, infirm, and suffering brothers and sisters.” These careful, faith-based steps, draw us to love in Christ which then pulls us beyond ourselves to “the other” who is no longer the stranger. The love in Christ of others changes us into community. When this change in relationship occurs, and community replaces isolation, we see we are responsible as well as able to do more.
In section 4 of his Message Pope Francis speaks to people working within healthcare. An effective therapy, he says, has a relational aspect allowing a holistic approach to the patient. The benefits of a trusting interpersonal relationship, a covenant, serve the sick and their families as well as healthcare workers. Francis brings us back to the Good Samaritan – the authentic personal encounter, doing the right thing to help return the stranger to health.
In closing Francis leaves us to consider yet again the second part of Jesus’s great commandment, to love our neighbour as ourselves. We trust that should we fall ill on the road, there will be men and women who care personally to foster our recovery.
Jesus frequently begins His teaching, with “Do not be afraid.” Flourishing in faith, with good hearts, knowing we are in relation with others through Jesus, may we live our vocation to serve with humility and trust.
Bambi Rutledge
Canadian Catholic Bioethics Institute
MESSAGE OF HIS HOLINESS POPE FRANCIS
FOR THE XXIX WORLD DAY OF THE SICK 2021
“You have but one teacher and you are all brothers” (Mt 23:8). A trust-based relationship to guide care for the sick
Dear brothers and sisters,
The celebration of the XXIX World Day of the Sick on 11 February 2021, the liturgical memorial of the Blessed Virgin Mary of Lourdes, is an opportunity to devote special attention to the sick and to those who provide them with assistance and care both in healthcare institutions and within families and communities. We think in particular of those who have suffered, and continue to suffer, the effects of the worldwide coronavirus pandemic. To all, and especially to the poor and the marginalized, I express my spiritual closeness and assure them of the Church’s loving concern.
1. The theme of this Day is drawn from the Gospel passage in which Jesus criticizes the hypocrisy of those who fail to practise what they preach (cf. Mt 23:1-12). When our faith is reduced to empty words, unconcerned with the lives and needs of others, the creed we profess proves inconsistent with the life we lead. The danger is real. That is why Jesus uses strong language about the peril of falling into self-idolatry. He tells us: “You have but one teacher and you are all brothers”(v. 8).
Jesus’ criticism of those who “preach but do not practise” (v. 3) is helpful always and everywhere, since none of us is immune to the grave evil of hypocrisy, which prevents us from flourishing as children of the one Father, called to live universal fraternity.
Before the needs of our brothers and sisters, Jesus asks us to respond in a way completely contrary to such hypocrisy. He asks us to stop and listen, to establish a direct and personal relationship with others, to feel empathy and compassion, and to let their suffering become our own as we seek to serve them (cf. Lk 10:30-35).
2. The experience of sickness makes us realize our own vulnerability and our innate need of others. It makes us feel all the more clearly that we are creatures dependent on God. When we are ill, fear and even bewilderment can grip our minds and hearts; we find ourselves powerless, since our health does not depend on our abilities or life’s incessant worries (cf. Mt 6:27).
Sickness raises the question of life’s meaning, which we bring before God in faith. In seeking a new and deeper direction in our lives, we may not find an immediate answer. Nor are our relatives and friends always able to help us in this demanding quest.
The biblical figure of Job is emblematic in this regard. Job’s wife and friends do not accompany him in his misfortune; instead, they blame him and only aggravate his solitude and distress. Job feels forlorn and misunderstood. Yet for all his extreme frailty, he rejects hypocrisy and chooses the path of honesty towards God and others. He cries out to God so insistently that God finally answers him and allows him to glimpse a new horizon. He confirms that Job’s suffering is not a punishment or a state of separation from God, much less as sign of God’s indifference. Job’s heart, wounded and healed, then makes this vibrant and touching confession to the Lord: “I had heard of you by word of mouth, but now my eye has seen you” (42:5).
3. Sickness always has more than one face: it has the face of all the sick, but also those who feel ignored, excluded and prey to social injustices that deny their fundamental rights (cf. Fratelli Tutti, 22). The current pandemic has exacerbated inequalities in our healthcare systems and exposed inefficiencies in the care of the sick. Elderly, weak and vulnerable people are not always granted access to care, or in an equitable manner. This is the result of political decisions, resource management and greater or lesser commitment on the part of those holding positions of responsibility. Investing resources in the care and assistance of the sick is a priority linked to the fundamental principle that health is a primary common good. Yet the pandemic has also highlighted the dedication and generosity of healthcare personnel, volunteers, support staff, priests, men and women religious, all of whom have helped, treated, comforted and served so many of the sick and their families with professionalism, self-giving, responsibility and love of neighbour. A silent multitude of men and women, they chose not to look the other way but to share the suffering of patients, whom they saw as neighbours and members of our one human family.
Such closeness is a precious balm that provides support and consolation to the sick in their suffering. As Christians, we experience that closeness as a sign of the love of Jesus Christ, the Good Samaritan, who draws near with compassion to every man and woman wounded by sin. United to Christ by the working of the Holy Spirit, we are called to be merciful like the Father and to love in particular our frail, infirm and suffering brothers and sisters (cf. Jn 13:34-35). We experience this closeness not only as individuals but also as a community. Indeed, fraternal love in Christ generates a community of healing, a community that leaves no one behind, a community that is inclusive and welcoming, especially to those most in need.
Here I wish to mention the importance of fraternal solidarity, which is expressed concretely in service and can take a variety of forms, all directed at supporting our neighbours. “Serving means caring … for the vulnerable of our families, our society, our people” (Homily in Havana, 20 September 2015). In this outreach, all are “called to set aside their own wishes and desires, their pursuit of power, before the concrete gaze of those who are most vulnerable… Service always looks to their faces, touches their flesh, senses their closeness and even, in some cases, ‘suffers’ that closeness and tries to help them. Service is never ideological, for we do not serve ideas, we serve people” (ibid.).
4. If a therapy is to be effective, it must have a relational aspect, for this enables a holistic approach to the patient. Emphasizing this aspect can help doctors, nurses, professionals and volunteers to feel responsible for accompanying patients on a path of healing grounded in a trusting interpersonal relationship (cf. New Charter for Health Care Workers [2016], 4). This creates a covenant between those in need of care and those who provide that care, a covenant based on mutual trust and respect, openness and availability. This will help to overcome defensive attitudes, respect the dignity of the sick, safeguard the professionalism of healthcare workers and foster a good relationship with the families of patients.
Such a relationship with the sick can find an unfailing source of motivation and strength in the charity of Christ, as shown by the witness of those men and women who down the millennia have grown in holiness through service to the infirm. For the mystery of Christ’s death and resurrection is the source of the love capable of giving full meaning to the experience of patients and caregivers alike. The Gospel frequently makes this clear by showing that Jesus heals not by magic but as the result of an encounter, an interpersonal relationship, in which God’s gift finds a response in the faith of those who accept it. As Jesus often repeats: “Your faith has saved you”.
5. Dear brothers and sisters, the commandment of love that Jesus left to his disciples is also kept in our relationship with the sick. A society is all the more human to the degree that it cares effectively for its most frail and suffering members, in a spirit of fraternal love. Let us strive to achieve this goal, so that no one will feel alone, excluded or abandoned.
To Mary, Mother of Mercy and Health of the Infirm, I entrust the sick, healthcare workers and all those who generously assist our suffering brothers and sisters. From the Grotto of Lourdes and her many other shrines throughout the world, may she sustain our faith and hope, and help us care for one another with fraternal love. To each and all, I cordially impart my blessing.
Rome, Saint John Lateran, 20 December 2020,
Fourth Sunday of Advent
Franciscus
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